LNMT and National Disability Insurance Agency

This matter concerned an application by LNMT, a child with blindness, epilepsy, and cognitive impairments, seeking a review of a decision made by the National Disability Insurance Agency (NDIA). The dispute centred on the NDIA's refusal to fund certain supports deemed reasonable and necessary for the applicant, including increased support coordination, enhanced social and community participation, additional respite care, and a cognitive assessment. The case was heard by Deputy K Bean P.

The legal issues before the court were whether the NDIA's decision to exclude or limit funding for specific supports was correct, and consequently, whether the applicant's NDIS plan should be varied to include additional funding for support coordination, increased social and community participation, core supports (specifically respite care), and a cognitive assessment. The court was required to determine if these requested supports met the criteria of being reasonable and necessary within the framework of the National Disability Insurance Scheme.

The court reasoned that the NDIA's initial removal of support coordination from the applicant's plan was not adequately defended, particularly given that it had been included in a prior plan. While the NDIA later conceded that support coordination was appropriately funded by the NDIS, it contested the amount sought by the applicant. Considering the applicant's complex and evolving needs, the court found that a high level of support coordination was necessary and that the applicant's requested amount of $12,228.32 for 104 hours over six months was reasonable and necessary. The court also addressed other areas of disagreement, ultimately varying the decision under review to include additional funding for increased social and community participation, core supports, and a cognitive assessment, among other items. The court declined to extend the review date of the current plan, deeming it appropriate for a comprehensive review to occur as scheduled due to the applicant's deteriorating condition.