Stringer and Chief Executive Officer, National Disability Insurance Agency (NDIS) - [2025] ARTA 2192

Stringer and Chief Executive Officer, National Disability Insurance Agency (NDIS) [2025] ARTA 2192 (13 October 2025)
Applicant:Sarah May Stringer
Respondent: Chief Executive Officer, National Disability Insurance Agency
Tribunal Number: 2024/7014

Tribunal:General Member A Colvin
Place:Brisbane
Date:13 October 2025

Decision:The Tribunal sets aside the decision under review made on 26 August 2024, which affirmed an approval of a statement of participant supports dated 20 June 2024, and remits this matter to the Respondent with a direction that within 21 days of the date of this decision, the Respondent must facilitate the approval of a statement of participant supports (SOPS) for the Applicant, containing the following provisions:
1. A provision to approve funding for the following supports:
(a) fortnightly psychology in place of the funding for psychology services in the existing SOPS dated 20 June 2024;
(b) no funding for plan management; and
(c) replication of the remaining reasonable and necessary supports in the existing SOPS dated 20 June 2024 on a pro rata basis from the date the supports in 1(a) and (c) are included in a SOPS to the varied review date; and

2. A provision that the funding be self-managed.

...........[SGD]....................
General Member A Colvin
Catchwords
NATIONAL DISABILITY INSURANCE SCHEME – National Disability Insurance Scheme Act 2013 (Cth) – consideration of section 34 – reasonable and necessary supports – psychology – occupational therapy – physiotherapy – osteopathy – nutritional therapy – exercise sessions – support worker assistance – gardening service – cleaning service – whether self-management of funding would present an unreasonable risk to participant – whether funding must be Agency-managed
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 Amendment (Getting the NDIS Back on Track No 1) Act 2024 (Cth)
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 (Cth)
National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (Miscellaneous Provisions) Transitional Rules 2024 (Cth)
National Disability Insurance Scheme Amendment (Management of Funding and Plan Management) Rules 2025 (Cth)
Cases
Drake v Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 60
National Disability Insurance Agency v WRMF [2020] FCAFC 79
Miller and National Disability Insurance Agency [2025] ARTA 1870
Secondary Materials
NDIS – Operational Guidelines Reasonable and necessary supports
Statement of Reasons
BACKGROUND

Ms Stringer is an adult participant in the National Disability Insurance Scheme (NDIS). She has multiple tertiary qualifications, works fulltime, is single and has two school-aged sons. Ms Stringer was granted access to the NDIS based on impairments arising from autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and anxiety disorder.
As an NDIS participant, Ms Stringer has a plan that includes a statement of participant supports (SOPS). The current SOPS was approved on 20 June 2024 by a delegate of the Chief Executive Officer (CEO) of the National Disability Insurance Agency (Agency) pursuant to the National Disability Insurance Scheme Act (NDIS Act). That decision was affirmed on internal review on 26 August 2024.
The current SOPS includes total funding of $27,187.40/year. That includes approximately $25,000 for improved daily living skills including occupational therapy, psychology, speech pathology, and individual skills building of three hours per week.
The funding in the current SOPS is plan-managed. Ms Stringer wants to self-manage the funding. Ms Stringer also seeks funding in the SOPS for additional supports (some of which were previously included in her plan) including:
·support worker assistance;
·fortnightly osteopathic or physiotherapy services;
·weekly exercise sessions;
·weekly psychotherapy;
·an assessment by a nutritional therapist;
·three hours/fortnight of gardening services;
·three hours/week of cleaning services; and
·additional occupational therapy.
Ms Stringer applied to the Administrative Appeals Tribunal (AAT) on 10 September 2024. From 14 October 2024, the AAT became the Administrative Review Tribunal.[1]
[1] Applications for review to the AAT that were not finalised before 14 October 2024 are taken to be an application for review to the Tribunal, and the Tribunal has authority to continue and finalise any aspect of the review not already completed by the AAT. See the transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024
The hearing took place by videoconference on 2, 3 and 4 October 2025. Ms Stringer was represented at the hearing by a friend, Ms Brix.
The Tribunal heard oral evidence from Ms Stringer and her support worker, Ms Walker. It also heard evidence from Ms Houston, an independent occupational therapist engaged by the Agency to undertake an assessment and provide a report.
The Agency provided a Statement of Facts, Issues and Contentions (SFIC). Documents available to the Tribunal included:
·a joint hearing bundle lodged by the Agency (Exhibit 1);
·a letter from Dr Couchman dated 19 September 2025 (Exhibit 2);
·signed terms of agreement dated 17 September 2025 (Exhibit 3); and
·document prepared by Ms Brix describing Dr Couchman’s qualifications (Exhibit 4).
THE LAW
The legislative framework
The statutory provisions relevant to this application for review are found within the NDIS law, including:[2]
·the NDIS Act;
·the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth) (Supports Rules);
·the National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (Miscellaneous Provisions) Transitional Rules 2024 (Cth) (Miscellaneous Provisions Rules);
·the National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 (Cth) (NDIS Supports Transitional Rules); and
·the National Disability Insurance Scheme Amendment (Management of Funding and Plan Management) Rules 2025 (Cth) (Management of Funding Rules).
[2] The statement of the law that follows largely adopts the summary in Miller and National Disability Insurance Agency [2025] ARTA 1870
The Agency also issues Operational Guidelines. The Tribunal is not bound to follow Operational Guidelines issued by the Agency but, in the absence of any statutory indication to the contrary, any lawful executive policy enacted to guide the exercise of a statutory power is a relevant factor for the Tribunal to take into account in performing its review task.[3] Operational Guidelines considered in the present matter are published by the Agency on its website and include guidelines on Reasonable and Necessary Supports.[4]
[3] Re Drake v Minister for Immigration and Ethnic Affairs(No 2) (1979) 2 ALD 634
[4] Webpage: ourguidelines.ndis.gov.au
Approving the SOPS in participants’ plans
Section 3 of the NDIS Act sets out the objects of the NDIS Act. Sections 4 and 5 of the NDIS Act set out general principles guiding actions under the NDIS Act, and sections 17A and 31 of the NDIS Act set out principles that relate to participation in the NDIS and plans.
