PRALJAK and NATIONAL DISABILITY INSURANCE AGENCY

This matter concerned an application by the applicant, Mr Praljak, challenging a decision by the National Disability Insurance Agency (NDIA) regarding his eligibility for the National Disability Insurance Scheme (NDIS). The dispute centred on whether Mr Praljak's impairments met the NDIS access criteria, specifically the requirements relating to permanency and substantially reduced functional capacity. The decision was made by Senior Member Katter of the Administrative Appeals Tribunal.

The legal issues before the Tribunal were whether the applicant's impairments, including an anxiety disorder, acrophobia, claustrophobia causing vertigo, and delusional disorder, were permanent or likely to be permanent. Furthermore, the Tribunal had to determine if these impairments resulted in a substantially reduced functional capacity to undertake one or more of the activities listed in section 24(1)(c) of the National Disability Insurance Scheme Act 2013 (Cth), namely communication, social interaction, learning, mobility, self-care, and self-management. The Tribunal also considered whether the applicant was likely to require NDIS support for his lifetime.

The Tribunal reasoned that an impairment could be considered permanent even if it continued to be treated or reviewed, provided no further medical treatment or review was required to demonstrate its permanency. Evidence from medical professionals, including Dr Varghese and Dr Whittington, indicated that the applicant's impairments were permanent or likely to be permanent and significantly impacted his functional capacity. Dr Whittington noted the applicant's mobility was "extremely limited" and that social interaction could be "very difficult" due to panic, anxiety, and feeling trapped. Dr Varghese highlighted the significant decline in the applicant's professional functioning due to his delusional ideation. The Tribunal found that these impairments resulted in a substantially reduced functional capacity in social interaction and self-management, and affected his capacity for social and economic participation. The Tribunal also applied sections 24(2) and 24(3) of the Act, which allow for impairments that vary in intensity or are episodic to be considered permanent if lifetime support is likely.

Consequently, the Tribunal set aside the NDIA's decision of 3 March 2021 and substituted a decision that the applicant meets the access criteria under section 21(1)(a), (b), and (c)(i) of the National Disability Insurance Scheme Act 2013 (Cth).