Wator and CEO, National Disability Insurance Agency (NDIS) - [2025] ARTA 1360

Wator and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 1360 (23 April 2025)
Applicant:Cameron Wator
Respondent: CEO, National Disability Insurance Agency

Tribunal Number: 2023/6022

Tribunal:Senior Member K Bean
Place:Sydney
Date:23 April 2025

Decision:
1. The internal review decision of 13 July 2023 is set aside and in substitution for that decision it is decided that the Statement of Participant Supports (SOPS) of 28 April 2023 is varied such that Ms Wator is approved to be paid as a formal support for her son for up to 3 hours per day from 28 April 2023 to 2 February 2025;
2. The SOPS dated 3 February 2025 is set aside, and the matter is remitted to the Respondent for reconsideration with orders that:
(a)The review date of the SOPS is to be in 12 months’ time;
(b)22 hours per year is to be included for psychology supports;
(c)The allowance for physiotherapy is to be 104 hours per year for the Kieser program and 24 hours of standard physiotherapy;
(d)Ancillary to his capital supports, Mr Wator’s supports are to include 20% of the cost of the insurance premiums on his modified vehicle;
(e)Core supports are to include the cost of taxi travel from Mr Wator’s home to his workplace for up to 2 days per week until 1 August 2025;
(f)From 4 August 2025 the following capacity building transport plan is to be implemented:

Weeks 1 to 8

The Applicant will be supported with transport funding to catch taxis to and from work for 1 day a week. For 1 day a week the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by PWC to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day.

An OT will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).

Weeks 9 to 12

The Applicant will be supported with transport funding to catch taxis to and from work for 1 day a week. For up to 2 days a week, the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by PWC to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day.

An OT will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).

An additional 2 hours will be funded for report writing.

After the 12-week period, the Respondent will continue to fund the taxis to and from Hallam Train Station for the remainder of the plan.
(g)Ms Wator is approved to be paid as a formal support for her son for up to 3 hours per day from 3 February 2025;
(h)Core supports are to include 39 hours per week for support worker assistance; and
(i)All other supports in Mr Wator’s SOPS dated 3 February 2025 are to be replicated on a pro rata basis.

..................[SGD]......................................................
Senior Member K Bean
CATCHWORDS
National Disability Insurance Scheme – review of supports in plan – approval of a Statement of Participant Supports (SoPS) – increase of psychology hours – physiotherapy hours – Keiser program – insurance premiums for vehicle modification – transport funding – support worker hours – increasing Applicant’s independence – decision set aside and remitted to the Agency
LEGISLATION
National Disability Insurance Scheme Act 2013 (Cth)
National Disability Insurance Scheme (Getting the NDIS Back on Track No.1) Act 2024
CASES
McGarrigle v National Disability Insurance Agency [2017] FCA 308
Statement of Reasons
INTRODUCTION

