MKKX and National Disability Insurance Agency

This matter concerned an appeal by MKKX against a decision of the National Disability Insurance Agency (NDIA) regarding the provision of reasonable and necessary supports under the National Disability Insurance Scheme. The dispute involved a range of items and services MKKX sought funding for, including a Thermomix, a fixed air-conditioning unit, minor home modifications, various assistive technology items such as compression garments and a recumbent bicycle, CPAP accessories, and reimbursement for out-of-pocket psychology expenses. The case was heard by J Collins SM.

The primary legal issues before the court were to determine which of the requested supports were reasonable and necessary in accordance with section 34 of the National Disability Insurance Scheme Act 2013 (Cth), and to decide on the appropriate duration for MKKX's NDIS plan. The court was required to consider how each support would assist MKKX in achieving her goals, facilitate her daily life, and contribute to her independence and well-being, while also having regard to the financial sustainability of the Scheme.

The court reasoned that while many of the supports sought by MKKX were indeed reasonable and necessary, including a range of splints, braces, compression garments, mobility aids, therapeutic devices, orthopaedic footwear, a home oxygen concentrator, and a fixed air-conditioner, the NDIA's concession on these items was accepted. However, the court found that reimbursement for out-of-pocket psychology expenses was not a reasonable and necessary support. Regarding the plan duration, the court accepted the NDIA's submission that a 12-month plan was appropriate due to the fluctuating nature of MKKX's condition, ensuring the sustainability of the scheme. The court also noted the importance of considering the financial sustainability of the NDIS as an object of the Act.

Consequently, the decision under review was set aside and remitted to the NDIA for reconsideration. The NDIA was directed to include specific listed supports as reasonable and necessary within 28 days, to set the plan reassessment date at 12 months from the inclusion of these supports, to replicate other existing supports pro-rata until the reassessment date, and to maintain the existing funding management arrangements.