TJYS and National Disability Insurance Agency

This matter concerned an application by TJYS, the applicant, for review of a decision made by the National Disability Insurance Agency (NDIA). The dispute centred on whether the NDIA had correctly determined that a claimed support, specifically an assistance dog, was not reasonable and necessary for the applicant under section 34 of the *National Disability Insurance Scheme Act 2013* (Cth). The decision under review was heard by Deputy B W Rayment Oam Qc P.

The court was required to determine whether the assistance dog was a reasonable and necessary support for the applicant, considering the criteria set out in section 34 of the Act. This involved assessing whether the claimed support was likely to be effective and beneficial for the applicant, whether it represented value for money, and if comparable supports existed that could achieve the same outcome at a lower cost. The court also needed to consider whether the proposed support posed any risk to the applicant or others.

In its reasoning, the court examined the applicant's goals as outlined in their plan, noting evidence that the assistance dog would provide sensory contact and deep pressure, aiding emotional regulation and participation in daily routines and social interactions. The court found that the requirement under section 34(1)(a) was satisfied, as experiments with the dog appeared to confirm its benefits. Regarding social participation (section 34(1)(b)), the court accepted that the dog was likely to assist the applicant in her school and home environments. The court also considered whether a companion pet would serve the same outcome (section 34(1)(c)), distinguishing the training and objectives of an assistance dog from a companion dog. The court found an assistance dog to be significantly more beneficial and that the costs did not appear excessive, with expert evidence suggesting it could reduce long-term costs associated with support worker hours. Finally, the court accepted expert opinion that the assistance dog represented current good practice and was likely to be effective for the applicant and other children with autism spectrum disorder, satisfying section 34(1)(d). The court set aside the NDIA's decision and substituted its own.