Ulrick and Chief Executive Officer, National Disability Insurance Agency (NDIS) - [2025] ARTA 1957

Ulrick and Chief Executive Officer, National Disability Insurance Agency (NDIS) [2025] ARTA 1957 (25 September 2025)
Applicant:Mandy Ulrick
Respondent: Chief Executive Officer, National Disability Insurance Agency
Tribunal Number: 2024/1226

Tribunal:General Member A Colvin
Place:Brisbane
Date:25 September 2025

Decision:The Tribunal affirms the decision under review.

......................................................
General Member A Colvin
Catchwords
NATIONAL DISABILITY INSURANCE SCHEME – access – adult participant – whether applicant meets disability requirements under section 24 of the NDIS Act – whether substantially reduced functional capacity in undertaking one or more of activities under paragraph 24(1)(c) of the NDIS Act
Legislation
Administrative Appeals Tribunal Act 1975 (Cth)
Administrative Review Tribunal Act 2024 (Cth)
Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024
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 (Becoming a Participant) Rules 2016 (Cth)
Cases
Drake v Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 60
National Disability Insurance Agency v Foster [2015] FCA 544
Mulligan v National Disability Insurance Agency [2015] FCA 544
National Disability Insurance Agency v Davis [2022] FCA 1002
Madelaine and National Disability Insurance Agency [2020] AATA 4025
Davis and National Disability Insurance Agency [2023] AATA 1437
Burrows and National Disability Insurance Agency 2025 [ARTA] 607
Foster and National Disability Insurance Agency 2025 [ARTA] 718
Secondary Materials
NDIS – Applying to the NDIS Guidelines
Statement of Reasons
BACKGROUND

This review is about whether Ms Ulrick should be granted access to the National Disability Insurance Scheme (NDIS). Ms Ulrick is 45 years old and lives in south-east Queensland. She ceased work some years ago and receives a disability support pension. She has adult children and young grandchildren. She seeks access to the NDIS based on impairments arising from mental health conditions and a chronic skin condition (hidradenitis suppurativa).
Ms Ulrick applied to the National Disability Insurance Agency (Agency) to become a participant in the NDIS but on 16 October 2023 the Agency decided that she did not meet the criteria to become a participant. It confirmed that decision on internal review on 8 February 2024.
Ms Ulrick applied to the Administrative Appeals Tribunal (AAT) on 27 February 2024 seeking review of the Agency’s decision. From 14 October 2024, the AAT became the Administrative Review Tribunal (Tribunal). 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.[1]
[1] Transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (Cth)
Documents available to the Tribunal included:
·a Hearing Bundle (HB) comprised of 284 pages (Exhibit 1);
·An email from Ms Ulrick 24 July 2025, containing her final statement and submission (Exhibit 2); and
·An email from the Agency to the Tribunal dated 16 July 2025, indicating that both parties consented to the matter being determined in the absence of the parties, with an attached email from Ms Ulrick dated 10 July 2025 (Exhibit 3).
The Agency provided a Statement of Facts Issues and Contentions, contained within the hearing bundle. It also provided further submissions in a document headed ‘Respondent’s Further Contentions’ dated 11 June 2025.
The matter was listed for hearing on the papers on 29 July 2025. Both parties consented to this proceeding being determined in the absence of the parties and I am satisfied for the purposes of subsection 106(2) of the Administrative Review Tribunal Act 2024 (Cth) that the issues can be adequately determined in the absence of the parties.
ISSUES
To become a participant in the NDIS, a person must meet the requirements in section 21 of the National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act), referred to as the ‘access criteria’. A person meets the access criteria if the person meets three requirements: the age requirements,[2] the residence requirements,[3] and either, the requirements set out in section 24 (the disability requirements) or section 25 of the NDIS Act (the early intervention requirements).
[2] Section 22 of the NDIS Act
[3] Section 23 of the NDIS Act
It is not in contention, and I so find, that Ms Ulrick meets the age and residence requirements in section 21 of the NDIS Act. The issue in this case is whether Ms Ulrick meets the disability requirements or early intervention requirements.
THE LEGAL FRAMEWORK[4]
[4] This largely adopts the statement of law in Gambrill and CEO, National Disability Insurance Agency [2025] ARTA 1357
The statutory provisions relevant to this review are contained in the NDIS legislation, including:
·the NDIS Act; and
·the National Disability Insurance Scheme (Becoming a Participant) Rules 2016 (Cth) (Access Rules).
The NDIS Act was amended on 3 October 2024 by the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1) Act 2024 (Amending Act). Sections 21, 24 and 25 were amended but the amendments only apply to a person who makes an access request on or after 3 October 2024.[5] Ms Ulrick’s application was made prior to that date. Accordingly, where those provisions are discussed below, it is the provisions in force prior to amendment on 3 October 2024.
[5] Items 125 and 126, Part 3 of the Amending Act
The Agency also issues operational guidelines. The Tribunal is not bound to follow operational guidelines issued by the Agency. However, 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 consider in performing its review task.[6] The relevant guidelines in this review are the NDIS – Applying to the NDIS Guidelines (Access Guidelines).
[6] Re Drake and Minister for Immigration and Ethnic Affairs(No 2) (1979) 2 ALD 634
The disability requirements
The disability requirements are set out in section 24 of the NDIS Act, as follows:[7]
[7] Section 24 as in force immediately prior to 3 October 2024
(1) A person meets the disability requirements 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.
(2)For the purposes of subsection (1), an impairment or impairments that vary in intensity may be permanent, and the person is likely to require support under the National Disability Insurance Scheme for the person’s lifetime, despite the variation.
