SHQH and National Disability Insurance Agency (NDIS)
[2025] ARTA 1747
•10 September 2025
SHQH and National Disability Insurance Agency (NDIS) [2025] ARTA 1747 (10 September 2025)
Applicant:SHQH
Respondent: National Disability Insurance Agency
Tribunal Number: 2023/6653
Tribunal:General Member J Toohey
Place:Brisbane
Date:10 September 2025
Decision:The Tribunal affirms the decision under review. The Applicant does not meet the access requirements in section 21 of the National Disability Insurance Scheme Act 2013 (Cth).
Statement made on 05 September 2025 at 4:36pm
.................................[SGD]...................................
General Member Justin Toohey
Catchwords
National Disability Insurance Scheme – Access – Becoming a Participant Rules –– Substantially Reduced Functional Capacity – Ehlers-Danlos Syndrome – Fibromyalgia – Assessing Activities and Tasks – Fluctuating Capacity – Domestic Tasks in Self-Care Activity
Legislation
Administrative Appeals Tribunal Act 1975 (Cth)
Administrative Review Tribunal Act 2024 (Cth)
Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (Cth)National Disability Insurance Scheme Act 2013 (Cth)
National Disability Insurance Scheme (Becoming a Participant) Rules 2016 (Cth)
Cases
Angelopoulos and National Disability Insurance Agency [2025] ARTA 521.
JLZT and National Disability Insurance Agency [2022] AATA 541
Morris and National Disability Insurance Agency (NDIS) [2024] ARTA 186
Mulligan v National Disability Insurance Agency [2015] FCA 544
National Disability Insurance Agency v Foster [2023] FCAFC 11
National Disability Insurance Agency v Deayton [2025] FCA 562
NRNK and National Disability Insurance Agency [2024] AATA 110
PNCB and the CEO, National Disability Insurance Agency [2025] ARTA 66Secondary Materials
Applied Principles and Tables of Support to Determine the Responsibilities of the NDIS and other Service Systems
People with disability in Australia 2024: Australian Institute of Health and Welfare
Operational Guideline: Applying to the NDIS, published 14 October 2024Statement of Reasons
SUMMARY
I have found that the Applicant does not have impairments that result in a substantially reduced functional capacity to undertake the one of more of the activities in section 24(1)(c) of the National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act). I have decided that the Applicant does not meet the access requirements as set out in section 21 of the NDIS Act. My reasons for reaching this decision are set out below.
BACKGROUND
The issue before the Tribunal is whether the Applicant, SHQH, meets the access criteria to be a participant of the National Disability Insurance Scheme (NDIS) in accordance with section 21 of the NDIS Act.
SHQH is a 65-year-old woman who lives on her own in a retirement village near Brisbane. SHQH is impacted by her diagnosed medical conditions of Ehlers-Danlos Syndrome (hypermobility type) (hEDS) and fibromyalgia (FM).
The Tribunal is reviewing a decision made by a delegate of the Chief Executive Officer (CEO) of the National Disability Insurance Agency (Agency) on 23 August 2023 which affirmed an earlier decision that the Applicant did not meet the criteria for access to the NDIS. SHQH applied for a review by the Administrative Appeals Tribunal (AAT) on 7 September 2023. This application was made under section 103 of the NDIS Act and section 25 of the AAT Act.[1] SHQH was aged 63 when she applied to the Tribunal in September 2023 and more recently turned 65.
[1] On 14 October 2024, the Administrative Appeals Tribunal (AAT) became the Administrative Review Tribunal (the Tribunal). Under the transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024, proceedings in the AAT that were not finalised before 14 October 2024 are to be continued and finalised by the Tribunal. Anything done in relation to the proceeding before 14 October 2024 is taken to have been done by the Tribunal.
The Tribunal held a hearing by video on 9, 10 and 11 June 2025. The Applicant was represented by Counsel, Peta Willoughby, as instructed by Legal Aid Queensland. The Agency was represented by Counsel, Aaron Hartnett, as instructed by Maddocks Lawyers. Following the hearing, both parties were provided with the opportunity to make written submissions. Final submissions were received on 15 August 2025.
ISSUE
The issue before the Tribunal is whether the Applicant meets the disability requirements under section 24 of the NDIS Act.
The Applicant does not contend that they meet the early intervention requirements in section 25 of the NDIS Act.
OVERVIEW OF THE NDIS DECISION-MAKING FRAMEWORK[2]
[2] I have used a similar overview in other matters dealing with access to the NDIS.
Chapter 1, Part 2 of the NDIS Act sets out the objects and principles including, for example, that the NDIS Act is to support the independence and social and economic participation of people with disability,[3] and that decision-makers are to have regard to the need to ensure the financial sustainability of the scheme.[4] Section 21(1) of the NDIS Act sets out that a person meets the criteria to become a participant in the NDIS if:
[3] Section 3(1)(c).
[4] Section 3(3)(b).
(a) the CEO is satisfied that the person meets the age requirements (see section 22); and
(b) the CEO is satisfied that, at the time of considering the request, the person meets the residence requirements (see section 23); and
(c) the CEO is satisfied that, at the time of considering the request:(i) the person meets the disability requirements (see section 24); or
(ii) the person meets the early intervention requirements (see section 25).A person meets the disability requirements in section 24(1) of the NDIS Act if:
(a) the person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or the person has one or more impairments to which a psychosocial disability is attributable; and
(b) the impairment or impairments are, or are likely to be, permanent; and
(c) the impairment or impairments result in substantially reduced functional capacity to undertake one or more of the following activities:
(i) communication;
(ii) social interaction;
(iii) learning;
(iv) mobility;
(v) self-care;
(vi) self-management; and
(d) the impairment or impairments affect the person’s capacity for social or economic participation; and
(e) the person is likely to require support under the National Disability Insurance Scheme for the person’s lifetime.