If a person becomes a participant, under section 32 of the NDIS Act the CEO must facilitate the preparation of a plan for the participant. Ms Stringer’s plan is an ‘old framework plan’. For those plans, section 33 of the NDIS Act sets out the matters that must be included in a participant’s plan. A plan must include a statement of the participant’s goals and aspirations. It must also include a SOPS, prepared with the participant and approved by the CEO. The SOPS in a participant’s plan must specify, among other things, ‘the reasonable and necessary supports (if any) that will be funded’ under the NDIS.[5]
[5] Paragraph 33(2)(b) of the NDIS Act
When approving a SOPS in a participant’s plan, the CEO must comply with the mandatory requirements contained in subsection 33(5) of the NDIS Act. One of the requirements in subsection 33(5) is that the CEO ‘be satisfied as mentioned in section 34 in relation to the reasonable and necessary supports that will be funded’: paragraph 33(5)(c) of the NDIS Act.
Subsection 34(1) of the NDIS Act deals with ‘reasonable and necessary supports’.[6] It sets out matters that the decision-maker must be satisfied about before funding a support. These are more than mandatory considerations. They are more in the nature of criteria that the decision‑maker must be positively satisfied about on the material.[7]
[6] After Ms Stringer applied to the AAT, the NDIS Act was amended by the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1) Act 2024 (Cth) (the Amending Act). This is subsection 34(1) of the NDIS Act as amended. The effect of item 129 in Part 3, Schedule 1 to the Amending Act is that the Tribunal can only vary the SOPS in Ms Stringer’s plan if section 34 of the NDIS Act, as amended by the Amending Act, is met.
[7] National Disability Insurance Agency v WRMF [2020] FCAFC 79 at 201
34 Reasonable and necessary supports
(1) For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:
(aa)the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements (see section 24) or the early intervention requirements (see section 25);
(a)the support will assist the participant to pursue the goals, objectives and aspirations included in the participant’s statement of goals and aspirations;
(b)the support will assist the participant to undertake activities, so as to facilitate the participant’s social and economic participation.
(c)the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support;
(d)the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice;
(e)the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide;
(f)the support is a NDIS support for the participant.
Note: For the purposes of paragraph (aa):
(a)the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and
(b)a participant’s disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.
When approving a SOPS in a participant’s plan the Supports Rules are relevant. The Miscellaneous Provisions Rules are also relevant. Rule 7 imposes a requirement that the support is most appropriately funded through the NDIS and not through other systems or bodies as part of universal service obligations or in accordance with reasonable adjustments required under laws dealing with discrimination.
Specifying the management of funding in SOPS
The SOPS in a plan must specify the management of the funding for supports under the plan, by specifying either that the funds are to be managed wholly, or to a specified extent by the participant or the plan nominee (self-managed), or by a registered plan management provider (plan-managed), or by the Agency (Agency-managed).[8]
[8] Section 42 of the NDIS Act
Subsection 43(3) of the NDIS Act states that, if a participant chooses to self-manage funds, the SOPS in the participant’s plan must provide for the funding to be Agency-managed if subsection 44(1) of the NDIS Act applies in relation to the participant. Subsection 44(1) applies to a participant if the participant is an insolvent or convicted of certain offences, or where compliance with provisions on acquittal of funds is unlikely. It also applies if paragraph 44(1)(b), which deals with ‘unreasonable risk’, is met:
(b) the CEO is satisfied that the participant’s management of the funding for supports under the plan to a particular extent would:
(i) present an unreasonable risk to the participant; or
(ii) permit the participant to manage matters that are prescribed by the National Disability Insurance Scheme rules as being matters that must not be managed by a participant.
In determining, for the purposes of subsection 44(1) of the NDIS Act, whether self-management would present an unreasonable risk to a participant, regard must be had to Part 3 of the Management of Funding Rules, particularly the matters set out in Rule 6(2).
CONSIDERATION
Ms Stringer’s goals
Ms Stringer’s goals, set out in her current plan, include goals around healthier eating habits, friendships, coping strategies, budgeting, developing skills at home and in the workplace, and maintaining a clean house and garden.
The evidence
I make the following observations about the evidence.
Evidence from allied health professionals
It was submitted on Ms Stringer’s behalf that I should prefer the evidence of her treating practitioners to that of Ms Houston. The information that Ms Stringer provided included reports from the following practitioners:
·Dr Couchman (various letters, most recently 17 September 2025);
·Mr Phoon, physiotherapist (report dated 9 August 2024);
·Ms Tay, occupational therapist (report dated 7 August 2024);
·Ms Hayward, occupational therapist (report dated 14 December 2023);
·Ms Botter, osteopath (report dated 6 November 2023); and
·Mr Metrovich, occupational therapist (report dated 1 September 2022).
However, none of the above practitioners gave oral evidence. That meant that the Tribunal was unable to clarify or test the opinions they had expressed in their reports. Also, most of the reports were at least a year old and Ms Stringer’s circumstances had changed significantly. In contrast, Ms Houston gave oral evidence and could indicate her current view in light of Ms Stringer’s evidence and changed circumstances. It was also possible to clarify with Ms Houston her reasoning for some of the conclusions she had reached.
Further, unlike Ms Houston’s report, the reports by the above practitioners generally did not comply with all the requirements in the Tribunal’s practice directions regarding expert reports. Those requirements include requirements that the Tribunal be provided with details of the qualifications and expertise of the expert, and letters of instruction, and that the report contain a declaration that the expert understood they had an overriding duty to provide impartial assistance to the Tribunal and that no matters of significance had been withheld from the Tribunal. Failure to comply with these requirements can affect the reliance the Tribunal can place on a report.
This was a significant issue with Dr Couchman’s letters. Until recently, Ms Stringer saw Dr Couchman regularly for counselling. Ms Stringer described a process of going back and forth with Dr Couchman about the content of Dr Couchman’s recent letter. Ms Stringer denied telling Dr Couchman what to write in that letter but did give examples of suggestions she made to Dr Couchman. None of that exchange with Dr Couchman, or any earlier draft of Dr Couchman’s letter, was provided to the Tribunal.