(3)For the purposes of subsection (1), an impairment or impairments that are episodic or fluctuating may be taken to be permanent, and the person may be taken to be likely to require support under the National Disability Insurance Scheme for the person’s lifetime, despite the episodic or fluctuating nature of the impairments.
(4)Subsection (3) does not limit subsection (2).
A disability attributable to impairments
The first requirement in subsection 24(1) of the NDIS Act is the requirement in paragraph 24(1)(a) that 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.
The term ‘disability’ in the NDIS Act, and section 24, is a descriptive concept for the overall effect of a person’s impairments on that person’s abilities to participate in all aspects of personal and community life while an ‘impairment’ is generally understood as involving the loss of, or damage to, a physical, sensory, or mental function.[8] Section 24 focuses on a person’s impairments, rather than the name of a person’s disability or the diagnosis given to a person.[9] Using the concept of impairment enables an assessment of the severity and permanency of the person’s condition, and of the effects of that condition.[10]
[8] Mulligan v National Disability Insurance Agency [2015] FCA 544 (Mulligan), [51]
[9] National Disability Insurance Agency v Davis [2022] FCA 1002 (Davis), [69]
[10] Mulligan at [55]
The impairments are permanent or likely to be permanent
The second requirement in subsection 24(1) of the NDIS Act is the requirement in paragraph 24(1)(b) that the person’s impairments are, or are likely to be, permanent.
The Access Rules contain the following relevant provisions when determining whether an impairment is permanent or likely to be permanent:
When is an impairment permanent or likely to be permanent for the disability requirements?
5.4 An impairment is, or is likely to be, permanent (see paragraph 5.1(b)) only if there are no known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy the impairment.
5.5 An impairment may be permanent notwithstanding that the severity of its impact on the functional capacity of the person may fluctuate or there are prospects that the severity of the impact of the impairment on the person's functional capacity, including their psychosocial functioning, may improve.
5.6 An impairment may require medical treatment and review before a determination can be made about whether the impairment is permanent or likely to be permanent. The impairment is, or is likely to be, permanent only if the impairment does not require further medical treatment or review in order for its permanency or likely permanency to be demonstrated (even though the impairment may continue to be treated and reviewed after this has been demonstrated).
5.7 If an impairment is of a degenerative nature, the impairment is, or is likely to be, permanent if medical or other treatment would not, or would be unlikely to, improve the condition.
‘Permanent’ in the context of paragraph 24(1)(b) of the NDIS Act means ‘enduring’; this reflects the purpose and context of the legislative scheme, as a scheme intended to deliver lifelong support to persons with disability.[11] It is the person’s impairments that must be permanent, rather than the cause of the impairments or the diagnoses that might apply to a medical condition. The focus of paragraph 24(1)(b) of the NDIS Act is on whether the impairments have an enduring quality so as to fit within the conceptual emphasis of the scheme.[12]
[11] Davis at [85]
[12] Davis at [86]
The NDIS Act expressly provides that impairments that ‘vary in intensity’ may be permanent[13] and that impairments that are ‘episodic or fluctuating’ may be taken to be permanent.[14] The Access Rules further provide that an impairment may be permanent notwithstanding that the severity of its impact on functional capacity may fluctuate or there are prospects this may improve.[15]
[13] Subsection 24(2) of the NDIS Act
[14] Subsection 24(3) of the NDIS Act
[15] Rule 5.5 Access Rules
On the relevance of treatment, the Access Rules provide that an impairment is permanent only if there are no treatments that would be likely to remedy the impairment.[16] ‘Remedy’ in this context means something more than ‘just relieve or improve’ and instead means something approaching ‘a removal or cure of the impairment’. That interpretation is consistent with interpreting ‘permanent impairment’ as meaning an impairment that is enduring; the impacts on a person might fluctuate from time to time, but the impairment is not likely to be removed or cured. [17]
[16] Rule 5.4 Access Rules
[17] Davis at [136]
In determining whether there are no treatments that would be likely to remedy an impairment, consideration is only given to treatments that are, among other things, ‘available’ and ‘appropriate’.[18]
[18] Rule 5.4 Access Rules
In this context, ‘appropriate’ connotes a treatment that has capacity to ‘remedy’ a person’s impairment and is suitable for that particular individual to undergo; ‘the capacity of individuals with an impairment to undergo certain treatments may vary depending on their physical and psychological capabilities, other aspects of their physical and mental health, on their personal circumstances in terms of where they live and who they live with, and who cares for them’.[19]
[19] Davis at [137]
‘Available’ means available to a particular individual. It should be understood as directed at what treatments an individual can, in reality, access: ‘whether a person can afford a treatment will form part of the factual circumstances a decision-maker may need to examine in deciding if a treatment is one that an individual can in reality access’.[20]
[20] Davis at [137] to [142]
Substantially reduced functional capacity
The third requirement in subsection 24(1) of the NDIS Act is the requirement in paragraph 24(1)(c) that a person’s impairments result in substantially reduced functional capacity to undertake one or more of six activities: communication; social interaction; learning; mobility; self-care; and self-management.