The Applicant, Mr Wator, is a 23-year-old man who lives with his parents and two siblings in outer metropolitan Melbourne. Mr Wator is a participant in the National Disability Insurance Scheme (NDIS) based on physical impairments attributable to cerebral palsy. He lives a rich and active life, has completed a University degree and recently commenced part-time work.
This application concerns the precise supports which should be contained in Mr Wator’s NDIS plan and whether his supports in some areas should be increased.
The procedural history of the matter is straightforward. Mr Wator sought review of his Statement of Participant Supports (SOPS) for the period 28 April 2023 to 26 October 2024, resulting in an internal review decision of 13 July 2023 affirming the original decision. He then applied to this Tribunal for review of that decision, giving rise to this application. On 20 December 2024, Mr Wator’s plan was extended to 26 October 2025, and a further plan was subsequently put in place on 3 February 2025 with a review date of 4 August 2025. As it is the current operative SOPS, the SOPS in that most recent plan is in effect the most relevant for the purposes of my decision.[1]
[1] See s 103(2) of the National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act).
A hearing ultimately took place over four days, concluding on 14 January 2025. At the hearing, Mr Wator was represented by Ms Julie Stephenson and assisted by his mother, Ms Wator, who took a very active part in the hearing and was of great assistance to the Tribunal. The Respondent was represented by Ms Louise Martin of Counsel.
At the hearing, the issues which remained in dispute were limited to:
(a)Psychology hours;
(b)Physiotherapy hours and the Keiser program;
(c)Insurance premiums for Mr Wator’s modified vehicle;
(d)Transport funding for Mr Wator to attend work;
(e)Payment of Mr Wator’s mother, Ms Wator, as a formal support and reimbursement for past support hours provided by her; and
(f)Support worker hours.
The provision of a powered wheelchair (PWC) for Mr Wator had also been in dispute between the parties. However, just before the hearing the Respondent conceded this was a reasonable and necessary support. Accordingly, the Respondent has now agreed to fund a PWC, and rental of a PWC for up to 12 weeks pending provision of a PWC by Mr Wator.
I will next set out the legislative framework before addressing each of the above issues having regard to the evidence presented at the hearing.
THE STATUTORY FRAMEWORK
The NDIS was established under the National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act). Its objectives are set out in section 3 and the general principles guiding actions taken under the NDIS Act are set out in section 4.
A participant’s plan must include a SOPS, approved in accordance with the NDIS Act, and any rules made under the NDIS Act such as the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (‘Supports for Participants Rules’).
Section 33(5) of the NDIS Act requires that the CEO (or his or her delegate), in deciding whether to approve the SOPS under s 33(2), must have regard to a number of factors including the participant’s statement of goals and aspirations and relevant assessments conducted in relation to the participant, and be satisfied the supports are reasonable and necessary.
The NDIS Act has recently been amended, with a number of changes taking effect from 3 October 2024. The amending legislation, the National Disability Insurance Scheme (Getting the NDIS Back on Track No.1) Act 2024 (Cth) provides that the legislative provisions regarding preparing participant’s plans as in force after 3 October 2024 apply in relation to an approval or variation of a SOPS after that date.[2] As the Applicant is seeking a variation to his SOPS, it follows that I am obliged to apply the Act and Rules as in force after 3 October 2024.
[2] At s 129.
Subsection 34(1) of the NDIS Act provides, with respect to reasonable and necessary supports as follows:
(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 an 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.
The term “reasonable and necessary support” is not defined in the NDIS Act. In McGarrigle v National Disability Insurance Agency [2017] FCA 308 Mortimer J observed, at [91], with respect to the term:
Whether a support is “reasonable” requires a different assessment to whether a support is “necessary”. Again, it is not necessary in the context of this proceeding to be definitive about the nature and extent of the meaning of the phrase, or its components. It is enough to observe that using the concept of necessity would appear to tie one aspect of the CEO’s assessment to an evaluation of the kinds of factors set out in s 34(1)(a) and (b) and (d). The word “reasonable” would appear to be directed at factors such as those set out in s 34(1)(c) and (f). That is not to say the meaning of each word is exhausted by the factors set out in s 34(1): rather, it is to illustrate the different work that each concept does as an adjective in the phrase “reasonable and necessary supports”.