In addition, the Tribunal was not provided with reliable evidence of Dr Couchman’s qualifications and experience. Ms Brix contended that Dr Couchman was a psychologist but Dr Couchman described herself in her most recent letter as an ‘autism psychotherapist’ who had provided ‘counselling’ to Ms Stringer. There is nothing on the face of that letter to indicate that Dr Couchman has medical qualifications or qualifications and current registration as a clinical psychologist. Ms Brix provided a resume for Dr Couchman generated by Ms Brix from internet sources, using AI. It states that Dr Couchman has a Master of Clinical Psychology and PhD in Clinical Psychology, that she is registered as a psychologist with AHPRA, and that she is currently a Senior Lecturer in Clinical Psychology at the University of Sydney. Given the potential for serious error in that document I am unable to rely on it as an accurate representation of Dr Couchman’s experience and qualifications.
I acknowledge the reasons that Ms Stringer was unable to provide Dr Couchman’s resume. However, the result is that I cannot place significant weight on Dr Couchman’s letter. I accept that she has provided counselling to Ms Stringer but, beyond that, it is not clear what qualifications and experience she has and whether she is an expert qualified to provide an opinion on relevant matters.
For these reasons, I have had regard to the letters and reports provided by Ms Stringer from treating allied health practitioners. In general, however, in determining the supports that are reasonable and necessary now for Ms Stringer I prefer the evidence of Ms Houston.
Ms Stringer’s evidence
In general, I have also placed limited reliance on Ms Stringer’s own evidence in determining her functional capacity and need for supports. Ms Stringer gave extensive oral evidence. She said several times during the hearing that she was not explaining herself well. However, she was articulate and responded comprehensively in her evidence.
The reason that I have generally placed limited reliance on Ms Stringer’s evidence is that it is difficult to reconcile aspects of her evidence. For example, Ms Stringer gave evidence that she could self-manage her own funding, that she worked fulltime managing supports for other NDIS participants, that she liked her work, that she did not struggle with a spreadsheet and calculating how much needs to go where and sending invoices, and that she liked budgeting.
However, in describing her current need for a support worker, Ms Stringer said she required assistance at present for four hours/week and that this would be taken up with assistance in ‘life admin’ matters. She gave examples of a support worker assisting her to pay bills, ensure her rent was paid, deal with Centrelink, and seek assistance from community organisations. Even allowing for some variability in Ms Stringer’s impairments, it is difficult to reconcile this evidence of very reduced functional capacity for self-management and a need for significant support with her evidence that she can manage supports for other NDIS participants.
Similarly, in her evidence, Ms Stringer described extremely reduced functional capacity in grocery shopping and cooking and a need for assistance, which she attributed to ASD. She said that, although she might know the steps in a task, executive dysfunction prevented her from putting that into practice. She said that she might know she needed to cook something but could look at a recipe book for four hours and never decide what to make because there were so many decisions involved. If she did decide on what to cook, she would then have to go to the supermarket to buy the ingredients, but if one of those ingredients was not there, she would ‘freeze up completely’. She said that the same issues then arose when attempting to cook that meal.

Ms Stringer said that she needed someone to assist with meal preparation. She felt she needed somebody to help her make decisions and to help her, step-by-step, prepare meals. She also needed someone to help her to ‘know what to do’ with those meals (for example, to not leave them on the stove overnight).
Eventually, Ms Stringer was asked in cross-examination whether she was still able to, as a worst‑case scenario, reheat a frozen meal. She would only concede that she could reheat a frozen meal ‘after a meltdown’.
Ms Stringer trained overseas at Le Cordon Bleu and has worked as a cook. In her evidence she said she only just passed the training, that it was not an elite course when she attended, and that it was more than 15 years ago. She also asserted that cooking in a restaurant was not the same as cooking a meal at home for herself and her children. Even so, it is difficult to reconcile this evidence and accept that, despite previously training and working as a cook, and currently working fulltime managing other people’s NDIS funding, Ms Stringer’s impairments from ASD, anxiety or ADHD result in such reduced functional capacity in grocery shopping and cooking that she struggles to reheat a frozen meal or buy ingredients and requires a support worker to provide step-by-step assistance with meal preparation.
Ms Stringer’s impairments
To meet the requirements of paragraph 34(1)(aa) of the NDIS Act, any supports Ms Stringer seeks must be supports that are necessary to address needs of Ms Stringer from an impairment in relation to which she meets the access requirements, that is, the disability requirements in section 24 or the early intervention requirements in section 25.
Ms Stringer was granted access to the NDIS based on impairments arising from ASD, anxiety and ADHD. There was also evidence however that she may experience hypermobility, chronic fatigue syndrome, and disordered eating, and I have therefore next considered these issues.
Hypermobility
Ms Stringer asserted that she has hypermobility, and the material includes reference to Ehlers‑Danlos syndrome (EDS). Ms Stringer’s evidence was that she had obtained a referral to a rheumatologist to investigate whether she has EDS but had not yet seen that specialist.
Ms Stringer’s osteopath, Ms Botter, provided a report dated 16 November 2023 indicating that Ms Stringer had shown ‘strong signs’ of hypermobility and noted that there was a strong link between EDS and ASD. Ms Tay provided a report dated 7 August 2024 noting that Ms Stringer had ‘joint hypermobility syndrome’ but did not indicate the basis for that statement. Mr Phoon provided a report on 9 August 2024. He recorded Ms Stringer’s comments to him about hypermobility and noted that there is increasing evidence linking autism and hypermobility.
If Ms Stringer has impairments from EDS (or another condition that includes hypermobility as a symptom), I am not satisfied on the material before me that she meets the access requirements regarding those impairments. At its highest, the evidence is that in 2023 an osteopath observed that Ms Stringer had ‘strong signs’ of hypermobility. There is no current, comprehensive evidence from an appropriately qualified health practitioner addressing diagnosis of a condition, associated impairments, and permanency of those impairments (including treatment options, if any, for those impairments). EDS and ASD are different conditions. Even if there was reliable evidence before me of a correlation, that is not evidence that a person has a condition and has impairments from that condition and that the access requirements are met. I am therefore not satisfied that any of the requirements in subsections 24(1) or 25(1) are met in relation to hypermobility and/or impairments from EDS.
