Schaefer and National Disability Insurance Agency (NDIS) - [2025] ARTA 1541

Schaefer and National Disability Insurance Agency (NDIS) [2025] ARTA 1541 (25 August 2025)

Applicant/s:  Ruth Schaefer
Respondent:  National Disability Insurance Agency
Tribunal Number:                2024/9568
Tribunal:General Member Gooch
Place:  Adelaide
Date:25 August 2025

Decision: The Tribunal affirms the decision under review pursuant to section 105(a) of the Administrative Review Tribunal Act 2024.

Statement made on 25 August 2025 at 4:44pm

Catchwords

National Disability Insurance Scheme – reviewable decision of Chief Executive Officer – Statement of Participant Supports – reasonable and necessary supports- Getting the NDIS Back on Track Transitional Support rules – NDIS support –– plan management – transport – behavioural support – movement of funding between categories – reasonable and necessary – Note 1 to section 34 - payment of invoices – reviewable decisions - decision affirmed

Legislation

Administrative Review Tribunal Act 2024, ss12, 105

National Disability Insurance Scheme Act 2013 (Cth), ss 3, 4, 10, 24, 25, 33, 34, 35, 99, 103, 209

National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 Items 129, 138, 139 of Schedule 1

National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth)

National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 rr 4, 5, 6, Schedule 1 & 2

National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (Miscellaneous Provisions) Transitional Rules 2024

Cases

Drake and Minister for Immigration and Ethnic Affairs (No. 2) 1979 2 ALD 634

McGarrigle v National Disability Insurance Agency [2017] FCA 308

National Disability Insurance Agency v WRMF [2020] FCAFC 79

Secondary Materials

Revised Explanatory Memorandum - National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024, Item 46

NDIS Operational Guidelines – Principles we follow to create your plan, dated 27 April 2025

NDIS Operational Guidelines - Reasonable and Necessary Supports, dated 28 March 2025.

NDIS Operational Guidelines – Including specific types of supports in plans dated 2 December 2024

NDIS Operational Guidelines – Supports funded by the NDIS dated 26 March 2025.

NDIA Information Sheet – Support co-ordination Support coordination | NDIS

NDIA Information Sheet – Psychosocial recovery coach PB Psychosocial Recovery Coach Information PDF.pdf

Reasons for Decision

This is a review of a decision by a delegate of the CEO of the National Disability Insurance Agency (the Agency) to approve a statement of participant supports (SOPS) for Ms Schaefer.
Relying on the Agency’s Statement of Facts, Issues and Contentions (SFIC) the history of this review involves an ongoing process of negotiation, change and requests for change which have continued from the previous plan. The original decision in this dispute involved a SOPS made on 7 October 2024 for the period 7 October 2024 to 6 October 2025 and included the following funding:
a.Assistance with daily life - $62,472.96
b.Assistance with Social, Economic and Community Participation - $25,370.28
c.Behaviour Support - $14,494.32
d.Improved Daily Living Skills - $5,819.76; and
e.Support co-ordination…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

Continue reading Schaefer and National Disability Insurance Agency (NDIS)

Details

AGLC: Schaefer and National Disability Insurance Agency (NDIS) [2025] ARTA 1541
Case: [2025] ARTA 1541
Decision Date: 25 August 2025

CaseChat Overview and Summary

The case of Schaefer and National Disability Insurance Agency (NDIS) involved Ms Schaefer, who sought a review of the National Disability Insurance Agency's decision regarding her Statement of Participant Supports. The dispute primarily centred around the Agency's refusal to change her plan management from agency-managed to plan-managed, the allocation of funding between various support categories, and the payment of outstanding invoices for services rendered by her preferred providers. Ms Schaefer argued that the transition to an agency-managed plan had reduced her access to necessary services due to the limited availability of registered services in her area. Additionally, she sought to have unpaid invoices settled from funds outside her current plan.

The legal issues before the court were whether the Agency's decision to maintain the agency-managed plan was reasonable and necessary under section 34 of the NDIS Act, and whether the Agency was obligated to pay the outstanding invoices from funds other than those allocated in her current plan. The court needed to assess whether the Agency's decision was within the scope of its powers and whether the Agency had properly exercised its discretion in determining the reasonableness and necessity of the supports provided.

