Pavilupillai and National Disability Insurance Agency

The Administrative Appeals Tribunal considered the dispute between Mr Pavilupillai and the National Disability Insurance Agency (NDIA) concerning the NDIA's decision to refuse funding for specific orthotic footwear. The core of the disagreement centred on whether the provision of left and right high heel foot sections constituted reasonable and necessary supports under the National Disability Insurance Scheme (NDIS).

The Tribunal was required to determine whether the NDIA's decision to refuse funding for the proposed orthotic footwear was the correct and preferable decision. This involved assessing whether the requested supports aligned with the objects of the NDIS, specifically whether they would facilitate Mr Pavilupillai's social and economic participation, represented value for money, and were likely to be effective and beneficial for him.

Deputy President Forgie affirmed the NDIA's decision, finding that the evidence did not establish that the proposed high heel foot sections were reasonable and necessary supports. The Tribunal concluded that the supports did not meet the criteria outlined in the NDIS legislation, particularly in relation to their effectiveness, benefit, and contribution to social and economic participation. Consequently, the NDIA's original decision was upheld.