Chronic Fatigue Syndrome (CFS)
Ms Stringer’s evidence was that she has been diagnosed with CFS by her GP. It was not contended on Ms Stringer’s behalf that she has impairments from CFS that meet the access requirements and I am not satisfied on the material before me that she does so. There is no evidence from an appropriately qualified expert confirming she has CFS and has impairments from CFS, and addressing issues such as treatment options, and permanency of those impairments. In the absence of that evidence, I am unable to be satisfied that Ms Stringer has impairments from CFS and that those impairments are permanent, or likely to be permanent. I am therefore not satisfied that any of the requirements in subsections 24(1) or 25(1) are met in relation to impairments from CFS.
While I am not satisfied that the access criteria are met regarding impairments from CFS, I accept on Ms Stringer’s evidence that she has been experiencing daily exhaustion. Ms Stringer acknowledged that CFS caused daily tiredness but also asserted that she was exhausted because of ASD. I accept that she may experience tiredness as an impairment related to ASD or anxiety. In the absence of evidence addressing this issue, however, I consider it more likely that her tiredness is multifactorial and situational, given the many demands on her time and recent stressful events.
At the time of the hearing, Ms Stringer had many demands on her time and resources. She was trying to maintain a house and garden, care for two children, and deal with ongoing court proceedings, financial strain, recent major life events and multiple changes in her employment. This included recently commencing a new fulltime role.
Disordered Eating
In her evidence, Ms Stringer described a range of current issues with eating. These included a complete absence of appetite or thirst, going long periods without food or water, consuming an extremely restricted range of foods and fluids, and feeling revulsion at certain foods. Ms Stringer asserted that her current issues with eating were all ‘sensory issues’ attributable to ASD.
However, Ms Houston recorded that Ms Stringer informed her that she had previously been diagnosed with an eating disorder. Ms Houston thought that, while Ms Stringer’s eating may be influenced by some sensory-based food aversion ‘related to her neurodivergent traits’, the main condition or impairment was her untreated bulimia nervosa.
Ms Stringer said that she had never been formally diagnosed with an eating disorder. She said that she had always experienced disordered eating, that she had experienced ‘bouts of anorexia and bulimia’, and that she last experienced bulimia about three years ago. She said that about nine months ago she asked her GP for a referral to a particular eating disorders clinic but he declined. She said her GP did not regard her as having an eating disorder but he had recently prescribed a new medication for her anxiety. She commenced taking that medication in the weeks before the hearing. Prior to that, she had not been taking medication for anxiety for six months.
It was not contended on Ms Stringer’s behalf that she has an eating disorder and that impairments from that condition meet the access requirements, and I am not satisfied on the material before me that is the case. This is because, in the absence of comprehensive evidence from an appropriately qualified medical practitioner or mental health professional addressing matters including the diagnosis, impairments, and treatment for those impairments, I cannot be satisfied that any of the requirements in subsections 24(1) or 25(1) are met in relation to impairments arising from an eating disorder.
Although I am not satisfied that Ms Stringer meets the access requirements regarding impairments from an eating disorder, I am satisfied based on her evidence that she has recently been experiencing disordered eating.
Ms Stringer’s assertion, that her disordered eating is an impairment arising from ASD, was supported to some extent in the letter provided by Dr Couchman dated 17 September 2025:
Some points that Sarah and I have discussed are related to her interoceptive system as she has difficulty regulating her intake of fluids and foods. Sarah does not often receive signals indicating that she needs to eat or drink and can go all day at work without stopping to do so. She also has sensitivity to taste and smell that can make eating more difficult. We have discussed strategies to prompt her or make eating more appealing, however, she has continued to struggle in this area. Sarah requires support from an OT, Speech Therapist or Dietitian to assist with developing additional strategies to encourage regular food and liquid intake. Sarah would require fortnightly sessions with an OT, Speech Therapist or Dietitian.
Dr Couchman has not addressed the issue directly in her letter. I have also set out earlier some issues regarding Dr Couchman’s letter. She did not give oral evidence, the Tribunal had no reliable details of her qualifications and experience, and Ms Stringer also described correspondence with Dr Couchman over the content of the letter. Given these factors, I am unable to place weight on Dr Couchman’s letter as an expert opinion that Ms Stringer’s disordered eating is an impairment related to her ASD.
It may be that Ms Stringer’s disordered eating is a permanent impairment of ASD or anxiety but I am unable to conclude this on the evidence before me. There is no reliable evidence supporting this and the evidence raises the possibility that Ms Stringer’s disordered eating is instead an impairment related to an undiagnosed and untreated eating disorder or a temporary exacerbation of symptoms of anxiety for which she has recently recommenced medication. I note in that regard the nature and severity of the symptoms Ms Stringer reported, the history Ms Stringer described of ‘bouts of bulimia and anorexia’, her GP’s recent decision to prescribe medication for anxiety, and Ms Houston’s opinion.
Psychology
At the commencement of the hearing, Ms Brix indicated that Ms Stringer sought funding for weekly therapy of one hour with a psychotherapist.
In her report, Ms Houston considered fortnightly counselling sessions ‘more than adequate’. In discussing the frequency of those appointments, she noted that Ms Stringer had been attending appointments by telehealth in her car while her children attended appointments. Ms Houston regarded it as important that Ms Stringer was not overwhelmed with commitments and was able to attend appointments face-to-face.
Prior to the hearing, the parties provided a signed agreement dated 17 September 2025 asking the Tribunal to remit the matter to the Respondent for reconsideration pursuant to section 85 of the Administrative Review Tribunal Act 2024. Given the proximity to the hearing, the Tribunal did not make an order for remittal. Relevantly, the terms noted that the request was made having regard to the Respondent’s intention to recommend to a delegate of the CEO that certain supports be included in Ms Stringer’s SOPS, one of which was fortnightly psychology. During the hearing, Ms Stringer stated that she was unaware of that signed agreement. However, she confirmed that she would no longer press her claim for weekly psychotherapy and would accept funding for fortnightly psychology sessions.