In its reasoning, the court examined the statutory requirements set out in section 34 of the NDIS Act, which outlines the criteria for determining the inclusion of specific supports in a participant's plan. The court noted that the Agency had considered Ms Schaefer's requests and the availability of services in her area. The court also reviewed the relevant support rules and found that the Agency had adhered to the necessary procedures in making its decision. Regarding the payment of invoices, the court found that the Agency had no obligation to pay these invoices from funds outside Ms Schaefer's current plan as the invoices were related to services already provided and funded under the plan. The court ultimately affirmed the Agency's decision, finding it to be reasonable and within the Agency's statutory powers.

The final orders of the court were that the decision of the National Disability Insurance Agency to maintain Ms Schaefer's plan as agency-managed, and to not pay the outstanding invoices from funds other than those allocated in her current plan, were affirmed. Ms Schaefer's application for review was dismissed.

Orders

Orders of the court

Full text does not contain this section.

Background

Background to the litigation

Full text does not contain this section.

Evidence

Evidence Before The Court

Full text does not contain this section.

Decision

Reasons for decision

Ms Schaefer applied for an internal review and on 8 November 2024 a different delegate of the CEO affirmed the original decision. (the decision under review). On 18 November 2024 Ms Schaefer applied to the Administrative Review Tribunal (the Tribunal) for review of this decision.[3][3] Page 103 Exhibit 1 In seeking her review Ms Schaefer asserted she had previously been receiving 18 hours a day, 7 days a week support under plan management which she required as her impairments ‘created a need for extensive support’. She stated that the change to Agency managed had limited her access to services as there were few registered services in her area. She requested her plan be changed back to plan managed.[4] [4] Pages 6, 46 and 47 of Exhibit 1 The decision under review set out the Agency’s understanding of Ms Schaefer’s requests (made in writing and by phone call) as follows:[5]a.a change in plan-management from Agency-managed to plan-managed;b.a change to funding distribution by moving funding assigned to behaviour supports to funding for support co-ordination/psychosocial recovery coaching;c.a request for the inclusion of transport funding in her plan.[5] Page 62 of Exhibit 1 Ms Schaefer submitted multiple emails to the Tribunal, both prior to and after the substantive hearing. In those emails (and orally at hearing) she confirmed that one of her most significant concerns was that the Agency had not paid past invoices for support work she had received and that as a result she was unable to continue to receive services from her preferred providers. She sought orders the Agency be required to pay these invoices from funds other than those in her current plan. These invoices included:a.Invoice no. INV-6529 issued by Ann Atkinson on 26 July 2023 in the amount of $564.00b.Invoice no. INV-7642 issued by Jim’s Bookkeeping/Ann Atkinson on 18 September 2024 in the amount of $1,584.00c.Invoice no. 1075 issued by Incorporeal Charity of God Ltd on 27 June 2023 in the amount of $26,358.00d.Invoice no. 1077 issued by Incorporeal Charity of God Ltd on 12 July 2023 in the amount of $12,984.00e.Invoice no. 1078 issued by Incorporeal Charity of God Ltd on 16 July 2023 in the amount of $12,302.00f.Invoice no. 1079 issued by Incorporeal Charity of God Ltd on 10 October 2023 in the amount of $28,414.00g.Invoice no. 1100 issued by Incorporeal Charity of God Ltd on 16 September 2023 in the amount of $18,695.00 The total owed for Ms Atkinson is $2,148. The total owed to Incorporeal Charity of God is $98,753. The principal place of business address of Incorporeal Charity of God per ASIC company search completed on 30 May 2025 is listed as c/- Ann Atkinson, 9 Wiskar Close, Bentley Park QLD 4869. Section 34 of the NDIS Act sets out all the matters a decision maker must be satisfied of before determining a specific support should be included in a statement of participant supports. These matters are also reflected in Rule 2.3 of the Support Rules. Section 34 reads as follows:

Ratio Decidendi

Legal Principle Established

Full text does not contain this section.