MMBX and National Disability Insurance Agency

This matter concerned an appeal by MMBX (the applicant) against a decision of the National Disability Insurance Agency (the respondent) regarding the applicant's statement of participant supports under the National Disability Insurance Scheme. The core dispute revolved around whether certain supports, specifically home modifications to create an independent living space and the provision of a companion dog, should be included in the applicant's statement of supports.

The Tribunal was required to determine whether the proposed supports met the criteria for reasonable and necessary supports under the National Disability Insurance Scheme. Specifically, the issues included whether items facilitating independent living within the family home should be assessed individually or as a single 'independent living' support, and whether a companion dog constituted a reasonable and necessary support. The Tribunal also had to consider whether the identified supports should be included in the applicant's statement of participant supports.

The Tribunal acknowledged criticisms of the health professional reports, noting that the impetus for the plan changes appeared to originate from the applicant's family rather than professional recommendations. However, the Tribunal found this not to be fatal to the applicant's claims, placing significant reliance on the evidence provided by the applicant's mother due to her long history of making sound judgments regarding the applicant's development and independence. This assessment was further supported by the lived experience of another family facing similar issues. Given the modest funding sought and the potential for significant value in minimising future care needs, the Tribunal was satisfied that the supports met the necessary criteria.

Accordingly, the Tribunal ordered that home modifications creating an independent living space, funded to a maximum of $57,145, and the provision of an assistance animal, funded to a maximum of $7,229, should be included in the applicant's statement of participant supports. The Tribunal set aside the respondent's decision of 13 August 2021 and directed the respondent to provide a statement of participant supports consistent with these reasons within 14 days for approval.