VZLK and National Disability Insurance Agency

This matter concerned an application by VZLK for a review of a decision by the National Disability Insurance Agency (NDIA) to refuse funding for certain supports. The dispute centred on VZLK's request for funding for 20 sessions per year of a specialised sex worker and 168 hours per year of level 2 support coordination. The Tribunal was tasked with determining whether these supports constituted reasonable and necessary supports for VZLK under the National Disability Insurance Scheme Act 2013 (Cth) and the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth).

The primary legal issues before the Tribunal were whether the requested supports were "reasonable and necessary" for VZLK, considering his severe disabilities stemming from a brainstem cavernoma. VZLK argued that his inability to engage in sexual activity since 2017 due to his disablement caused him stress and frustration, and that the requested sex worker services were therefore a necessary support. The Tribunal also considered the NDIA's Operational Guidelines, which, unless inconsistent with the legislation, are to be applied in determining whether a support is reasonable and necessary.

The Tribunal acknowledged VZLK's significant physical and communication impairments, noting his reliance on a powered wheelchair and his limited ability to speak. It was satisfied that efforts were made to facilitate VZLK's evidence through hand signals. The Tribunal considered the objective of promoting public trust and confidence in its decision-making, alongside the NDIS Act's principle of respecting the privacy and dignity of people with disability, when deciding to disclose intimate details of VZLK's request under an anonymised identity. The Tribunal's reasoning indicated that the assessment of "reasonable and necessary" would involve evaluating whether the support addresses a particular need of the participant, represents value for money, and is effective and beneficial.

The decision was ultimately set aside and remitted.