Section 27 of the NDIS Act provides for the making of rules in relation to the disability requirements. The relevant rules in respect of this review are the National Disability Insurance Scheme (Becoming a Participant) Rules 2016 (Becoming a Participant Rules). Rule 5.8 of the Becoming a Participant Rules states:
When does an impairment result in substantially reduced functional capacity to undertake relevant activities?
5.8 An impairment results in substantially reduced functional capacity of a person to undertake one or more of the relevant activities—communication, social interaction, learning, mobility, self-care, self-management (see paragraph 5.1(c))—if its result is that:
(a) the person is unable to participate effectively or completely in the activity, or to perform tasks or actions required to undertake or participate effectively or completely in the activity, without assistive technology, equipment (other than commonly used items such as glasses) or home modifications; or
(b) the person usually requires assistance (including physical assistance, guidance, supervision or prompting) from other people to participate in the activity or to perform tasks or actions required to undertake or participate in the activity; or
(c) the person is unable to participate in the activity or to perform tasks or actions required to undertake or participate in the activity, even with assistive technology, equipment, home modifications or assistance from another person.
The Federal Court in Mulligan held that it is sufficient for a person to have substantially reduced functional capacity in relation to one activity.[5]
[5] Mulligan v National Disability Insurance Agency [2015] FCA 44, [56].
The NDIS Operational Guidelines also assist in making decisions in accordance with the NDIS Act. Operational guidelines represent government policy and should be applied by the Tribunal unless there is good reason not to do so.[6] The relevant operational guideline is Applying to the NDIS (Access Guidelines).[7]
[6] Re Drake and Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 634.
[7] Accessed at While the date on this guideline is 14 October 2024, which is after the Back on Track Amendments, the post-amendment update is only to the name of ART. This was advised by Counsel for the Agency in another matter.
SUMMARY OF EVIDENCE
The Tribunal was provided with a joint hearing bundle by the parties, and this was accepted into evidence at the hearing.[8] This bundle of documents included:
[8] The page numbering in the joint hearing bundle is adopted throughout these reasons.
(a)The ‘T-documents’,[9]
[9] Which are all the records that the Agency considered when making the decision under review as was required by section 37 of the AAT Act.
(b)Letters and reports from Dr T, the Applicant’s treating rheumatologist,
(c)Letters and reports from Dr F, the Applicant’s general practitioner,
(d)A report from Ms S, occupational therapist,
(e)Statements of lived experience from the Applicant,
(f)An independent functional capacity assessment report from Ms C, occupational therapist.
The Tribunal also had the benefit of oral evidence from the Applicant, Ms C, and Dr T.
CONSIDERATION
Age and residence requirements[10]
[10] Sections 22 and 23 of the NDIS Act.
There is no dispute the Applicant satisfies the age and residence requirements. I am satisfied that these requirements are met.
Disability requirements
I must consider whether the Applicant meets the disability requirements in section 24 of the NDIS Act.
Impairments, likely to be permanent, affecting social and economic participation
There is no dispute that SHQH has a disability attributable to impairments arising from her conditions of hEDS and FM,[11] which are permanent,[12] and which affect her capacity for social and economic participation.[13] Based on the reports before me, I am satisfied that SHQH has a disability attributable to physical, neurological, cognitive, and sensory impairments, that these impairments are permanent, and that they affect her capacity for social and economic participation.
[11] NDIS Act, section 24(1)(a). See the Agency’s Statement of Facts, Issues and Contentions, at paragraph 22.
[12] NDIS Act, section 24(1)(b). See the Agency’s Statement of Facts, Issues and Contentions, at paragraph 23.
[13] NDIS Act, section 24(1)(d). See the Agency’s Statement of Facts, Issues and Contentions, at paragraph 29.
Substantially reduced functional capacity in one of more activities
The parties do not agree on whether SHQH’s impairments result in a substantially reduced functional capacity in respect one of the activities listed in section 24(1)(c). The Applicant contends the SHQH has a substantially reduced functional capacity in respect of mobility and self-care.
Fluctuating and worsening capacity
Before turning to an assessment of mobility and self-care, I will deal with the question of the Applicant’s fluctuating capacity. The evidence before the Tribunal indicates that the Applicant’s functional capacity varies from day-to-day and has worsened recently.
The NDIS Act and the Becoming a Participant Rules deal with fluctuating impairments in relation to assessing permanency,[14] but are silent on how to consider fluctuation with regards to assessing functional capacity.
[14] See for NDIS Act, section 24(2) and (3), and Rule 5.5 of the Becoming a Participant Rules.
The Applicant refers to the Tribunal’s decision in JLZT[15] which said:
[15] JLZT and National Disability Insurance Agency [2022] AATA 541, [121].
When assessing episodic or fluctuating impairments, the important point is to make a practical judgment of the effect of the impairment on the person’s functional capacity to undertake the specified activities.
I agree with this statement in JLZT but also note that this observation rejected the wording in a previous guideline which said that is what appropriate to ‘consider the impact on the person’s ability to function in the periods between acute episodes’. This wording is no longer included in the current Access Guidelines, which instead says:
Your needs might go up and down each day or each month. … We consider your ability over time, taking into account your ups and downs.
The Agency does not contend that a different approach should be taken to that which is set out in this guideline.