The test in paragraph 24(1)(c) is an objective assessment of functional capacity. The legislative scheme is based on a ‘functional, practical assessment of what a person can and cannot do’.[21] No qualitative judgements are involved in assessing a person’s impairments; the decision-maker does not need be satisfied, for example, that a person’s impairment is ‘serious’, or more serious than another person’s impairment. [22]
[21] Mulligan at [55]
[22] Mulligan at [55] to [56]
To satisfy paragraph 24(1)(c), an applicant need only experience substantially reduced functional capacity in one of the six activities in paragraph 24(1)(c). Each activity has a different focus and each must be examined individually rather than globally.[23] Decision-makers must exercise a relatively high degree of precision in assessing what a person can or cannot do.[24]
[23] Mulligan at [55] and [60]
[24] Mulligan at [55]
The two paths to satisfying paragraph 24(1)(c) of the NDIS Act
The Access Rules contain the following provisions relevant to paragraph 24(1)(c) of the NDIS Act:
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 effect of these provisions in the Access Rules is that there are two paths to satisfying paragraph 24(1)(c) of the NDIS Act. One path is to meet the terms of paragraph 24(1)(c) itself and the other path is to meet Rule 5.8 of the Access Rules.[25] Rule 5.8 is a deeming provision. It mandatorily includes some people in the category of persons with substantially reduced functional capacity if the requirements in Rule 5.8 (a),(b) or (c) are met.[26]
[25] Davis and National Disability Insurance Agency [2023] AATA 1437 at [79] (DP Donovan)
[26] Mulligan at [77]
Rule 5.8(a) deals with circumstances where a person utilises assistive technology, equipment or home modifications. Rule 5.8(b) deals with circumstances where a person utilises assistance (including physical assistance, guidance, supervision or prompting). Rule 5.8(c) deals with circumstances where a person is unable to participate in an activity even with assistive technology, equipment, home modifications or assistance.
Although rule 5.8 provides a shortened path to meeting paragraph 24(1)(c) of the NDIS Act, it sets a high threshold and is intended for clear cases.[27]
[27] Foster and National Disability Insurance Agency 2025 [ARTA] 718 at [105] (Foster 2025)
The scope of each of the six activities
In determining whether a person has substantially reduced functional capacity in an activity, the Tribunal must consider the range or bundle of tasks that fall within the relevant activity (such as self-care) rather than a specific task or action that falls within that activity (such as toileting).[28]
[28] National Disability Insurance Agency v Foster [2015] FCA 544 (Foster) at [65] to [67]
The Access Guidelines contain the following relevant provisions when assessing functional capacity:
Your permanent impairment needs to substantially reduce your functional capacity or ability to undertake activities in one of the following areas:
·     Socialising – how you make and keep friends, or interact with the community, or how a young child plays with other children. We also look at your behaviour, and how you cope with feelings and emotions in social situations.
·     Learning – how you learn, understand and remember new things, and practise and use new skills.
·     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.
·     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.
·     Self-management (if older than 6) – how you organise your life. We consider how you plan, make decisions, and look after yourself. This might include day-to-day tasks at home, how you solve problems, or manage your money. We consider your mental or cognitive ability to manage your life, not your physical ability to do these tasks.
Your impairment substantially reduces your functional capacity if you usually need disability specific supports to participate in or complete the above tasks.
These disability-specific supports include:
·     a high level of support from other people, such as physical assistance, guidance, supervision or prompting.
·     assistive technology, equipment or home modifications that are prescribed by your doctor, allied health professional or other medical professional.
In Burrows and CEO, National Disability Insurance Agency[29] the Tribunal regarded the scope of each of the six activities in paragraph 24(1)(c) of the NDIS Act to be as follows:
·‘social interaction’ in paragraph 24(1)(c) of the NDIS Act is limited to tasks associated with making and keeping friends, interacting with other people in the community (who are not friends), and maintaining behavioural and emotional regulation in a social context;[30]
·‘learning’ in paragraph 24(1)(c) of the NDIS Act is limited to tasks associated with acquiring knowledge, skills or understanding, and tasks associated with cognition, and memory;[31]
·‘mobility’ in paragraph 24(1)(c) of the NDIS Act is limited to tasks associated with moving around within the home, and in the community, and getting in and out of bed and a chair;[32]
·‘self-care’ in paragraph 24(1)(c) of the NDIS Act is limited to tasks associated with personal care (including hygiene and grooming), eating and drinking, and health care,[33] and does not include domestic tasks such as laundry, domestic cleaning, gardening and yard maintenance;[34]‘
·communication’ in paragraph 24(1)(c) of the NDIS Act is limited to tasks associated with expressive and receptive language;[35] and
·‘self-management’ in paragraph 24(1)(c) of the NDIS Act is limited to cognitive tasks associated with personal organisation, personal planning, personal decision-making, self-care, problem solving and personal financial management.[36]
[29] [ARTA] 607 at [73] (Burrows)
[30] Burrows at [87] and [108]–[109]
[31] Burrows at [87] and [117]
[32] Burrows at [87] and [97]
[33] Burrows at [87] and [140]
[34] Burrows at [90]
[35] Burrows at [87] and [97]
[36] Burrows at [87] and [149]

It has been observed that the threshold requirements of functionality in mobility, in the Access Guidelines, are relatively modest.[37] Similarly, the functionality included in ‘communication’ is ‘fairly basic’, for example, telling a family member about something that has happened, explaining to a doctor in what part of the body pain is experienced, or asking for help to reach something.[38]
[37] Madelaine and National Disability Insurance Agency [2020] AATA 4025 (Madelaine) at [104]–[105], when considering an earlier similar version of the Access Guidelines
[38] Madelaine at [79]
Regarding social interaction, ‘the criteria in the Access Guidelines for assessing functionality in ‘social interaction’ are ‘directed principally at personal skills needed for social interaction, and only marginally about opportunities to exercise those skills’.[39]
[39] Madelaine at [87]
The early intervention requirements
The early intervention requirements are set out in section 25 of the NDIS Act. Those requirements include the requirement that the person has certain impairment/s that are or are likely to be permanent or is a child who has developmental delay (paragraph 25(1)(a)), that the provision of ‘early intervention supports’ for the person is likely to benefit the person by reducing the person’s future needs for supports in relation to their disability (paragraph 25(1)(b)) and that the provision of early intervention supports is likely to benefit the person in other specified ways (paragraph 25 (1)(c)).