Having regard to the evidence before me, including Ms Houston’s report, I am satisfied that the Agency’s concession is appropriately made and that the requirements of subsection 34(1) of the NDIS Act are met for fortnightly psychology sessions.
Occupational therapy
Occupational therapy is funded in the current SOPS at a level of 40 hours/year. Ms Stringer sought funding for an additional 30 hours/year of occupational therapy, that is, 70 hours/year of occupational therapy. However, during the hearing, Ms Stringer said that she sought one hour/week of occupational therapy plus sufficient funding for a report which she considered would require six hours. This totals 32 hours/year.
The Agency contended that funding beyond 40 hours/year did not meet the requirements in paragraph 34(1)(aa) of the NDIS Act.
Ms Tay recommended occupational therapy of 30 hours/year in 2024. Ms Houston considered that some occupational therapy support was required. She noted Ms Tay’s recommendation and the current funding of 40 hours/year and made no recommendation for additional occupational therapy.
In the absence of any evidence supporting funding of 70 hours/year of occupational therapy, I am unable to be satisfied that paragraphs 34(1)(aa) and (c) of the NDIS Act are met for funding at that level. In either case, funding at that level was ultimately not pressed by Ms Stringer.
I am satisfied however that paragraphs 34(1)(aa) and (c) of the NDIS Act are met, based on Ms Houston’s report, for funding of 40 hours/year. I am also satisfied that the Agency’s concessions regarding the remaining requirements in subsection 34(1) are appropriately made. As each of the requirements of subsection 34(1) of the NDIS Act is met, the funding for occupational therapy at 40 hours/year is a reasonable and necessary support pursuant to subsection 34(1) of the NDIS Act.
Nutritional therapy
At the commencement of the hearing, Ms Brix clarified that Ms Stringer sought funding for an assessment with a nutritionist, estimated to involve two hours for an assessment and three hours for report writing. Ms Stringer did not seek funding for ongoing contact during the year with a nutritionist.
Ms Tay recorded in her report on 7 August 2024 that Ms Stringer informed her that she was not able to prepare meals due to her atypical sensory processing ‘and past trauma’ and that meals were prepared by her partner at the time of that report. Ms Tay also recorded that Ms Stringer was limited in her ability to try foods with different textures and to develop nutritious food to maintain her physical wellbeing, and that Ms Stringer reported that tremors in her hands (related to joint mobility) impaired her ability to use a knife and pan. Ms Tay recommended that Ms Stringer receive funding for dietician services to assist and support Ms Stringer with different types of food textures and to plan suitable balanced meals to provide a better quality of life.
The Agency submitted in its SFIC that assistance from a nutritional therapist was not a support related to an impairment for which the Applicant was granted access to the scheme, as required by paragraph 34(1)(aa) of the NDIS Act. It also submitted that the Tribunal could not be satisfied that this support was most appropriately funded under the NDIS. It contended that the diagnosis and clinical treatment and management of an eating disorder was more appropriately dealt with under the universal healthcare system.
For reasons that have already been set out, I am unable to be satisfied on present evidence that Ms Stringer’s disordered eating is an impairment attributable to ASD or anxiety. This means that the requirements of paragraph 34(1)(aa) of the NDIS Act are not met for nutritional therapy.
Even if Ms Stringer’s disordered eating is the result of an exacerbation of symptoms of her anxiety, in my view nutritional advice in that context is clinical in nature. The NDIS is not intended to replace health services. Having regard to Rules 7.6 and 7.7 of the Supports Rules and Rule 7 of the Miscellaneous Provisions Rules, services that are clinical in nature are not a reasonable and necessary support that could be included in a SOPS for Ms Stringer.
Further, even if nutritional advice might assist in regard to Ms Stringer’s impairments arising from ASD, I am not satisfied on current evidence that this support will be, or is likely to be, effective and beneficial for Ms Stringer, having regard to current good practice.
Ms Houston considered that Ms Stringer had an eating disorder and recommended treatment and support for that condition rather than nutritional advice for ASD. In recommending dietitian support, Ms Tay does not address the possibility that Ms Stringer has an untreated eating disorder or disordered eating related to an exacerbation of her anxiety, and I am therefore unable to rely on her recommendation. If Ms Stringer does have an eating disorder, that is a serious mental health condition, carrying serious risks. It requires specialised treatment and care.
If Ms Stringer has disordered eating related to an eating disorder or an exacerbation of her anxiety, I am not satisfied that it is likely to be effective and beneficial for Ms Stringer, having regard to current good practice, to provide nutritional advice other than in conjunction with investigation and clinical management of her disordered eating. This means that the requirement in paragraph 34(1)(d) of the NDIS Act is not met.
For these reasons, I am not satisfied that the requirements of paragraphs 34(1)(aa) and (d) of the NDIS Act are met.
Osteopathy, physiotherapy and exercise sessions
Ms Stringer sought funding for fortnightly sessions lasting one hour with either an osteopath or physiotherapist. Ms Stringer also sought funding for weekly exercise sessions. In her own evidence she said that there were physical symptoms that came with ASD, and that it could affect a person’s whole body. She was concerned that if she attended a gym and tried to, for example, lift weights, she might injure herself if she did this without guidance.
In a report in November 2023, Ms Botter recommended that Ms Stringer engage in fortnightly one-hour osteopathic sessions at a total cost of approximately $5,000/year, and weekly exercise sessions at a cost of approximately $4,700/year. Ms Botter’s report refers to hypermobility and EDS. It does not clearly indicate why this support is necessary to address Ms Stringer’s needs arising from impairment related to ASD, anxiety or ADHD. The only connection is a reference to individuals with ASD experiencing pain and to osteopathy helping to ‘identify dysfunctions and the cause of pain’.