The assessment report of Ms S, occupational therapist, dated 3 March 2021, does not specifically address the frequency of SHQH’s fluctuating impairments. In summary, Ms S concluded that:
[SHQH]’s personal and domestic activities of daily living are significantly impacted with chronic pain, limited strength, decreased mobility, and fatigue leading to exhaustion. The limited mobility is exasperated [sic] with activities that involve long sitting, bending, twisting, walking and her only result with rest to void significant increases in the above symptoms. [SHQH] experiences days with pain so severe she is unable to mobilise at all.
In the Applicant’s Statement of Lived Experience (SLE), dated 9 December 2023, SHQH categorises her varying capacity into days which are ‘bad’, ‘medium good’, ‘good’ or ‘best’.[16] With regards to the proportion and frequency of good and bad days the Applicant’s experience is that:
[16] JHB, pages 191 to 193.
• Bad days far outnumber good days and are increasing in frequency.
• The pattern is never more than one consecutive good day in a row, whereas it is frequently more than one consecutive bad day.
• Days that start out as good days can rapidly turn into bad days if I do not pace myself in order to attempt ADLs [activities of daily living] and as a consequence overexert and/or injure myself.[17]
[17] JHB, page 190.
This is broadly consistent with Dr T’s oral evidence. While I note that Dr T has not seen the Applicant since September 2023, overall, he considered that SHQH experienced ‘a lot more bad days than good days’.[18]
[18] Transcript, P-131.
The independent OT report of Ms C dated 15 May 2024 said the following about the Applicant’s symptoms variation:
[SHQH] reported that she does experience variations in symptoms, but experiences symptoms of her conditions every day. She stated that on a good day it is not as difficult to walk around her home and she may get one task done such as changing the sheets or going shopping between resting. [SHQH] explained that she will not attempt more than one activity per day to help manage her symptoms of fatigue, pain and prevent injury.
[SHQH] described that on her worst day, she would wake up with a migraine which included symptoms of aura, photosensitivity, visual disturbances, and facial droop. She stated that on those days she will stay in bed, she reported that she can get herself up to the toilet and attend to other basic needs such as having medication and making a tea. [SHQH] reported that she is often not hungry on her worst days. [SHQH] said that she will ring and cancel any appointments that she might have during periods of migraine and stay home and rest. She reported that migraine is associated with “extraordinary pain and horrendous earache”. [SHQH] explained that the migraine can last from one to four days. She did not elaborate on how often she would experience a migraine but stated that the frequency of migraines is slowly getting worse, and she has some form of the symptoms up to fifty percent of the month.[19]
[19] JHB, page 211 and 212.
Ms C’s report recorded the Applicant’s description of a typical day as:
·I practice preventative pacing, if I know I have to do something tomorrow, I will rest the day before and day after.
·I get up for [pet dog] each morning, give him his tablet, have a cup of tea and some breakfast, and go back to bed.
·I’ll get up an hour later. On bad days I will decide whether or not I will have a shower. I wouldn’t have a shower if I’m going to aqua aerobics. If I’m having a good week, I’m going to aqua 3 times a week, Mondays, Wednesdays, and Saturdays. I can’t remember the last time I was able to do 3 times a week. Most of the time I go once.
·I rest, lying down in-between various activities including making the bed.
·I read a lot. I speak French, so I’ve been keeping up with French. I like art but doing that depends on my fingers. I can’t do handwriting anymore. I can do art because it is not controlled.
·I do have lunch, but no particular time. I tend to have snacks throughout the day.
·There is no particular routine in the evening, I’m in bed in the early afternoon/evening. I start lock down about 4pm in the afternoon. It depends on whether I’m feeling hungry or not if I cook. If I do cook, I will cook one dish of enormous quantities that I can eat over several days.
·Once I’m in bed I will watch tv or read. I wake up a couple of times overnight due to pain or nightmares. My sleep can impact the next day.
·I attend French class once a week, it starts at 5pm. If I can’t get there myself, I will attend online.[20]
[20] JHB, page 212.
At the time of Ms C’s assessment, 17 April 2024, it appears that the Applicant was able to travel to an participate in an activity around three days per week. According to the Applicant’s SLE, the Applicant is only able to attend these activities on ‘good’ or ‘best’ days. I consider that, in April 2024, the Applicant typically experienced three ‘good’ or ‘best’ days per week.
I also note that Ms C said the following with regards to the Applicant’s function on the day of assessment:
[SHQH] reported that the day of the assessment was “a bit worse than a typical day” due to left thumb pain and stress associated with the assessment. [SHQH] stated that her voice was going hoarse due to stress, and she will likely need to sleep after the assessment. [SHQH] was observed to become visibly fatigued within an hour of the assessment, loosing concentration, and requiring questions to be repeated.[21]
[21] JHB, page 212.
In the Applicant’s oral evidence, SHQH stated that she had not experienced any ‘good days’ since Easter.[22] The Applicant also said that, since Easter, she had only been able to attend one French conversation group, one aqua exercise class, and four or five art group classes.[23] In 2025, Easter was observed from 18 to 21 April. This means that there were around seven weeks between Easter and the hearing. I consider that the Applicant has experienced approximately one day per week since Easter that would equate to being ‘good’.
[22] Transcript, P-24.
[23] Transcript, P-25.
Overall, I accept that SHQH’s experiences worse impairments on a majority of days. I also accept that the frequency of days on which she is more impaired has increased recently, particularly since mid-April 2025. However, it is not clear to me that this recent deterioration represents an ongoing change in the frequency of the Applicant’s worse days.