APPLICANT’S CONTENTIONS AND EVIDENCE
Ms Ulrick provided emails and statements, including documents dated 29 October 2023, 17 April 2024 and 24 July 2025.[40] She contended that she has impairments arising from the following physical and mental health conditions that she described as follows:[41]
·stage 2 hidradenitis suppurativa;
·‘severe anxiety/agoraphobia’;
·‘major depressive disorder treatment refractory’;
·obsessive compulsive disorder (OCD); and
·severe complex PTSD (complex PTSD).
[40] T17, C2 and Exhibit 2 respectively
[41] HB pages190-1
In her email dated 29 October 2023 Ms Ulrick said that the reports that she had provided stated that she suffered severely with mental health issues and would require treatment for the rest of her life. She said that she did not leave the house except for necessary appointments and that this was a struggle. She also said that she suffered with chronic pain and infections, and that her skin condition was regarded as one of the most painful conditions in the world. She said that she struggled to sit, did not work, and had home care as she could not manage to clean. She said that she could not understand why things like massage, mental health therapies and a carer when in public, which she felt would give her back some quality of life, were not being considered given her list of lifelong conditions.[42]
[42] T17
In her letter dated 17 April 2024, Ms Ulrick explained the impact that her conditions have had on her.[43] She described the pain and complex treatment related to her skin condition. She said her mental conditions had spanned 20 years and that she struggled daily with OCD, only leaving her house for medical appointments. She said her social life was non-existent, and that she panicked around unfamiliar noises and places.
[43] C2
THE EVIDENCE
Ms Atkinson, an independent occupational therapist, provided a functional capacity assessment dated 27 February 2025. This followed an assessment undertaken on 6 February 2025 at the request of the Agency.[44]
[44] D2
The material before the Tribunal also includes various documents completed by Ms Ulrick’s GP, Dr Kelly. Ms Ulrick has attended the practice where Dr Kelly works since 2001.
Ms Ulrick’s psychologist, Mr Brownhill, completed documents including a report dated 14 June 2023 and a response to targeted questions dated 1 September 2024.[45] Ms Ulrick’s psychiatrist, Dr Garg, also provided a letter dated 12 September 2023.[46] There are also letters from Dr Garg to Dr Kelly dated 25 August 2023 and 24 October 2023.[47]
[45] T11 and C6 respectively
[46] T15
[47] T14 and C5 respectively
There is also some correspondence from Gold Coast University Hospital where Ms Ulrick was being treated for her skin condition. This includes correspondence from Dr Ijdo, Director of Rheumatology.
Ms Bawden, a Manager with Centacare also provided a letter dated 10 May 2022 regarding the assistance that organisation had provided Ms Ulrick.
CONSIDERATION
The disability requirements
There are five criteria in subsection 24(1) of the NDIS Act. All of these must be satisfied for a person to meet the disability requirements.
A disability attributable to an impairment
The Agency conceded that Ms Ulrick has physical impairments attributable to her skin condition (hidradenitis suppurativa) and psychosocial impairments attributable to the following psychological conditions, meeting the requirements of paragraph 24(1)(a) of the NDIS Act.
Regarding Ms Ulrick’s mental health conditions, Dr Garg stated in a letter dated 12 September 2023 that Ms Ulrick had complex PTSD, panic disorder, and major depressive disorder that was treatment refractory.[48] More recently Mr Brownhill described the appropriate diagnoses as major depressive disorder, OCD, generalised anxiety disorder, agoraphobia and complex PTSD (in his response to targeted questions dated 1 September 2024). Mr Brownhill described Ms Ulrick’s associated impairments as reduced cognitive ability, decreased socialising, less general activity, compulsions, restricted activities (including not attending new places), being ‘triggered’ in certain situations, avoiding public spaces, and being fearful in public places.
[48] T15
Ms Atkinson administered a Montreal Cognitive Assessment. She noted Ms Ulrick’s low score. She observed that Ms Ulrick’s score did not indicate cognitive impairment but Ms Atkinson also expressed caution regarding use of that assessment.
Mr Brownhill commenced treating Ms Ulrick in 2022 and by September 2024, he had seen her in 18 sessions. He has therefore had significant contact with Ms Ulrick and has provided more recent information than Dr Garg. I am satisfied based on Mr Brownhill’s response to targeted questions that Ms Ulrick has major depressive disorder, OCD, generalised anxiety disorder, agoraphobia and complex PTSD. She has impairments to which a psychosocial disability is attributable including impaired cognition, reduced motivation, impaired mood or emotional function, avoidance and compulsions.
I am therefore satisfied that the requirements of paragraph 24(1)(a) of the NDIS Act are met regarding psychosocial impairment from Ms Ulrick’s psychological conditions, and that the Agency’s concession in that respect is appropriately made.
Regarding Ms Ulrick’s skin condition, Dr Ijdo wrote in November 2020 that Ms Ulrick had hidradenitis suppurativa.[49] More recently, Dr Kelly provided a letter dated 27 July 2023 regarding Ms Ulrick’s skin condition. He stated that Ms Ulrick had been diagnosed with hidradenitis suppurativa. He described this as a progressive, chronic skin condition and noted that it was stage II, which is characterised by recurrent lesions, scarring and tunnelling.[50]
[49] T4
[50] T13
Ms Atkinson set out in her report the symptoms that Ms Ulrick relayed to her, related to her skin condition. Ms Atkinson reported that Ms Ulrick developed abscesses, approximately fortnightly, that were very painful and affected functioning depending on where the abscess formed.[51]
[51] HB page 234
I am satisfied based on this evidence that Ms Ulrick has hidradenitis suppurativa and has impairments attributable to that condition including restricted movement at times. She has physical impairments attributable to her skin condition (hidradenitis suppurativa), meeting the requirements of paragraph 24(1)(a) of the NDIS Act, and the Agency’s concession in this respect is also appropriately made.