In August 2024, Ms Tay recommended that Ms Stringer receive 60 hours of physiotherapy or osteopathy services to monitor and manage her mobility progression and regression, and to implement a falls prevention strategy
In August 2024, Mr Phoon, physiotherapist, provided a report stating that Ms Stringer would benefit from fortnightly physiotherapy of 30 minutes per week costing approximately $5,000/year. He considered that Ms Stringer’s overall fitness and pain levels had been affected by ASD. However, he then referred to ‘central nervous system syndromes’ and hypermobility.
Ms Houston did not recommend physiotherapy and osteopathy services. She regarded the requests for those supports as requests related to hypermobility. Ms Houston regarded the request for exercise sessions as a request related to Ms Stringer’s general wellbeing.
The Agency contended that the requirements in paragraph 34(1)(aa) of the NDIS Act were not met in relation to physiotherapy, osteopathy and exercise sessions. I agree with that submission. This is because the evidence set out above from treating practitioners does not establish that physiotherapy, osteopathy and exercise sessions are necessary to address needs of Ms Stringer from an impairment in relation to which she meets the access requirements. The reports do not provide a clear connection to impairments from ASD, ADHD and/or anxiety.
Regarding exercise sessions, I accept on Ms Houston’s evidence that exercise may benefit Ms Stringer’s general wellbeing. However, that is not the test in paragraph 34(1)(aa) of the NDIS Act. It requires that the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the access requirements.
Further, Ms Stringer can engage in a wide range of exercise without weekly exercise sessions. In fact, Ms Houston commented in her report on the other demands on Ms Stringer’s time (including work, therapies, and caring commitments), the risk that she will feel more overwhelmed by attending exercise sessions, and the desirability instead of Ms Stringer incorporating functional exercises into her daily routine with input, for example, from an occupational therapist.

I am therefore not satisfied on the evidence that the requirements of paragraph 34(1)(aa) of the NDIS Act are met in relation to physiotherapy, osteopathy and exercise sessions.
Support worker assistance, gardening and cleaning services
Ms Stringer sought funding for a support worker for four hours/week throughout the year. She also sought funding for a gardener for three hours/fortnight and a cleaner for three hours/week.
The Agency conceded that some support worker assistance was appropriate and this was reflected in the request for remittal dated 17 September 2025 indicating an intention to include funding as follows:
1:1 support worker assistance weekday rate for a 12-month period as follows:
o   four hours per week for first four months
o   three hours per week for the following two months
o   two hours per week for remaining six months.
The Agency’s concession was based on Ms Houston’s recommendations in her report. The Agency contended that funding beyond that level did not meet the requirements in paragraph 34(1)(aa) of the NDIS Act.
The Agency also contended that gardening and cleaning did not meet the requirements in paragraphs 34(1)(aa), (c) and (d) of the NDIS Act. It considered that an occupational therapist could support Ms Stringer to address issues in relation to completing gardening and cleaning and that funding these supports separately would constitute a duplication of supports. It referred to Rule 5.1 of the Supports Rules.
Ms Stringer’s evidence was that she wanted a cleaner to guide her and help her. She said she wanted to be able to do the tasks herself and stay on track. She referred to executive dysfunction. She said that it was the steps that go into cleaning and sensory overload that make a task so much harder if there is not someone there to guide or assist with that task.
Regarding gardening, Ms Stringer said that she enjoyed gardening and had raised garden beds where she grew vegetables and that she was able to perform this aspect of gardening. She said that she lived in a rental property and was required to maintain the garden. She wanted a gardener to assist with tasks such as lawn mowing and tree lopping and trimming. She described these as things she was not ‘physically and mentally capable of doing’.
At the same time, Ms Stringer’s evidence was that she did not want someone to do gardening tasks for her, and that instead she wanted somebody to help her. Asked to explain why the tasks she described would take a gardening service three hours/fortnight to complete, she said that a gardener could probably do the task in an hour but that it took longer because she always worked beside the gardener, and that slowed the gardener down. She thought mowing lawns might be fun but was concerned about the physical and mental energy required. She was also concerned about performing some tasks herself, noting that last time she tried to use a whipper snipper she had injured herself because she forgot it was on.
Ms Stringer acknowledged that, like many people working fulltime and caring for children and pets, she would struggle with gardening and cleaning. However, she said that she had an extra challenge. She did not agree that it was her commitments, including fulltime work and caring for children, that prevented her from attending to gardening and cleaning.
Later in her evidence, Ms Stringer said that lawn mowing was painful on her hands because of ‘sensory vibrations’ on her body and that she could only mow for around five minutes and could not mow her entire lawn. Nor could she wear gloves because gloves would ‘literally burn’. She said that by working with the gardener, the gardener could take over the mowing from her and direct her to do another task.
Regarding support worker assistance, Ms Stringer’s evidence was that she required four hours of assistance and would likely use that four hours/week of assistance in a single block at first, but then in two blocks of two hours. She would initially use that time to assist her with ‘life admin’ tasks. That included assistance with paying bills, making sure the rent was paid, engaging with Centrelink, and accessing community organisations that provide support. She thought that the time would also be spent now with organising appointments and ‘admin’ for the week. There were no tasks, such as assistance with personal care, that she identified as being tasks that she required assistance with each week. She also did not identify any time at present as being spent assisting with cooking, despite her evidence about her need for assistance with cooking.
Ms Walker gave evidence that she had worked as a support worker for many years. She said that she was providing six hours/week of assistance to Ms Stringer as an independent support worker and had been providing support to Ms Stringer for about 12 months. She said that she commenced working for Ms Stringer after she was approached directly by Ms Stringer. She had known Ms Stringer because she and Ms Stringer’s former partner had been colleagues. Ms Walker said that she had a Bachelor of Arts, a Diploma of Community Development and a Certificate in Aged Care.
Ms Walker said that she generally provided support work assistance to Ms Stringer in the evenings after Ms Stringer had finished work for the day. This included assistance with meal planning and preparation, including deciding on meals to prepare within the resources Ms Stringer had. Ms Walker said she also assisted Ms Stringer with budgeting, and communicating with agencies such as Centrelink and service providers. She also prompted Ms Stringer to consume food and fluids and prompted her with self-care. Ms Walker said she also assisted in ‘task breakdown’ to assist with ‘task paralysis’ when Ms Stringer was overwhelmed. Ms Walker said she was involved in a community garden and could assist Ms Stringer with gardening if that was something Ms Stringer required.