In her oral evidence, SHQH described how her impairments are exacerbated by stress.[24] SHQH also said that stress had impacted her sleep and migraines in the days leading up to the hearing process,[25] and that it had been very difficult time as she had to provide more care for her pet dog who passed away four weeks prior to the hearing.[26] During the hearing, it was clear to me that SHQH’s impairments were impacted by the stress of the hearing process.
[24] Transcript, P-23.
[25] Transcript, P-35.
[26] Transcript, P-44.
On balance, I am not satisfied that the worsening of SHQH’s impairments since April 2025 represents a new baseline for her functional capacity. Taken together, I consider that the frequency of SHQH’s most impaired days fluctuates between 4-6 days per week. In my view, it remains likely that SHQH will usually experience an average of two days per week when her impairments are more moderate.
Mobility
The Applying to the NDIS Guideline describes mobility as:
Mobility, or moving around – how easily you move around your home and community, and how you get in and out of bed or a chair. We consider how you get out and about and use your arms or legs.
The Applicant submits that she does have a substantially reduced functional capacity in the mobility activity, saying in summary:
… the Applicant cannot mobilise effectively outside the home because she is unable to walk for more than 15 minutes, even with a stick or crutch or on rough, sloped, or slippery ground at all. Within the home, she requires the support of walls, door frames, or furniture, and can only mobilise approximately 20m. She cannot safely mobilise up her internal stairs or into the shower, onto the bed, or onto the toilet. She has difficulty getting out of a chair.
Thus, the Applicant is not able to mobilise safely and effectively inside or outside the home without assistive technology or home modifications (including installation of grab rails). [notes omitted] [27]
[27] Applicant’s Closing Submissions, page 16.
In her SLE, the Applicant’s says that:
On ‘bad’ days she is unable to: walk further than to her bathroom or kitchen; shower; drive; take part in recreation activities; or sit at a desk.
On ‘medium good’ days she cannot drive due to her use of medication.
On ‘good’ days she still experiences some impacts of her function.
On ‘best’ days she is able to drive, shop, attend appointments, attend recreation or exercise classes, and walk less than a kilometre with rest breaks. However, she does not complete more that one high energy activity on these days.[28]
[28] JHB, pages 191 to 193.
Ms C reported that the Applicant:
Used a modified technique to access entrances, rooms and storage areas in her home.
Was at a high risk of falls, particularly on slippery or uneven surfaces and used a single point walking stick when feeling unsteady.
Used a modified technique for bed, chair, toilet, shower, and car transfers.
Used a modified technique when using stairs, including carrying items in a backpack to be able to support herself using both hands on handrails.
Limited herself to carrying 1 kg.
Was able to drive up to 30 minutes but avoided driving at night or when impacted by medication.
Was unlikely to be able to use public transport.
Was able to mobilise in the community, with rest breaks after five minutes, depending on her symptoms that day.[29]
[29] JHB, pages 220 to 223.
In his letter dated 12 December 2023, Dr T said that SHQH:
… suffers poor proprioception and has suffered a history of joint dislocation, tendinopathy, some features of postural orthostatic hypotension and ongoing widespread pain and fatigue due her hypermobile EDS and fibromyalgia.
This causes her constant pain, fatigue, at risk of injury such as subluxed joints and tendinopathy and secondary early osteoarthritis from previous abnormal joint loading and behaviours.[30]
[30] JHB, pages 182 and 183.
In his oral evidence, Dr T said that the Applicant:
Could not bend her knees beyond 20-30 degrees and struggles with stairs.
Experienced pain when lifting her arms above her shoulder and would not be able to repeat this movement.
Is at risk of shoulder injury due to joint subluxation when lifting or carrying heavier objects.
Becomes dizzy if standing for long periods.
In summary, the Respondent submits that the Applicant does not have a substantially reduced functional capacity with mobility as the Applicant can:
Independently transfer to and from a bed, chair, car, and toilet, using a modified technique.
Use the stairs in her home using the wall or handrail for support, noting greater difficulty with going downstairs, and that stairs are avoided on ‘bad’ days.
Walk outside her home for about 15 minutes, using a single point walking stick due to her unbalanced gait.
Drive for around 20-30 minutes.[31]
[31] Respondent’s Closing Submissions, pages 13 and 14
The Applicant submits that the evidence supports a finding that rule 5.8 of the Becoming a Participant Rules deems that SHQH has a substantially reduced functional capacity with mobility. This is because the Applicant is ‘unable to effectively or completely mobilise within her home and the community, and/or perform tasks which require the use of her body due to the combined impact of pain, fatigue and real risk of injury.’[32]
[32] Applicant’s closing Submission, page 17.
With regards to the term ‘completely’ in rule 5.8(a), the Full Court of the Federal Court in Foster found that:
In the overall legislative scheme, the adverb “completely” appears to be redundant, and in any event, unachievable. If “completely” is to be given its ordinary meaning, what is being asked of the rule is an assessment of whether a person’s impairment results in substantially reduced functional capacity to participate “wholly” or “perfectly” in the activities of communication, social interaction, learning, mobility, self-care and self-management – an impossible bar for almost everyone. That would be an absurd construction. [33]
[33] National Disability Insurance Agency v Foster [2023] FCAFC 11, [83].