The impairments are permanent or likely to be permanent
The Agency conceded that the requirements in paragraph 24(1)(b) of the NDIS Act were met.
Regarding Ms Ulrick’s mental health conditions, in September 2023, Dr Garg described those conditions as chronic. He noted that Ms Ulrick had been treated with several psychotropic treatments and psychological interventions without much improvement. He regarded any further treatments as preventing decline and unlikely to improve her socio-occupational impairment.[52] In September 2024, Mr Brownhill was also of the opinion that Ms Ulrick’s impairments arising from her mental health conditions had been optimally treated and there would most probably be no further improvement.[53]
[52] T15
[53] C6
I am satisfied on this evidence that the requirements in paragraph 24(1)(b) of the NDIS Act are met regarding Ms Ulrick’s psychosocial impairments attributable to her psychological conditions. The Agency’s concession is appropriately made.
Regarding Ms Ulrick’s impairments from hidradenitis suppurativa, Dr Ijdo wrote in November 2020 that this condition was being treated with medication but that Ms Ulrick was not tolerating this well and that on review the next month her treatment might change to Humira injections (an injectable steroid medication).[54] Dr Gramp, a dermatology registrar at Gold Coast University Hospital, subsequently provided an undated letter stating that Ms Ulrick had been attending that hospital for a year and was being treated for hidradenitis suppurativa stage II. At that time, Ms Ulrick was being treated with Humira which was ‘controlling her disease well’.[55]
[54] T4
[55] T18
In July 2023, Dr Kelly outlined Ms Ulrick’s treatment regime for her skin condition, noting that she was under the care of a dermatologist and being managed with injections of immunotherapy (Humira) as well as antibiotics, analgesics, anti-inflammatories and steroid injections into the lesions. He regarded her condition as ‘fully treated and stable’.[56]
[56] T13
While I am satisfied on this evidence that Ms Ulrick’s skin condition is permanent, it is less clear that her impairments from her skin condition are permanent. Impairments that are episodic or fluctuating, and that vary in intensity, can still be permanent, but Ms Ulrick’s physical impairments (for example, her restricted movement) seem to be very changeable and depend on the site of each abscess. However, I accept for present purposes that her impairments related to her skin condition are permanent.
Ms Ulrick did not assert that she met the access criteria based on impairments from other conditions. Ms Atkinson recorded in her report that Ms Ulrick reportedly experienced arthritis and fibromyalgia but that, due to difficulties in collating relevant information, Ms Ulrick had not included these as part of her NDIS application. Ms Atkinson recorded that:[57]
‘Ms Ulrick reports musculoskeletal pain in her neck secondary to moderate degenerative spondylitis C5 – C7 level, she also experiences C6/C7 moderate foraminal stenosis … She also reports arthritis in her hands which is constantly present but exacerbated by factors including activity and movement. She also experiences pain in her lower back which may be due to arthritis, or she suggests due to referred pain from altered stance and movements secondary to neck pain. The pain reduces her ability to bend, mobilise and move without pain and strength in her hands’
[57] HB pages 237-9
For completeness I have considered the available material regarding impairments Ms Ulrick may have that arise from conditions other than hidradenitis suppurativa and her mental health conditions.
Ms Ulrick has previously been diagnosed with fibromyalgia. Dr Ijdo referred to this diagnosis in his letter dated 1 November 2020. He noted that when Ms Ulrick’s skin condition was more active she had more symptoms of fibromyalgia and that one may drive the other.[58] Dr Kelly also listed fibromyalgia as Ms Ulrick’s primary impairment in the Access Request -Supporting Evidence Form that he completed in 2021.[59] In a letter dated 10 July 2022, Dr Kelly said that Ms Ulrick had fibromyalgia for which she was being treated with paracetamol, tramadol and occupational and hand therapy, and review every three months by a rheumatologist.[60]
[58] T4
[59] T5
[60] T7
Ms Ulrick has also previously been diagnosed with degeneration in her cervical spine. A CT of her cervical spine in 2018 showed multilevel cervical spondylosis and moderate right foraminal stenosis at C5-6 and moderate left foraminal stenosis at C6-7.[61] Dr Kelly subsequently described Ms Ulrick as having cervical degeneration with right foraminal stenosis at C5/6 and left foraminal stenosis at C6/7 in the Access Request - Supporting Evidence Form he completed in 2021.[62] He also referred to her having cervical spondylosis and experiencing chronic neck pain, in a form completed for Australian Super in 2022.[63]
[61] T3
[62] T5
[63] T6
Dr Kelly also described Ms Ulrick as having degenerative osteoarthritis affecting her hands, spine and neck in a letter dated 10 July 2022. At that time her treatment included Celebrex, analgesics, physiotherapy and massage therapy. He said that pain and functional impairment of her hands and neck diminished her capacity to perform most work duties including computer work. [64]
[64] T7
Paragraph 24(1)(b) of the NDIS Act focuses on impairments. There is no recent information regarding Ms Ulrick’s fibromyalgia, arthritis and cervical spondylosis, the impairments she currently has related to those conditions, the treatment options if any, and expected outcomes of treatment. I am therefore unable to conclude on the available evidence that the requirements in paragraph 24(1)(b) of the NDIS Act are met for impairments related to conditions other than physical impairments arising from Ms Ulrick’s skin condition and psychosocial impairments arising from her mental health conditions.