Ms Walker gave evidence that she often spoke to service providers on Ms Stringer’s behalf, on speaker phone, and prepared notes in advance with Ms Stringer. She said that Ms Stringer was very articulate but experienced ‘paralysis’, and that she found engaging with service providers emotionally draining and exhausting.
Ms Walker’s evidence was that Ms Stringer prioritised her children over her own care and focused on her work. Ms Walker acknowledged that when Ms Stringer had a more exhausting day at work, she was more burnt out and her capacity was reduced, and in the weeks when she did not have the care of her children, Ms Stringer had greater capacity. However, she said there was no shift where it was not necessary to assist Ms Stringer with the kinds of tasks she had described.
Ms Hayward recommended in her report in 2023 that Ms Stringer receive three hours/fortnight of gardening services and three hours/week of cleaning services. She recorded that Ms Stringer reported being able to perform gardening but needing assistance to plan, organise and complete gardening. She also recorded that Ms Stringer reported cleaning was affected by planning, energy levels and motivation.
Ms Tay recommended in 2024 that Ms Stringer receive gardening support of four hours/fortnight for ‘front and back yard maintenance’. She also recommended ‘six hours/week of support hours for home management including meal preparation, house cleaning, household management and more’. She referred in her report to distraction from ASD and ADHD impacting completion of tasks, symptoms of anxiety impacting Ms Stringer’s efficiency in completing tasks, sensory issues affecting meal preparation, and anxiety and ASD symptoms affecting Ms Stringer’s ability to independently go shopping. Ms Tay also referred to hypermobility affecting completion of tasks.
Ms Houston recommended support worker assistance for the hours set out above. She did not recommend support in the form of gardening services or cleaning services.
Ms Houston said that Ms Stringer had described her support worker as a ‘body double’ in that Ms Walker would perform a task and Ms Stringer then copied that task. Ms Stringer also reported to Ms Houston that if she became very overwhelmed, Ms Walker provided ‘hand-over-hand’ support. Ms Stringer gave Ms Houston an example of sitting with her support worker to fold laundry, and reported to Ms Houston that sometimes she was so overwhelmed that she did not know what to do or how to get started. Ms Houston also reported that Ms Stringer described Ms Walker helping to organise her home, go shopping, and cook a meal.
Ms Houston concluded that support worker assistance would assist Ms Stringer to make a successful transition into her new role. That was Ms Houston’s reasoning for recommending decreasing support hours over the year.
In her oral evidence, Ms Houston maintained the view she had expressed in her report regarding the amount of support worker assistance required in the next year. This was despite her assessment taking place more than six months ago, and the significant changes in Ms Stringer’s circumstances since then. She considered that recent changes in Ms Stringer’s circumstances meant that the same model, of reducing support, would apply now.
Ms Houston was asked in oral evidence to explain how she considered that Ms Stringer could effectively utilise four hours of support and the kinds of tasks the support worker would undertake. Ms Houston said that she found Ms Stringer’s approach to support workers and cleaners intriguing and inconsistent. She noted that Ms Stringer reported using a support worker by sitting beside her to do tasks such as folding washing and using a hand-over-hand technique. Ms Houston said it was unclear whether Ms Stringer was asserting a skills deficit or that she lacked the energy to undertake tasks like cleaning.
Ms Houston did not consider that Ms Stringer required support worker assistance to learn how to do tasks since Ms Stringer knew how to cook and clean. Ms Houston also did not regard it as efficient for Ms Stringer to use a support worker to prompt her to undertake tasks. In Ms Houston’s view, if the issue was prompting, then that was best addressed with strategies from an occupational therapist together with appropriate assistive technology.
Ms Houston’s evidence was also that, at the time she assessed Ms Stringer, she did not require assistance with tasks such as calling Centrelink or attending community organisations. In her report Ms Houston noted the personal relationship between Ms Stringer and Ms Walker, and in her oral evidence she indicated that a support worker provided some social interaction.
I have had regard to Ms Walker’s evidence regarding the way she assists Ms Stringer. However, in determining whether, and to what degree, support worker assistance is a reasonable and necessary support for Ms Stringer, Ms Walker does not have the necessary level of expertise or qualifications in, for example, mental health or occupational therapy, that would be relevant in assessing the assistance required by Ms Stringer.
I am also unable to place significant weight on the opinions of Ms Hayward and Ms Tay for reasons set out earlier. Their recommendations are not recent and there have been significant changes since then. They also did not provide oral evidence and it was therefore not possible to fully understand and test their opinions. For example, it was not possible to ascertain the extent to which hypermobility was a factor in Ms Tay’s recommendations.
Ms Stringer is single, working fulltime, maintaining a rental property, caring for pets, dealing with significant life events and has caring responsibilities for two children. She would clearly benefit from assistance with gardening and house cleaning. However, for those services to be funded under the NDIS, they must, as a first requirement, be necessary to address needs of Ms Stringer from an impairment in relation to which she meets the access requirements.
I accept that Ms Stringer experiences issues with planning and completing tasks, and with motivation, related to ASD, anxiety and/or ADHD. I also accept that she experiences fatigue related to ASD and anxiety, although for reasons set out earlier, I regard the cause of her fatigue as multifactorial.
Ms Stringer gave evidence that she enjoys gardening. Her request for gardening services primarily relates to assistance with lawn mowing and tree trimming. She may prefer assistance with these gardening tasks, or require this due to physical conditions. I am not satisfied on the evidence set out above however that a gardening service is necessary to address needs arising from impairment related to ASD, anxiety or ADHD. If impairments related to ASD, anxiety or ADHD cause her to have difficulty planning and completing gardening tasks, given Ms Houston’s evidence, I consider this can be addressed through strategies from an occupational therapist together with appropriate assistive technology.
Similarly, I am not satisfied that Ms Stringer requires cleaning services. She can carry out cleaning tasks. Issues with planning and completing cleaning can be addressed through strategies from an occupational therapist together with appropriate assistive technology.
