RKVM and National Disability Insurance Agency

This matter concerned an application by RKVM, a child participant in the National Disability Insurance Scheme (NDIS), for a review of an internal review decision by the National Disability Insurance Agency (NDIA). RKVM’s mother sought funding for several supports and a notional plan duration of three years. The NDIA's internal review had affirmed its original decision, which did not grant all the requested supports or the proposed plan duration. The case was heard by K. Parker SM.

The primary legal issues before the Tribunal were to determine what types and levels of supports constituted "reasonable and necessary supports" for RKVM under section 34(1) of the National Disability Insurance Scheme Act 2013 (Cth), and consequently, what should be included in his Statement of Participant Supports (SOPS) and funded under his NDIS plan. A secondary issue was to determine the appropriate notional duration for any new NDIS plan approved for RKVM.

During the hearing, the NDIA significantly revised its position in response to new evidence presented by RKVM. By the conclusion of the hearing, the NDIA agreed that virtually all of the supports requested by RKVM's mother, as well as some additional supports not initially requested, were "reasonable and necessary supports." The NDIA also conceded to the proposed notional plan duration of three years, a point initially contested. Given this evolution of the matter, the Tribunal found it unnecessary to conduct extensive fact-finding.

The Tribunal ordered that the decision under review be set aside and remitted with directions to facilitate the making of a new SOPS for RKVM. This new SOPS was to include virtually all of the requested supports, along with the agreed-upon notional plan duration of three years. The specific supports agreed upon included increased funding for core support worker assistance for self-care, overnight support, and community participation, as well as funding for swimming lessons, increased capacity building supports such as speech and occupational therapy, and transport funding equivalent to $3,456 per annum for a second vehicle.