Substantially reduced functional capacity
The Agency contended that the requirements in paragraph 24(1)(c) of the NDIS Act were not met. Ms Ulrick made no specific contentions regarding this paragraph but her evidence on each activity is set out where relevant.
As to the evidence from health professionals, Ms Atkinson undertook a recent, comprehensive functional capacity assessment.
Dr Kelly completed an Access Request - Supporting Evidence Form in 2021, stating that Ms Ulrick did not require assistance in the areas of mobility, communication, social interaction, learning and self-care but required assistance in self-management, in the form of home maintenance.
Dr Kelly also completed a report for Australian Super in February 2022 stating that Ms Ulrick’s concentration, memory, judgement and interpersonal interaction were not affected, except when she was unable to sleep. He considered that her manual dexterity, lifting and neck movement were partly affected but that (except when she had an abscess to the affected area) she was able to sit, walk, bend or crouch, reach above shoulder height, kneel or crawl, and drive.[65]
[65] T6
Dr Kelly commented in his letter dated 10 July 2022 that Ms Ulrick’s regular skin lesions impaired her capacity to perform physical tasks as well as her ability to maintain desk related activities.[66]
[66] T7
Mr Brownhill described the functional impact of Ms Ulrick’s mental health conditions in his reports in June 2023 and September 2024.[67] In 2023, he said that the impact of those conditions was severe. He considered Ms Ulrick was unable to work, study or attend meetings or groups, and noted that she reported ceasing work in 2020 because of her symptoms. He said that her compulsive activities, such as cleaning, occupied more than two hours/day. He also said that Ms Ulrick was severely affected in the domains of self-care and interpersonal relationships, and in the domains of ‘social/recreational/travel’.
[67] T11 and C6
Mr Brownhill also said that Ms Ulrick’s ability to train or work was severely impacted by her panic, and that her concentration and task completion was severely affected by her disorders. He noted that she was observed to have limited attention span, which he described as ‘severe’ and that she described racing thoughts and feeling under threat when faced with sustained mental effort. He also said that she described her functioning in planning and decision-making as severely affected and that her general activity outside the house had virtually ceased in the previous three years.[68]
[68] T11
In 2024, Mr Brownhill reported that Ms Ulrick’s mental health conditions resulted in reduced cognitive ability, decreased socialising, restricted activities, an avoidance of being in public places or novel places, and an inability to do her own shopping.
I place minimal weight on Dr Kelly’s assessments since his comments are brief and refer to Ms Ulrick’s functional capacity more than three years ago. Mr Brownhill is Ms Ulrick’s long-term treating psychologist and I have had regard to his comments in 2023 and 2024 where relevant. In general, however, in determining functional capacity I prefer the evidence of Ms Atkinson, given her expertise in assessing functional capacity, the thoroughness and recency of her assessment, and her detailed report.
Communication
Ms Ulrick experiences impairments related to her mental health conditions. The evidence is that, at times, these affect her functional capacity in expressive and receptive language.
Ms Atkinson reported that when Ms Ulrick’s mental health is acutely exacerbated her capacity for communication is reduced, and that she is unable to meaningfully communicate at those times, particularly regarding complex matters, and that these occasions may take a couple of hours. Ms Atkinson also recorded that Ms Ulrick stated that she benefitted from taking notes to ensure that she remembered pertinent information when engaged in exchanges of fast or complex information.[69] Ms Atkinson’s assessment is consistent with Mr Brownhill’s comments in 2023 that Ms Ulrick experienced panic, limited attention span and racing thoughts.
[69] D2 page 275
However, Ms Ulrick is generally able to communicate both in writing and orally. She provided relevant written material to the Tribunal, participated in a lengthy assessment with Ms Atkinson, and reported to Ms Atkinson that she was generally able to follow medical appointments. Ms Atkinson also reported that Ms Ulrick generally does not require assistance or equipment for receptive or expressive language.[70]
[70] D2 pages 274-5
As Ms Ulrick does not utilise assistive technology or require assistance to communicate, Rule 5.8 is not met. I also find on the evidence that although her functional capacity in expressive and receptive language is reduced at times, her impairments do not result in substantially reduced functional capacity in communication within the terms of paragraph 24(1)(c) of the NDIS Act.
Learning
‘Learning’ for the purposes of paragraph 24(1)(c) encompasses tasks associated with acquiring knowledge, skills or understanding, and tasks associated with cognition, and memory.
Ms Atkinson reported that Ms Ulrick experienced impaired mood and emotion, and high pain levels at times and that, during those times, Ms Ulrick had trouble focussing and retaining information. Ms Ulrick experienced high levels of pain, related to abscesses, intermittently but not infrequently. Ms Atkinson considered that when Ms Ulrick was not experiencing an exacerbation of her mental health or in high amounts of pain, Ms Ulrick did not have reduced capacity for learning. Ms Atkinson also considered that Ms Ulrick did not require aids or equipment in learning though benefitted from having extra time.
Mr Brownhill reported in 2023 that Ms Ulrick’s concentration and task completion was ‘severely affected’ and in 2024 he reported that she had reduced cognitive ability. Mr Brownhill also reported that Ms Ulrick’s ability to train or work was severely impacted by her mental health conditions.

I accept Mr Brownhill’s statements that Ms Ulrick has impaired cognition and concentration. However, ‘learning’ in paragraph 24(1)(c) of the NDIS is not focussed on work capacity or retraining for work, and broad qualitative assessments are also of limited assistance when what is required is a detailed functional assessment of what a person can or cannot do. I prefer Ms Atkinson’s detailed assessment when considering Ms Ulrick’s functional capacity in ‘learning’.
