NMFF and National Disability Insurance Agency

This matter concerned an application by a young woman, the Applicant, for review of a decision made by the Chief Executive Officer of the National Disability Insurance Agency (NDIA). The Applicant, who lives with multiple impairments and disabilities including Cowden Syndrome, POTS, Autism Spectrum Disorder, Depression, Anxiety, and Post Traumatic Stress Disorder, disputed the adequacy of her NDIS participant plan, specifically the statement of participant supports. The dispute centred on various requested supports, including transport funding, home modifications, medium-term accommodation, and funding for a wheelchair.

The Administrative Appeals Tribunal (AAT) was required to determine whether the requested supports were "reasonable and necessary" within the meaning of the National Disability Insurance Scheme Act 2013 (Cth). This involved assessing whether the supports would assist the Applicant to pursue her stated goals and aspirations, whether they represented value for money, were effective and beneficial, and were most appropriately funded or provided through the NDIS. The Tribunal also considered whether certain requested supports, such as project management for home modifications, were already incorporated into the Applicant's existing plan.

The Tribunal, having considered the evidence presented by the Applicant, her mother and carer, and expert witnesses, along with submissions from the NDIA, determined that while some supports were already adequately provided for or not deemed reasonable and necessary, the NDIA had reconsidered its position on four categories of additional support. Consequently, the Tribunal set aside the reviewable decision and remitted it to the CEO for reconsideration with a direction that these specific supports be incorporated into the Applicant's participant plan. However, the Tribunal declined to direct the incorporation of the remaining disputed supports, finding they did not meet the criteria of being reasonable and necessary.