Section 34(2) provides that the NDIS rules may prescribe methods or criteria to be applied, or matters to which the decision maker must have regard, in deciding whether they are satisfied that the criteria under section 34(1) are met in respect of a requested support.
The Supports for Participants Rules made pursuant to s 35(1) of the NDIS Act provide further guidance with respect to the assessment of reasonable and necessary supports that will be funded. Section 33(5)(d) requires that the CEO must apply any Rules made for the purposes of section 35. Pursuant to section 209 of the NDIS Act, the Rules are a legislative instrument and are therefore binding to the Tribunal.
The Tribunal notes the observations of Mortimer J in McGarrigle at [43] as follows:
The [Supports for Participants Rules] are an important element of the legislative scheme, introducing the ability to modify the operation of ss 33 and 34 by, for example, excluding certain kinds of supports from inclusion in participant plans. It is through the Rules that the executive is able to implement… some policy decision-making about the nature and extent of supports to be provided or funded under the NDIS.
Having explained the legislative context, I will next address each of the supports in issue.
PSYCHOLOGY HOURS
Mr Wator seeks 24 one-hour sessions per year with his current psychologist, Dr Fanning, with whom he has built a good relationship. Understandably, his preference is to see Dr Fanning for support with any issues which may arise, including those which arise very directly from his disability and others which arise from his life circumstances more generally.
At the outset of the hearing, the Respondent’s position with respect to this support was that Mr Wator’s NDIS Plan should only include funding for psychological support as a capacity-building tool, to assist him to “develop strategies specifically in relation to the anxiety caused by his disability”[3] and 15 hours should be sufficient for this. However, that position changed in view of Dr Fanning’s oral evidence at the hearing, in my view appropriately.
[3] Respondent’s Statement of Facts, Issues and Contentions, at [69].
During his evidence, Dr Fanning indicated that in his opinion, although he had somewhat elevated levels of anxiety and depression, Mr Wator did not currently meet the criteria for any mental health diagnosis. Therefore, rather than treating Mr Wator for a mental health condition, his current role was to support Mr Wator with respect to a range of impacts of his cerebral palsy;- in particular to assist Mr Wator to build his capacity for social and economic participation. He acknowledged that from time to time, he would also assist Mr Wator in addressing particular psycho-social stressors which arose, in the context of the numerous challenges associated with his cerebral palsy.
As to the treatment he saw as being necessary for Mr Wator in the coming year, he noted that Mr Wator was about to commence full-time employment with NEC, and this was likely to be a particularly challenging and stressful time for him. Dr Fanning recommended that for the first 3 months after commencing employment, Mr Wator was likely to require a “burst” of more frequent sessions, which he considered were likely to be required fortnightly for 3 months. After that, he considered Mr Wator was likely to require a session once every three weeks for the balance of the year before potentially transitioning to monthly sessions. He also indicated during his evidence that he would require an allowance of 2 hours for report writing, as well as an hour for participating in a care team meeting. I note Dr Fanning’s recommendation equates to 22 hours over a 12-month period.
With respect to the Respondent’s proposal that Mr Wator first exhaust his NDIS funding and then seek any additional treatment which may be required from Dr Fanning under a mental health care plan, Dr Fanning explained there were a number of difficulties with this. Fundamentally, he explained it was his understanding that a patient could only be referred to a psychologist for treatment with respect to a diagnosed mental health condition. In Mr Wator’s case, Dr Fanning did not consider he currently had a diagnosable mental health condition, therefore he did not actually meet the criteria for treatment under Medicare, although he acknowledged it was possible Mr Wator’s GP may nevertheless be prepared to refer him under mental health care plan.
In addition to this difficulty, Dr Fanning explained there would be significant constraints on the treatment he could offer Mr Wator under a mental health care plan. In particular, he would not be able to provide vocationally directed capacity building, as this would not be within the Medicare guidelines. This would be unfortunate given Mr Wator’s main need currently was for support in commencing employment for the first time, with a view to setting him up to succeed in building a long-term career with NEC.