The evidence is that Ms Ulrick does not require equipment or assistance to undertake tasks in the activity of learning. This means that Rule 5.8 is not met.
Based on Ms Atkinson’s assessment, I am also not satisfied that Ms Ulrick’s impairments result in substantially reduced functional capacity in learning within the terms of paragraph 24(1)(c).
Mobility
‘Mobility’ in the present context is limited to tasks associated with moving around within the home, and in the community, and getting in and out of bed and a chair. Ms Atkinson observed Ms Ulrick independently transferring in and out of a chair, and from sitting to lying on a bed.[71] She also observed Ms Ulrick mobilising independently and safely within her home, without aids or assistance. Ms Ulrick also reported to Ms Atkinson that she walked only short distances in the community and at a slow pace but reported she routinely went shopping independently. [72] She also reported that she had a car and was able to drive short, well-known distances.
[71] D2 page 257
[72] D2 pages 252-3
When Ms Ulrick has an abscess, her functional capacity in mobility can be reduced depending on the pain, the location of the abscess, and the overall impact of infection. However, even during those times, although Ms Ulrick was more sedentary, Ms Atkinson reported that Ms Ulrick generally got out of bed and went downstairs, and Ms Atkinson anticipated that Ms Ulrick would be able to attend the shops most days.[73]
[73] D2 page 253
Ms Atkinson did not recommend use of any assistive technology, equipment or home modifications to complete the bundle of tasks that fall within mobility. Ms Ulrick is also able to move around within her home, and in the community, and get in and out of bed and a chair, without assistance or aids. This means that Rule 5.8 is not met.
I am satisfied based on the evidence that Ms Ulrick has reduced functional capacity in mobility, particularly during times when she has an abscess. However, even at those times, she does not have substantially reduced functional capacity to undertake the bundle of tasks that fall within the activity of ‘mobility’ for the purposes of paragraph 24(1)(c) of the NDIS Act.
Self-care
‘Self-care’ in the present context, as set out earlier, is limited to tasks associated with personal care (including hygiene and grooming), eating and drinking, and health care, and does not include domestic tasks such as laundry, domestic cleaning, gardening and yard maintenance.
Ms Ulrick stated to Ms Atkinson that she generally prepared the evening meal three times each week and her son did this on the remaining evenings.[74] She also stated to Ms Atkinson that, due to her OCD, her morning ritual involved having a cup of coffee, vacuuming the floor and using a small mop, fixing the bed, showering, dressing, and going to the supermarket. On ‘bad days’, which occurred about once/week, she would still get out of bed and shower but might not go to the supermarket.[75] If she was experiencing a severe exacerbation of her mental health or severe pain due to an abscess, she would also neglect the light housework.[76]
[74] D2 page 265
[75] D2 pages 236-237
[76] D2 page 265
Ms Ulrick referred to domestic cleaning in her email dated 29 October 2023, stating that she had home care as she could not manage to clean. She also provided a letter indicating that Centacare was providing Ms Ulrick with two hours/fortnight of domestic assistance support to assist Ms Ulrick with everyday tasks that she was unable to undertake due to her medical conditions. Self-care does not encompass domestic cleaning. Further, although Ms Atkinson confirmed in her report that Ms Ulrick required assistance with heavy housework, based on Ms Ulrick’s statements to Ms Atkinson, Ms Ulrick routinely undertakes light household tasks including vacuuming and mopping.
Ms Atkinson reported that Ms Ulrick utilised a shower chair and would be unlikely to shower safely without this due to reduced balance and standing tolerance, particularly when she had an abscess. Ms Ulrick required no other assistive technology for self-care. [77] Ms Atkinson also reported that it was anticipated that when Ms Ulrick had an abscess, she would complete all self-care activities (including showering, dressing, toileting and grooming) at a slower pace or in a modified manner. This was to avoid pain or was the result of low energy and malaise related to infection or was due to impaired upper or lower limb function (depending on the site of the infection).
[77] D2 page 263
Mr Brownhill reported in 2023 that Ms Atkinson was severely affected in the domain of self-care. However, Ms Atkinson’s assessment is more detailed and recent. Based on her evidence, I consider that Ms Ulrick can independently attend to tasks associated with personal care (including hygiene and grooming), eating and drinking, and health care. She utilises a shower chair but generally does not require assistance from others or assistive technology, equipment or home modifications for the bundle of tasks encompassed within with self-care. Rule 5.8 is therefore not met.
When Ms Ulrick has an abscess, she completes showering, dressing, toileting and grooming at a slower pace or in a modified manner. In addition, when she has an exacerbation of mental health symptoms, she may not undertake activities such as cooking an evening meal. Longitudinally, however, and having regard to the tasks she can complete, for the purposes of paragraph 24(1)(c) of the NDIS Act, Ms Ulrick does not have substantially reduced functional capacity to undertake the bundle of tasks that fall within the activity of ‘self-care’.
Social interaction
‘Social interaction’ encompasses tasks associated with making and keeping friends, interacting with other people in the community (who are not friends), and maintaining behavioural and emotional regulation in a social context.
Ms Ulrick stated in her email dated 29 October 2023 that she did not leave her house except for ‘necessary appointments and that this was a struggle’. She also stated that she had ‘contacted help agencies who have to come to my house as I won’t meet in public’, and that one of things she sought was a ‘carer in public’. [78] In 2024, she said that she only left her home for medical appointments and that her social life was non-existent.
