TRCH and National Disability Insurance Agency

[2024] AATA 2918

TRCH and National Disability Insurance Agency [2024] AATA 2918 (15 August 2024)

Division:NATIONAL DISABILITY INSURANCE SCHEME DIVISION

File Number(s):      2021/9125

Re:TRCH

APPLICANT

AndNational Disability Insurance Agency

RESPONDENT

DECISION

Tribunal:Member T Bubutievski

Date:15 August 2024

Place:Sydney

1. The internal review decision of 25 October 2021 made under subsection 100(6) of the National Disability Insurance Scheme Act 2013 (Cth), which confirmed the reviewable decision of 27 August 2021, is set aside and remitted for reconsideration with directions that:

   a.the following reasonable and necessary support will be funded under the National Disability Insurance Scheme from 27 August 2021:

   (i)18 hours per annum of exercise physiology (including provider travel);

   (ii)75 hours per annum of speech pathology (including provider travel);

   (iii)48 hours per annum of occupational therapy (including provider travel);

   (iv)Support work:

   (a)two hours daily, seven days per week, of support for personal care and activities of daily living at the ratio of 1:1 (14 hours per week);

   (b)three hours per week at weekday rates of support for social, community and civic participation at the ratio of 1:1;

   (c)one hour per week at weekday rates of therapy support at the ratio of 1:1;

   (d)20 hours per annum of support work at the ratio of 1:1 to assist in the transition to holiday care and STA;

   (v)18 hours per week for 12 weeks per annum of holiday care at the ratio of 1:3;

   (vi)12 days per annum of STA at the ratio of 1:4;

   (vii)Transport funding at current NDIS Pricing Arrangements for SCCP and support worker attendance at therapy appointments once per month;

   (viii)$500 per annum for low-cost assistive technology.

   b.The date by which the Respondent will reassess the Applicant’s plan is 12 months from the date on which the supports under paragraph (a) are included in the Applicant’s existing statement of participant supports (the reassessment date).

   c.All other reasonable and necessary supports in the existing statement of participant supports, not funded under paragraph (a), excluding any one-off assistive technology already funded, shall be replicated for a period of 12 months, from the date on which the supports under paragraph (a) are included in the Applicant’s existing statement of participant supports until the reassessment date.

   d.The Respondent is to determine the appropriate mechanism for the reimbursement or payment of support work invoices.

   ............................[SGD]............................................

   Member T Bubutievski

   CATCHWORDS

   NATIONAL DISABILITY INSURANCE SCHEME – review of decision relating to approval of Applicant’s statement of participant supports (SOPS) under his NDIS plan – child participant has autism (level 3), severe intellectual disability, sensory processing disorder and attention deficit hyperactivity disorder – request for additional funding for allied health interventions, support worker assistance, feeding program and travel – whether “reasonable and necessary supports” criteria under s 34(1) of the National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act) are met – Tribunal satisfied that some requested supports meet those criteria and should be included in Applicant’s SOPS – payment of outstanding invoices - Decision Under Review set aside and remitted with direction to facilitate…