Nika & National Disability Insurance Agency

This matter concerned an application for review of a decision by the National Disability Insurance Agency (NDIA) to refuse access to the National Disability Insurance Scheme (NDIS). The applicant, who had sustained significant injuries in a motor vehicle accident in 2005, including complex fractures to her left leg and subsequent psychological conditions such as adjustment disorder, PTSD, and chronic pain, sought access to the NDIS. The NDIA's internal review had affirmed the original decision, finding that the applicant's impairments did not substantially reduce her functional capacity in areas such as social interaction, mobility, or self-care, nor were they likely to be permanent. The Tribunal was asked to determine whether the applicant met the access criteria for the NDIS.

The core legal issues before the Tribunal were whether the applicant's physical and psychological impairments substantially reduced her functional capacity to undertake social interaction, mobility, and self-care, and whether these impairments were likely to be permanent. Additionally, the Tribunal considered whether the early intervention requirements for NDIS access were met, specifically whether providing support would be considered early intervention and likely to reduce the applicant's future need for disability-related supports. The Tribunal had to assess the evidence presented, including medical reports and the applicant's statements of lived experience, against the criteria set out in the *NDIS Act 2013* (Cth).

Deputy President F Meagher P affirmed the NDIA's decision. The Tribunal found that while the applicant had experienced significant injuries and ongoing pain, and had received substantial support from family and allied health professionals, the evidence did not establish that her impairments substantially reduced her functional capacity in the specified areas to the degree required for NDIS access. The Tribunal noted the applicant's ability to work as a business manager, albeit with adjustments, and the long-standing nature of her conditions, which led to the conclusion that they were not likely to be permanent for the purposes of the NDIS Act. Furthermore, the Tribunal determined that the early intervention requirements were not met, as the long duration of the impairments meant that current support would not be considered early intervention and was unlikely to reduce future needs. Consequently, the Tribunal affirmed the decision under review.