Dr Fanning explained that by far the most beneficial form of support for Mr Wator was that which was enabled by the NDIS funding currently provided, which allowed Dr Fanning to address Mr Wator’s needs and challenges as they arose. Under NDIS funding, he was able to provide goal focussed capacity building therapies, while also providing emotional support and assistance with symptoms such as anxiety when they arose. In the event he was required to treat Mr Wator under the Medicare guidelines, he would be forced to reduce the scope of care and support he currently provided to Mr Wator, which he expected would be detrimental to him.
Having regard to Dr Fanning’s oral evidence, I am satisfied that Mr Wator requires ongoing psychological support directed to both capacity building and to support him in managing the emotional impacts of his disability. For the reasons given by Dr Fanning and in the absence of a current mental health diagnosis, I am not persuaded that any of the psychological support required by Mr Wator can be feasibly or more appropriately provided under a mental health care plan, and as I understand their position, the Agency no longer presses this approach.
I note Mr Wator has sought that the hours allowed for Dr Fanning in his plan be increased to 24 hours per year. However, given Dr Fanning’s opinion that 22 hours is likely to be sufficient for the coming year, I am satisfied I should adopt that recommendation and make allowance in Mr Wator’s plan for 22 hours of psychology supports, which I understand is also consistent with the position ultimately taken by the Agency.
For completeness, I note Mr Wator commenced employment approximately 2 months ago, and it is unclear on the material before me whether he has been having fortnightly sessions during that time or how much longer he may require fortnightly sessions for. However, I also note that during his evidence Dr Fanning initially gave an estimate of between 16 and 24 sessions being required for the coming 12-month period. Notwithstanding he has now commenced employment, taking the evidence as a whole, I remain satisfied it is appropriate to allow for up to 22 hours of psychology sessions in Mr Wator’s next SOPS.
PHYSIOTHERAPY AND KEISER
Mr Wator is seeking that his physiotherapy supports be increased such that they include 24 hours per year of standard physiotherapy, as well as 104 of specialised physiotherapy in the form of the Kieser program, which he has been participating in and has found extremely beneficial.
The Agency contends that 30 hours for physiotherapy should be sufficient. With respect to the Kieser program, the Agency contends Mr Wator can use some of his physiotherapy hours to access the Kieser program “if he views it as being more suitable to his needs”.[4] The Agency further contends that including additional hours for the Kieser program in Mr Wator’s plan would “duplicate the intended therapeutic outcomes of physiotherapy” which is already included in his plan,[5] and would not represent value for money.
[4] Respondent’s SOFIC at [82].
[5] Respondent’s SOFIC, at [85].
At the hearing, very helpful evidence was given by Mr Piotr Korcyk of the Keiser Burwood East practice in Melbourne. He explained the Kieser program offered very specific benefits to clients with cerebral palsy and other similar conditions, which could not be achieved through either standard physiotherapy or personal training. He explained the Kieser program utilised very specific machinery which was more targeted, safe and suitable than standard gym equipment. He further explained this equipment is designed to target specific muscles and muscle groups that were critical to improving strength, endurance and mobility in individuals with cerebral palsy, and therefore improving their functional capacity.
As to the duration and components of Keiser sessions, Mr Korcik indicated Mr Wator had been attending hourly sessions twice per week, and this was what was recommended for him, and had been shown to be beneficial through measurable increases in strength, speed and endurance. He said each session was broken into two halves, with a physiotherapy and an exercise physiology component. The physiotherapy half of the session would be focussed on utilising the various pieces of specialised equipment targeting different muscles and working them to the correct level of fatigue under close supervision in case of sudden contractures or other safety issues. Mr Korcik stated there had been noticeable improvement in Mr Wator’s endurance and speed since he commenced the program in October 2023, and he could now complete exercises on 7 different machines as opposed to 5 when he first started, within the same time period.