With regards to SHQH’s ‘bad’ days, I would consider that she is unable to perform most tasks or actions required to participate effectively in the activity of mobility. I accept that, on these days, SHQH is mostly restricted to her bed and only moves to her bathroom or kitchen if needed. On these days, she avoids the internal stairs in her home, does not leave her home, and cannot drive. However, on other days, SHQH is able to independently complete most of the tasks that make up the activity of mobility in a modified manner. On balance, considering that these ‘bad’ days are on average around five days per week, I am not satisfied that SHQH has a substantially reduced functional capacity with the overall activity of mobility.
I appreciated the Applicant’s detailed submissions with regards to whether a single point walking stick and grab rails are ‘commonly used items’ within the meaning of rule 5.8(a). This is the first time I have been referred to data in the Australian Institute of Health and Welfare’s report People with disability in Australia 2024 (AIHW report) with regards to the use of mobility aids, which I found helpful.
The AIHW report indicates, in 2018, there were an estimated 4.4 million Australians with disability (18% of the total population).[34] With regards to the use of mobility aids, the AIHW report states that:
[34] AIHW report, page 2.
More than 2 in 5 (42% or 78,000) of those aged 0–64 who use mobility aids use a walking stick … Almost 3 in 5 (58% or 284,000) of those aged 65 and over who use mobility aids use a walking frame, 40% (or 195,000) use a walking stick …[35]
[35] AIHW report, page 52.
Overall, this does indicate to me that a walking stick is a common mobility aid for people with a disability aged 65 or over. However, I agree with the Applicant’s submission that this does not indicate that a walking stick is a commonly used item in the broader population, such as is the case with glasses, being the example provided in rule 5.8(a).
Similarly, with regards to grab rails, the AIHW report states that:
For those with disability whose home was modified:
…
• almost half of those aged under 65 (46% or 72,000) had handrails or grab rails installed, compared with 3 in 4 (74% or 264,000) of those aged 65 and over.[36]
[36] AIHW report, page 225.
Again, I would agree with the Applicant that this data does not indicate that grab rails are commonly used items within the broader population.
Ultimately however, my finding above that SHQH does not have a substantially reduced functional capacity with regards to mobility does not turn on her use of a walking stick or recommendations to install grab rails. I agree with the Respondent’s submission that walking outside her home (when SHQH usually relies on a walking stick) is one task within the activity of mobility.[37] While walking is clearly a significant task when considering the activity of mobility, I do need to consider the overall activity of mobility along with the tasks and actions required to undertake the activity. Likewise, the recommendation to install grab rails in the Applicant’s bathroom does not change my view that the Applicant does not have a substantially reduced functional capacity with regards to the overall activity of mobility.
[37] Respondent’s Closing Submissions, page 17.
For the above reasons I do not consider that SHQH is deemed to have a substantially reduced functional capacity with regards to mobility under rule 5.8(a).
The Applicant also submits that SHQH requires supervision or assistance to mobilise on her sloped driveway and therefor meets rule 5.8(b). I agree that there is support for this proposition in the evidence of Ms S, Ms C and Dr T. However, I do not consider that this means that SHQH usually requires the assistance of others to perform tasks or actions required to undertake or participate effectively in the activity of mobility for the purpose of rule 5.8(b). Mobilising on slopes is one task with the activity of mobility and I do not consider this is sufficient to satisfy this deeming provision.
I also do not consider that or rule 5.8(c) applies. SHQH in not unable to participate in the activity of mobility, even with assistive technology, equipment, home modifications or assistance from another person. While SHQH does experience impairments with bending, lifting, transfers and walking, I do not consider that these impairments mean that SHQH is unable to undertake the activity of mobility.
Aside from these deeming provisions, I am also not otherwise satisfied that there are factors that support a finding that SHQH has a substantially reduced functional capacity with regards to mobility. Overall, SHQH retains a level of functional capacity, particularly on her better days. In my view, SHQH’s functional capacity for mobility fluctuates between a moderate and severe level of impairment.
Self-care
The Applying to the NDIS guideline describes self-care as:
Self-care – personal care, hygiene, grooming, eating and drinking, and health. We consider how you get dressed, shower or bathe, eat or go to the toilet.
The Applicant also submits that SHQH meets the requirements is rule 5.8 with regards to the activity of self-care. In summary, the Applicant submits that SHQH:
·Is unable to cut her toenails.
·Has difficulties transferring on an off the toilet.
·Is not able to shower everyday and has significant difficulties, including due to a risk of falls and requiring the use of a shower chair.
·Cannot dry her hair and experiences pain brushing her hair.
·Has to lean on the basin when brushing her teeth due to fatigue with standing.
·Has difficulties with dressing.
·Has difficulties with laundry tasks, including a risk of falls on the steps to the laundry, and is unable to hang washing out.
·Is limited to spot cleaning areas above her elbow height and is unable to complete heavier cleaning tasks.
·Is unable to complete gardening tasks.
·Has difficulties with opening medication bottles.[38]
[38] Applicant’s Closing submissions, pages 18-20.
In 2021, Ms S reported that:
[SHQH] is able to independently complete hygiene tasks, toileting and light dressing tasks. She requires assistance with domestic duties including cleaning, gardening and laundry secondary to chronic pain and decreased mobility. She has adapted many strategies to maintain her independence in meal preparation due to living alone without access to informal or formal supports.[39]
[39] JHB, page 90.
In his oral evidence, Dr T described the Applicant’s level of impairment related to her pain symptoms as:
I would think that her level of disability from this would be moderate to severe; probably more severe … she struggles with activities of daily living which most people in her age group should be able to do … she struggles with cooking, cleaning, which … anyone in her age group should be able to do quite independently. So I would call that a fairly severe disability.[40]
[40] Transcript, P-111.
