Markaboui and National Disability Insurance Agency

This matter concerned an appeal by Ms Markaboui against a decision of the National Disability Insurance Agency (NDIA) regarding the provision of supports under her NDIS plan. The dispute centred on whether certain requested supports, specifically voice and composition classes, hydrotherapy, and education-related expenses, were reasonable and necessary within the framework of the National Disability Insurance Scheme (NDIS).

The Administrative Appeals Tribunal (AAT) was required to determine whether the NDIA's decision to refuse funding for voice and composition classes, and education-related expenses, was correct. It also needed to consider the appropriateness of funding for hydrotherapy. The core legal issues revolved around the application of sections 33 and 34 of the National Disability Insurance Scheme Act 2013 (Cth) and the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth), particularly the criteria for determining whether supports are "reasonable and necessary."

The Tribunal applied the principles outlined in section 34 of the Act, which mandates that for a support to be funded, it must assist the participant to pursue their goals, facilitate social and economic participation, represent value for money, be effective and beneficial having regard to current good practice, and not be more appropriately funded through other systems. The Tribunal found that while hydrotherapy assessment was appropriate, it was not satisfied that the requested voice and composition classes would be effective and beneficial, nor that composition classes were most appropriately funded through the NDIS. Similarly, it was not satisfied that education-related expenses were most appropriately funded by the Scheme.

Consequently, the Tribunal set aside the NDIA's decision and remitted the matter to the NDIA for reconsideration of the supports in accordance with its findings.