[78] T17
Mr Brownhill also reported in 2023 that Ms Atkinson was severely affected in the domain of interpersonal relationships and in 2024 he described her decreased social interaction related to her mental health conditions.
Ms Atkinson reported that Ms Ulrick was able to interact appropriately in the assessment and was able to interact appropriately in appointments where she was familiar with the clinic and doctor. Ms Atkinson also reported that Ms Ulrick avoided phone calls from unknown numbers but could force herself to call someone she did not know, such as an electricity provider to discuss a bill, albeit with high anxiety. Ms Ulrick also used automatic checkouts to avoid tellers and would explore all other options before approaching staff in shops for directions.
Ms Atkinson reported that Ms Ulrick had a small group of friends whom she caught up with when she was mentally and physically well enough, such as for a short walk and coffee. She generally did not require support when with a small group of people whom she knew and with whom she was comfortable, but otherwise avoided social situations. Ms Atkinson considered that Ms Ulrick required support to attend new social situations and would benefit from a support worker when attending new activities and social occasions.[79]
[79] C2 page 273
Some of Ms Ulrick’s comments in 2023 and 2024 conflict with statements recently made to Ms Atkinson (for example, regarding her ability to leave her house). To that extent I prefer Ms Atkinson’s report.
Based on Mr Brownhill’s report, I accept that Ms Ulrick’s impairments from her mental health conditions impact her capacity for social interaction, but otherwise I rely on Ms Atkinson’s assessment of Ms Ulrick’s functional capacity in social interaction.
Based on Ms Atkinson’s assessment, I am satisfied that Ms Ulrick does not require assistive technology, equipment, or home modifications for the activity of social interaction. Ms Atkinson recommended support worker assistance in some circumstances, namely, when commencing new social occasions or activities. Rule 5.8 requires consideration of the range of tasks that fall within social interaction, which includes making and keeping friends and interacting with other people in the community (who are not friends) and maintaining behavioural and emotional regulation in a social context. It sets a high threshold and is intended for clear cases. Given the limited assistance from others recommended by Ms Atkinson, Rule 5.8 is not met.
Ms Atkinson indicated that Ms Ulrick avoided interacting with others in person when she had an abscess.[80] If Ms Ulrick can interact socially but chooses not to at times due to the presence of an abscess, that may be relevant to paragraph 24(1)(d) of the NDIS Act, but the present consideration is focussed on whether Ms Ulrick can undertake tasks involved in social interaction.[81]
[80] C2 page 271
[81] Foster 2025 at [82] and [83]
Ms Ulrick clearly experiences significant impairments arising from her mental health conditions and these negatively impact her functional capacity in social interaction. However, based on Ms Atkinson’s detailed assessment of Ms Ulrick’s capacity in social interaction she can maintain a small group of friends, interact in person at appointments and in the community with people she is familiar with who are not friends and, if she must, can call and interact in person with people with whom she is not familiar. She therefore does not have substantially reduced functional capacity for the purposes of paragraph 24(1)(c) of the NDIS Act, to undertake the bundle of tasks that fall within the activity of ‘social interaction’.
Self-management
‘Self-management’ is limited to cognitive tasks associated with personal organisation, personal planning, personal decision-making, self-care, problem solving and personal financial management.
In 2023, Mr Brownhill described Ms Ulrick’s functioning in planning and decision-making as ‘severely affected’. Ms Atkinson also described the impact of Ms Ulrick’s pain, related to abscesses, and her reduced concentration related to her mental conditions. I accept that these factors can reduce Ms Ulrick’s capacity for self-management at times. However, Ms Atkinson reported that Ms Ulrick was generally able to manage her household, interact with Centrelink on her son’s behalf, set up internet banking and use BPAY, and make personal decisions for herself. She reported that Ms Ulrick required no assistance or assistive technology but required additional time to make decisions.
Ms Ulrick therefore does not require assistance from others or assistive technology to undertake tasks that comprise ‘self-management’. Rule 5.8 is therefore not met. Any reduction in Ms Ulrick’s functional capacity to undertake the activity of ‘self-management’ is also not substantial.
Having found that Ms Ulrick’s impairments do not result in substantially reduced functional capacity to undertake any of the activities in paragraph 24(1)(c) of the NDIS Act, the disability criteria are not met.
The early intervention requirements
Ms Ulrick made no specific contention in relation to the early intervention requirements. The Agency contended that the requirements in paragraphs 25(1)(b) and (c) and subsection 25(3) were not met.
Ms Atkinson considered that provisions of some social support to assist Ms Ulrick engage in new activities, such as a social group at a library, would likely increase her confidence in taking that transport route and her level of comfort with that group. After a period, she would then be able to attend the group regularly.
However, Ms Atkinson considered that if Ms Ulrick’s interests and wishes changed, she would need the same ‘initiation’ into that new activity. Provision of this support would therefore not reduce Ms Ulrick’s future need for support as required by paragraph 25(1)(b) of the Act.
The evidence does not indicate that there is any other early intervention support that is likely to benefit Ms Ulrick in the ways specified in paragraphs 25(1)(b) and (c) of the NDIS Act. Since those provisions are not met, the early intervention requirements are not met.
As neither the disability requirements nor the early intervention requirements are met, Ms Ulrick does not meet the access criteria in section 21 of the NDIS Act.
DECISION
The Tribunal affirms the decision under review.

1. I certify that the preceding one hundred and thirteen (113) paragraphs are a true copy of the reasons for the decision herein of General Member A Colvin.

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Associate
25 September 2025

Dates of hearing: 29 July 2025

Applicant’s Advocate: Self-represented

Solicitor for the Respondent: Maddocks

Counsel for the Respondent: PM Nolan