With regard to impairments related to fatigue, Dr T describe these as ‘moderate to severe’ in relation to self-care. In respect of hEDS, Dr T also described these impacts in terms of being moderate to severe or ‘fairly significant’.
In Ms C’s report she assessed SHQH’s functional capacity for self-care as:
·Independent with toileting, noting she used a towel rail and door for support with transfers and recommended a grab rail.
·Using a modified technique for showering, including skipping some days, using a plastic stool, and using the shower screen and wall for support. A shower chair and grab rail were recommended.
·Using a modified technique for dressing, including avoiding clothing with buttons, zips on the back, and rear fastening bras.
·Using modified techniques for grooming, including wearing her hair in a side ponytail and cutting her toenails when seated. A foot stool for cutting her toenails was recommended.
·Using a modified technique for meal preparation and eating, including the use of a multi-cooker and bulk meal preparation.
·Using a modified technique for shopping, including home delivery or smaller shops. A trolley was recommended for lifting shopping into her home.
·Requiring physical assistance with heavier cleaning tasks. Lightweight tools such as a spray mop and stick vacuum were recommended.
·Requiring modifications to move the washing machine into her second bathroom as using the stairs with clothes in a backpack was unsafe.[41]
[41] This recommendation was made as a correction to Ms C’s report during her oral evidence. Transcript, P-81.
·Requiring physical assistance with lawn and garden maintenance.[42]
[42] JHB, pages 221 to 225.
The Applicant submits that rule 5.8(a) is met because SHQH is unable to safely perform tasks or actions require to participate effectively in the activity of self-care without assistive technology, equipment or home modifications. On balance, considering the evidence before the Tribunal, I am not satisfied that this is the case. In my view, SHQH requires home modifications for laundry tasks and would benefit from grabrails and a shower stool in her bathroom. SHQH is otherwise able to effectively (not ‘wholly’ or ‘perfectly’)[43] complete other self-care tasks in a modified manner without assistive technology, equipment or home modifications.
[43] National Disability Insurance Agency v Foster [2023] FCAFC 11, [83].
The Applicant also submits that rule 5.8(b) is met because SHQH requires assistance with dressing, acknowledging that SHQH has ‘adopted a workaround for this activity’.[44] In my view, this submission is somewhat misplaced. Comparing rule 5.8(a) and rule 5.8(b), I note that rule 5.8(b) omits the word ‘effectively’. SHQH does not usually require assistance with dressing and is able to manage this on her own, with a modified approach. SHQH does require physical assistance with heavier cleaning. However, these heavier cleaning tasks are only a component of the overall activity of self-care. I do not consider the rule 5.8(b) is met in these circumstances.
[44] Applicant’s closing Submissions, page 21.
With regards to rule 5.8(c), the Applicant submits this this rule is met as the Applicant is unable to perform shopping, cleaning, and garden management and is reliant on paid service providers. Again, I consider this submission is misplaced. Compared with rules 5.8(a) and (b), rule 5.8(c) requires that a person is unable to participate in the activity ‘even with … assistance from another person’. That SHQH requires assistance with some self-care tasks (such as heavier cleaning) is more correctly considered under rule 5.8(b). I am less persuaded that lawn and garden maintenance are properly considered within the activity of self-care.
Aside from the deeming provisions in rule 5.8, I also need to consider whether the Applicant otherwise has a substantially reduced functional capacity for self-care. As with the mobility activity above, I accept that SHQH’s experiences severe impairments with self-care on her worst days. However, I consider that SHQH experiences a moderate impairment on other days.
The Applicant refers to the WHO Disability Assessment Schedule 2.0 (WHODAS) tool administered by Ms S as reflecting a ‘significant deficit in most domains’.[45] However, I note the Ms S also comments that the WHODAS result of 54.17% ‘indicates a moderate level of disability impact’. Further, applying other standardised assessment, Ms S also comments that SHQH: has a ‘mild dependence in personal activities’; ‘can live alone but needs intermittent support’; and a ‘moderate level of support [is] required in instrumental activities of daily living’.[46] I do not consider that this demonstrates a substantially reduced functional capacity.
[45] Applicant’s closing Submissions, page 23.
[46] JHB, page 89.
SHQH has adopted several strategies that allow her to effectively complete self-care tasks. For example, bulk-cooking meals on better days so that these can be reheated on worse days, is a sensible adjustment. That SHQH is able to prepare these bulk meals on a regular basis demonstrates a level of functional capacity for meal preparation. Taken as a whole, I find that SHQH is able to effectively complete most of the tasks that make up the activity of self-care.
For completeness, I also consider that SHQH is independent with regards to taking her medication. I do not consider that the example that SHQH provided in her oral evidence regarding having to open a medicine bottle by standing on it (and injuring herself in the process) represents a typical experience for SHQH. I also consider that SHQH forgetting to take her medication on some occasions is not indicative of a substantially reduced functional capacity. Overall, I am not satisficed that SHQH has a substantially reduced functional capacity in the activity of self-care.
Considering domestic tasks in the self-care activity
I have included domestic tasks in my consideration of the activity of self-care. At the hearing, I invited submissions from the parties on the conclusion reached in the Tribunal’s decision in Burrows that:
… domestic tasks such as laundry, domestic cleaning, gardening and yard maintenance, as examples, do not fall within any of the s 24(1)(c) activity areas. That conclusion is reached on a straightforward reading of the statutory language of the section which does not refer to a domestic activity area, and the Agency’s operational policy, which does not include any reference to the physical tasks associated with domestic activity. In this respect the tasks attributed to self-management by the Agency’s operational policy include “day-to-day tasks at home”, but limit those tasks to mental or cognitive tasks, not physical ability to do these tasks. [47]
[47] Burrows and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 607, [90].