I am therefore not satisfied that the requirements of paragraph 34(1)(aa) of the NDIS Act are met in relation to gardening and cleaning services.
Regarding support hours, I note the Agency’s concession was made based on Ms Houston’s report. That concession was maintained after her oral evidence, but I am not satisfied, taking into account the totality of the oral evidence, that Ms Stringer requires support worker assistance. Ms Houston provided no real basis for the level of support that she recommended. She largely based her recommendation on Ms Stringer’s own description of how she utilised support hours. At the same time, Ms Houston stated, in essence, that if Ms Stringer required assistance to stay on task, that was best addressed through strategies from an occupational therapist together with appropriate assistive technology.
I am therefore not satisfied that the requirements of paragraph 34(1)(aa) of the NDIS Act are met in relation to support worker hours.
As each of the requirements of subsection 34(1) of the NDIS Act is not met, funding for gardening and cleaning services, and support worker hours, are each not a reasonable and necessary support pursuant to subsection 34(1) of the NDIS Act.
Other supports in the current SOPS
The current SOPS includes, in capacity-building supports, funding for 24 hours/year for a speech pathologist and skills-building support of three hours/week. Ms Stringer had been using the latter funding to engage her support worker. The hearing and submissions proceeded on the basis that neither party sought to reduce this capacity-building funding. The Agency’s concession regarding support worker assistance is expressed in its SFIC to be in addition to supports in the current plan.
On the view that I have taken of the evidence, I do not consider Ms Stringer requires any support worker assistance. However, the need for skills-building support of three hours/week was not addressed directly in evidence and submissions. Similarly, the issue of speech pathology was not addressed directly in evidence. It is therefore open to the Agency on remittal of this matter to replicate those supports provided that they are reasonable and necessary supports.
Management of funding
Ms Stringer requested that she be allowed to self-manage the funding in her plan. The Agency contended that if Ms Stringer was allowed to self-manage funding, there was an unreasonable risk within the meaning of subparagraph 44(1)(b)(i) of the NDIS Act. It contended that there was a risk to Ms Stringer because she may not manage her plan to procure the required and necessary supports and she may not ensure providers are paid. It contended that the SOPS should specify that Ms Stringer’s plan be managed by a registered plan manager.
Ms Stringer said that she would prefer to self-manage the funding in her plan but that issues regarding her supports were more important to her. She also preferred plan management to Agency management given the restrictions that Agency management would entail in her choice of support providers.
As set out earlier, Ms Stringer gave evidence that she was able to manage the funding in her plan and, in her employment, for other participants. She also however felt she needed assistance from a support worker with matters such as paying her bills and talking to agencies such as Centrelink.
Ms Stringer’s current SOPS includes no core funding for support worker assistance. It includes capacity-building funding and within that, as set out above, there is funding for improved daily living skills. One of the funded items is three hours/week for individual skills building. Ms Stringer’s evidence was that she had continued to engage a support worker for varying hours each week, most recently for six hours each week. She was aware that invoices for this were being charged against individual skills building in the capacity-building supports. She considered that this was in keeping with advice she was provided about use of that funding. Ms Stringer said that she usually kept an eye on how her funding was tracking but, given the other things on her plate recently, she did not know how that funding was tracking.
In her report, Ms Houston considered that self-management would put Ms Stringer’s mental and physical health at risk of harm and that there was a risk to her of not being able to make objective decisions when she was feeling overwhelmed or distracted. In oral evidence she said that if self-management of funding was added to Ms Stringer’s plate, that may overwhelm Ms Stringer, particularly given that Ms Stringer has recently been prescribed medication for anxiety. Ms Houston thought that there was also a ‘generic concern’ regarding Ms Stringer’s general health, for example, related to the impact on her eating.
Where a participant chooses to self-manage funds, subsection 43(3) of the NDIS Act states that the SOPS in the participant’s plan must provide for the funding to be Agency‑managed if subsection 44(1) of the NDIS Act applies in relation to the participant.
I am not satisfied on the evidence that Ms Stringer is unable or unlikely to engage service providers and ensure they are paid. It may well be desirable that Ms Stringer’s funding is plan-managed, given Ms Houston’s evidence, and Ms Stringer’s own evidence about the stressors she currently faces and her obligations at home and work. Plan-management would reduce the load on Ms Stringer. However, that is not the test that I must apply.
I have had regard to Part 3 of the Management of Funding Rules, particularly the matters set out in Rule 6(2). I have also had regard to the principles in section 31 of the NDIS Act, including that the management of funding be underpinned by the right of the participant to exercise control over his or her own life. I am not satisfied on the present evidence that any risk to Ms Stringer reaches a level that constitutes ‘unreasonable risk’ as that term is used in paragraph 44(1)(b) of the NDIS Act. This means that paragraph does not apply to Ms Stringer and that there is no requirement under subsection 43(3) of the NDIS Act for funding to be Agency-managed.
DECISION
The Tribunal sets aside the decision under review made on 26 August 2024, which affirmed an approval of a statement of participant supports dated 20 June 2024, and remits this matter to the Respondent with a direction that within 21 days of the date of this decision, the Respondent must facilitate the approval of a statement of participant supports (SOPS) for the Applicant, containing the following provisions:
1.       A provision to approve funding for the following supports:
(a)fortnightly psychology in place of the funding for psychology services in the existing SOPS dated 20 June 2024;
(b)     no funding for plan management; and
(c)      replication of the remaining reasonable and necessary supports in the existing SOPS dated 20 June 2024 on a pro rata basis from the date the supports in 1(a) and (c) are included in a SOPS to the varied review date; and
2.       A provision that the funding be self-managed.

1. I certify that the preceding one hundred and twenty (120) paragraphs are a true copy of the reasons for the decision herein of General Member A Colvin.

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Associate

Dates of hearing: 2, 3 and 4 October 2025

Representative for the Applicant: Ms Brix

Solicitor for the Respondent: Sparke Helmore

Counsel for the Respondent: Mr Elishapour