MPPZ and National Disability Insurance Agency

The Administrative Appeals Tribunal considered a dispute between MPPZ (the applicant) and the National Disability Insurance Agency (the respondent) concerning the provision of reasonable and necessary supports under the National Disability Insurance Scheme Act 2013 (Cth). The applicant sought funding for a range of supports, including a gym membership, assistive technology, sex worker services, equine therapy, a PTSD assistance dog, and overseas travel and accommodation for treatment. The applicant also sought funding for travel, accommodation, and a support worker to accompany her to the United States for medical treatment for Ehlers-Danlos Syndrome.

The Tribunal was required to determine which of the applicant's requested supports were reasonable and necessary within the meaning of section 34 of the NDIS Act. This involved assessing the applicant's conditions, including Ehlers-Danlos Syndrome, spinal cord injury, Post Traumatic Stress Disorder, anxiety, and depression, against the criteria for reasonable and necessary supports. The Tribunal also had to consider the evidence presented, which included extensive documentation from both parties and the applicant's oral evidence.

Deputy President Mischin reasoned that while the respondent had conceded a number of supports, the applicant had not established that all her requests met the criteria for reasonable and necessary supports. The Tribunal agreed with the respondent's concession regarding a one-off allocation of 20 hours for an occupational therapist to prepare an assistive technology assessment report for a PTSD assistance dog. The Tribunal directed that several specific supports, including various forms of individual support, yard maintenance, house cleaning, low-cost assistive technology, disability-related health consumables, prosthetics and orthotics, meal preparation, transport, support coordination, specialist support coordination, physiotherapy, exercise physiology (including gym membership), occupational therapy, podiatry, specialist sex therapy/counselling, and a dietician assessment, should be included in the applicant's statement of participant supports.

The Tribunal ordered that all other supports in the applicant's existing statement of participant supports, excluding any one-off assistive technology supports already used, were to be replicated from the date the specified supports were included until the reassessment date. The management of funding was to remain the same, and the respondent was directed to reassess the applicant's plan within 12 months of the inclusion of the specified supports.