As I have concluded that SHQH does not have a substantially reduced functional capacity with self-care, nothing particularly turns on whether domestic activities are included under the self-care activity, or not, in this matter. I have recently provided my reasons for continuing to consider domestic activities within self-care in my decision in Banoub.[48]
[48] Banoub and National Disability Insurance Agency (NDIS) [2025] ARTA 1552, [55 to 61].
However, as I have had the benefit of legal submissions from both parties in SHQH’s matter, and Mrs Banoub was self-represented, I will address some of the points identified in these submissions.
In summary, the Applicant submits that:
·Tasks related to laundry, cleaning, gardening, and yard maintenance are of fundamental importance to good health and hygiene.
·An interpretation which does not assess these tasks is inconsistent with the objects of the NDIS Act, as it could result in prospective participant’s being left in squalor.
·The NDIS Act is beneficial legislation to be given as generous a construction as permitted by the plain language of the Act.
·Extrinsic material, such as the ICF, should not used to interpret statutory provisions unless the meaning is ambiguous or leads to absurd results.
·The legislature did not adopt the recommendation of the productivity commission to apply the ICF assessment framework.
·As the activity of ‘self-management’ is limited to cognitive capacity, the ‘self-care’ activity is the appropriate domain for consideration of domestic tasks.[49]
[49] Applicant’s Closing Submissions, pages 7 to 9.
In summary, the Respondent submits that the conclusion reached in Burrows is correct, saying:
·The ICF was expressly referred to in the NDIS Bill’s explanatory memorandum.
·Extrinsic material may also be considered to confirm that the meaning of the provision is the ordinary meaning conveyed by the text.
·The activity of ‘self-management’ is limited to cognitive capacity.
·The ‘self-care’ activity does not include the ICF ‘domestic life’ and ‘major life areas’.
·The Access Guidelines are the assessment tool for the purpose of rule 5.7 of the Becoming a Participant Rules.
·The Access Guidelines are consistent with the ICF.
·The reasoning in Burrows is orthodox and should be followed.[50]
[50] Respondent’s Closing Submissions, pages 5 to 10.
In reply, the Applicant further submits that:
·The extrinsic material in Burrows was not used to confirm the ordinary meaning of the text.
·The conclusion in Burrows is inconsistent with the Federal Court findings in Mulligan[51] and Foster.[52]
[51] Mulligan v National Disability Insurance Agency [2015] FCA 544, [14, 56].
[52] National Disability Insurance Agency v Foster [2023] FCAFC 11, [62, 64, 65, 68].
I am also less persuaded that gardening and yard maintenance are sufficiently connected to good health and hygiene to be considered in the activity of self-care. In my view, these tasks are more directly connected to mobility.
More broadly, my observations on these submissions are as follows. I do consider that the distinction between ‘self-care’ and ‘self-management’ in sections 24(1)(c)(v) and (iv) of the NDIS Act is ambiguous. Reference to extrinsic material can assist to ascertain the meaning of these provisions.[53] The explanatory memorandum says:
[53] Acts Interpretation Act 1901, section 15AB.
The NDIS is designed to implement Article 26 by providing as much support to the greatest number of people with the widest range of disabilities. It does this by providing a variety of supports based on levels of assessed need, ranging from information, advice, specialist referral and linkages with mainstream services through to the provision of funding and support under a plan agreed with the participant.
Potential participants, or someone acting on their behalf, may request access to the scheme by providing information and documentation to the CEO of the Agency, in a specified form. Eligibility and assessment of need will be based on the World Health Organisation‘s International Classification of Functioning, Disability and Health (ICF).[54]
[54] National Disability Insurance Scheme Bill 2013: Revised Explanatory Memorandum, page 8.
I consider that referring to the ICF in an assessment of eligibility for access to the NDIS is consistent with the legislative intent. This legislative intent is also expressly referred to in Part 7 of the Becoming a Participant Rules which state:
7.2 The CEO may specify, in operational guidelines, assessment tools that may be used for the purposes of deciding whether a person meets the disability requirements or the early intervention requirements.
…
7.5 A tool must:
(a) be designed to ensure the fair and transparent assessment of whether a person meets the disability requirements or the early intervention requirements; and
(b) have reference to areas of activity and social and economic participation identified in the World Health Organisation International Classification of Functions, Disability and Health as in force from time to time
The Becoming a Participant Rules are not an extrinsic material. However, I am concerned that, if the Access Guidelines are an assessment tool specified under the Becoming a Participant Rules, and they do not include the ICF ‘domestic life’ and ‘major life areas’, it is difficult to see how Access Guidelines can properly be said to have reference to the areas of activity and social and economic participation identified in the ICF as required by rule 7.5(b).
I am also concerned that an interpretation that excludes the ICF ‘domestic life’ and ‘major life areas’ could be inconsistent with the guidance of the Full Federal Court in Foster that:
As such, the Guidelines are merely administrative “tools”. They do not provide a legislative definition of the relevant activities. They do not control the meaning of the phrase “substantially reduced functional capacity”. Nor do they alter the threshold criteria for when a person meets the disability requirements as specified in s 24(1) of the NDIS Act. They are not the equivalent of a statutory provision and are not to be construed in like manner: Australian Prudential Regulation Authority v TMEffect Pty Ltd [2018] FCA 508; 76 AAR 540 at [59] per Perry J. Rather, they provide non-exclusive content to the range of “tasks and actions” (as referred to in r 5.8) that comprise the “activities” the NDIA is required to consider, consistent with the legislative history, context, and purpose.
