RTRH and National Disability Insurance Agency

This matter concerned an application for review by RTRH against decisions made by the National Disability Insurance Agency (NDIA) regarding the provision of supports under the National Disability Insurance Scheme. The core of the dispute revolved around the assessment of reasonable and necessary supports, specifically concerning transport, and how these were reflected in RTRH's participant plans. The decision was made by Mr S. Webb, a Member of the Administrative Appeals Tribunal.

The legal issues before the Tribunal included determining the scope of its jurisdiction, particularly in light of serial participant plans and the statutory requirements for their commencement and cessation. The Tribunal was required to consider whether a plan issued to give effect to an internal review decision, without a full plan review, engaged the plan replacement provisions. Furthermore, the Tribunal had to ascertain whether the merits review of a decision was distinct from the statutory procedure for reviewing a participant's plan, and how the substitution of decisions on merits review affected the operative status of a participant's plan.

The Tribunal reasoned that the statutory provisions governing the commencement and cessation of NDIS plans were critical. It held that a plan issued to give effect to an internal review decision, without a review of the plan itself, did not engage the plan replacement provisions. Consequently, the previous plan continued to have effect. The Tribunal distinguished between a merits review of a decision and the statutory procedure for reviewing a participant's plan, concluding that a plan was not varied by the substitution of a decision on merits review. Where an approved statement of participant supports was confirmed, varied, or substituted on internal review, the Tribunal's jurisdiction ran during the period the statement had effect under a plan. The Tribunal's ultimate orders would depend on the resolution of these jurisdictional questions and the subsequent assessment of RTRH's transport support needs.