McKenzie and National Disability Insurance Agency

This matter concerned an application by Mr McKenzie for the National Disability Insurance Agency (NDIA) to fund the replacement of the air-conditioning system in his home. Mr McKenzie, who was diagnosed with Multiple Sclerosis in 2003, argued that the existing system was undersized, beyond its operational life, and that parts were no longer available, making it ineffective and prone to failure. The NDIA had refused to fund the replacement, deeming it a day-to-day living cost and not a reasonable and necessary support under the National Disability Insurance Scheme (NDIS) Act 2013. The Administrative Appeals Tribunal (AAT) was required to determine whether the replacement of the air-conditioning system constituted a reasonable and necessary support.

The Tribunal was tasked with considering whether the replacement of the air-conditioning system met the criteria for reasonable and necessary supports as defined by section 34 of the NDIS Act. This involved assessing whether the support represented value for money, was effective and beneficial, coordinated with other supports without replacing them, and was most appropriately funded by the NDIS rather than other systems. The Tribunal also had to consider the NDIA's Operational Guidelines, particularly those relating to home modifications and assistive technology, and whether the proposed support was a day-to-day living cost.

In its reasoning, the Tribunal found that the Explanatory Statement for the NDIS Act contemplated the installation of air-conditioning as a reasonable and necessary support for individuals with Multiple Sclerosis, particularly in relation to managing electricity costs. The Tribunal distinguished the replacement of an air-conditioning system from ordinary day-to-day living costs, such as rent or groceries, noting it was a significant, infrequent expense. The Tribunal accepted that the need for a functional air-conditioning system was directly related to Mr McKenzie's disability and his ability to manage his body temperature, maintain independence, and undertake daily living activities within his home. Furthermore, the Tribunal considered that the existing system's failure had a significant adverse impact on Mr McKenzie's living arrangements and his ability to manage his condition, and that a suitably qualified occupational therapist had recommended the replacement.

The Tribunal concluded that the replacement of the ducted air-conditioning system in Mr McKenzie's home met the requirements of a reasonable and necessary support under the NDIS Act. Consequently, the decision under review was set aside, and the matter was remitted to the NDIA with a direction to include sufficient funding in Mr McKenzie's plan for the replacement of the air-conditioning system, as quoted by an expert, and to set the plan review date at 12 months from the date of the decision.