An approach which excludes some tasks based on how the Access Guidelines are construed, such that the statutory threshold is altered, does not appear to me to be consistent with the above finding in Foster.
I am less concerned with a possible inconsistency with the guidance in Mulligan. In my view, the paragraphs referred to by the Applicant do need to be read in the context that the Federal Court was considering the issue of whether it was sufficient for a person to have a substantially reduced functional capacity in relation to just one of the section 24(1) activities. The importance of a detailed functional assessment as set out in Mulligan appears to me to be consistent with the application of standardised assessments as prescribed in the Becoming a Participant Rules with reference to the ICF.
Overall, I am left with the impression that the Access Guidelines are either: not an assessment tool specified for the purpose of Part 7 of the Becoming a Participant Rules; or are in need of revision to ensure that they do clearly have reference to the areas of activity and social and economic participation identified in the ICF.
As I have said above, I do not consider that my conclusion in SHQH’s application turns on this issue. However, as this is an issue which potentially impacts other access matters it may be appropriate for the parties to apply for a referral to the Tribunal’s guidance and appeals panel.[55]
[55] Administrative Review Tribunal Act 2024, section 123.
Likely to require lifetime support of the NDIS
Section 24(1)(e) of the NDIS Act also requires that a person is likely to require support under the scheme for the person’s lifetime. At paragraph 93 of Foster, the Court clarified that:
The focus of s 24(1)(e) is on whether a prospective participant is likely to require support under the NDIS, or whether those support needs are most appropriately met by other systems.
The Agency submits that a person will only be likely to require support under the NDIS for their lifetime if their impairments substantially reduce their functional capacity. As I found that the Applicant does not have a substantially reduced functional capacity to undertake one or more of the activities in section 24(1)(c) of the NDIS Act I do not need to consider section 24(1)(e).
However, I did also invite the parties to make submissions with regards to the impact, if any, of the Applicant having now turned 65 with regards to the appropriateness of the Aged Care System to meet the Applicant’s support needs. I referred the parties to other Tribunal decisions that have considered situations in which applicants have turned 65 prior to a final Tribunal decision. The parties agreed that the circumstances in NRNK,[56] PNCB,[57] and Angelopoulos[58] were different from SHQH’s in that these other matters the respective Applicant’s were in receipt of supports under the Commonwealth Home Support Program (CHSP) provided through the Aged Care system. I agree with this assessment.
[56] NRNK and National Disability Insurance Agency [2024] AATA 110.
[57] PNCB and the CEO, National Disability Insurance Agency [2025] ARTA 66.
[58] Angelopoulos and National Disability Insurance Agency [2025] ARTA 521.
The parties disagreed as to whether my observations on this issue in Morris[59] were correct.
[59] Morris and National Disability Insurance Agency [2024] ARTA 186.
The Respondent submits that the Applicant would be appropriately supported by the CHSP under the Aged Care system. The Respondent highlighted services available under the CHSP that could assist the Applicant to live independently in her home for as long as possible. These services include:
• transport to appointments and activities
• domestic help (e.g. house cleaning, washing clothes)
• personal care (e.g. help with showering or dressing)
• home maintenance (e.g. changing light bulbs, gardening)
• minor home modifications (e.g. getting a grab rail installed)
• aids and equipment (e.g. bath seat, raised toilet seat, mobility aids)
• meals, help with food preparation and cooking skills, nutrition advice
• nursing (e.g. wound care)
• allied health (e.g. podiatry, physiotherapy, occupational therapy)
• social support (e.g. accompanied activities, group excursions)
• respite (care for you while your carer takes a break)
• specialised support (to provide you with advice on clinical conditions like hearing loss or incontinence).
The Applicant submits that, to the extent that the reasons in Morris relied on the guidance of the Federal Court in Foster, the Court has since provided further guidance on the application of Foster in Deayton.[60] The Applicant also made further submissions with regards to the application of the Applied Principles and Tables of Support to Determine the Responsibilities of the NDIS and other Service Systems (ATPOS). I would note Principle 11 of ATPOS is framed in terms or participants rather than prospective participants choosing to receive services under the NDIS or Aged Care System.
[60] National Disability Insurance Agency v Deayton [2025] FCA 562, [105, 108 -109].
I have considered these submissions from the parties and am grateful for them. As I do not need to determine this issue in SHQH’s matter, I will respectfully decline to go into further depth in addressing these submissions here. I would say however that, if I had found that SHQH met the requirements in section 24(1)(c), I would have needed to carefully consider whether the NDIS, Aged Care System, or other systems of support were most appropriate to provide supports for SHQH. This is particularly so in circumstances where the Applicant’s impairments may have worsened after she turned 65. Now that SHQH’s application at the Tribunal has been finalised, I encourage her to apply for assistance through these other programs.
DECISION
I am not satisfied that the Applicant meets the disability requirements as set out in section 24 of the NDIS Act. The Applicant is not eligible to become a participant of the NDIS. The decision of the Agency under review is affirmed.
Dates of hearing: 9, 10 and 11 June 2025 Date final submissions received: 15 August 2025 Solicitors for the Applicant:
Counsel for the Applicant:
Lana Bellingham-Young, Legal Aid Queensland
Peta Willoughby, Inns of Court
Solicitors for the Respondent:
Counsel for the Respondent:
Angela Barac, Maddocks Lawyers
Arron Hartnett, Higgins Chambers
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