Mr Korcik also explained the exercise physiology component of the session was focussed more on cardio-vascular fitness, also intended to increase Mr Wator’s endurance, mobility and functional capacity. Under the supervision of an exercise physiologist, Mr Wator would undertake exercises designed to safely and appropriately increase his heart rate, such as use of an arm bike, boxing, and other seated exercises.
Mr Kocik also explained the Kieser program only involved exercises at the Kieser premises and did not replicate standard home-based physiotherapy aimed at improving Mr Wator’s ability to move around his home more independently and complete transfers more successful or independently. While the improved strength and endurance resulting from the Kieser program would be likely to help Mr Wator’s mobility and independence generally, both Kieser and standard physiotherapy were required to optimise his functional capacity.
I note Mr Korcik’s opinion as to the complementary nature of the Kieser program and standard physiotherapy, and the need for both, is consistent with a report provided by Mr Wator’s physiotherapist, Ms Scanlon, dated 11 December 2023, in which she stated:
“Cameron has recently begun Kieser therapy. He is attending exercise sessions twice a week. This program will address Cameron’s general health and fitness. As a result, Cameron’s ongoing (fortnightly) physiotherapy sessions can focus solely on specific functional flexibility, strength and balance (for example, movement in and out of bed, and to/from seats), and the teaching of strategies to support independence during these daily mobility tasks”.[6]
[6] JTB, 216.
Further from the oral evidence given by both Mr Wator and his mother, Ms Wator, I note these are the precisely the areas and goals his recent physiotherapy sessions have been directed toward.
For completeness, I also note that the Keiser program was recommended by Mr Wator’s Orthopaedic Surgeon, Dr Balakumar, who considered it was “critical to his ongoing management of his neuromuscular condition and would result in detrimental outcome if he does not have ongoing strength and conditioning training”.[7] In a subsequent report, Dr Balakumar also explained the differences between Kieser and standard physiotherapy, and emphasised both were required, and both were “critical to his disability”[8] and would minimise the need for future surgery.[9]
[7] Report of Dr Balakumar dated 23 August 2023, JTB 186.
[8] Report of Dr Balakumar dated 8 July 2024, JTB, 219.
[9] Report of Dr Balakumar dated 8 July 2024, JTB, 219.
I note all the above evidence is essentially consistent and supportive of the need for both the Kieser program and traditional physiotherapy. Notably, there is no expert evidence before me which contradicts the opinions of each of these treating practitioners, who have carefully and convincingly explained the need for Mr Wator to undertake the Kieser program to maintain and improve his strength, endurance and mobility, as well as less frequent standard physiotherapy focussed on improving his functional capacity for specific daily tasks.
Having regard to this consistent and persuasive evidence, I am satisfied that both the Kieser program and standard physiotherapy are reasonable and necessary supports for Mr Wator and represent good value for money. I therefore propose to vary his plan to include the 104 hours for twice weekly Kieser sessions, as well as 24 hours of standard physiotherapy as sought by Mr Wator.
INSURANCE PREMIUMS
The difference between the parties with respect to this support is not great. Mr Wator seeks to have the component of his insurance premiums which relates to the disability modifications made to his vehicle covered by the Agency. For its part, the Agency is willing to fund the proportion of Mr Wator’s insurance premium that relates to his disability-related modifications.[10] However, the sticking point between the parties is that the Agency is not satisfied as to what proportion of the premium that is, based on the information supplied to date.
[10] Respondent’s SOFIC, [41].
Mr Wator’s position is that 25% is a reasonable proportion of his premiums for the Agency to fund. He and his mother have also explained that, despite repeated requests, they have not been able to obtain this information from the insurer. Mr Wator relies in part on an estimate provided by a Legal Aid lawyer, who advised that 25% would appear to be a reasonable proportion.[11] In addition, Mr Wator relies on a comparison between the value of his modified vehicle and a comparable unmodified vehicle and contends that the difference is approximately 25%.
[11] Applicant’s Opening Submissions, p 3.
Doing the best I can on the limited evidence available, I am satisfied that 20% of Mr Wator’s premiums should be taken to represent the increased cost of his insurance premiums attributable to the disability modifications, and I propose to amend his plan accordingly.
TRANSPORT FUNDING
As already alluded to, Mr Wator has accepted a full-time graduate position with NEC in Docklands, Victoria which he commenced in February. This has given rise to the issue of precisely what supports should be included in his plan with respect to his transport to and from work. Consideration of this issue is complicated by a degree of uncertainty, at least at the time of the hearing, as to how many days a week Mr Wator was likely to be travelling to his workplace as opposed to working from home.
Again, the difference between the parties in relation to this issue is not large. The Agency has proposed a capacity building transport plan with a cascading level of support designed to increase Mr Wator’s confidence and capacity to travel independently to work and Mr Wator and his mother are relatively happy with the proposed plan, although they maintain a higher level of support will be required in the short to medium term.
At the conclusion of the hearing, the plan proposed by the Agency was as follows:
Modified 20-Week Capacity Building Transport Plan

Weeks 1 to 4	The Applicant will be supported with transport funding to catch taxis to and from work for each day of the week that he travels to the office.
Weeks 5 to 8	The Applicant will be supported with transport funding to catch taxis to and from work for up to 4 days a week. For one day a week the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by power wheelchair to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day. An occupational therapist will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).
Weeks 9 to 12	The Applicant will be supported with transport funding to catch taxis to and from work for up to 3 days a week. For two days a week the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by power wheelchair to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day.
Weeks 13 to 16	The Applicant will be supported with transport funding to catch taxis to and from work for up to 2 days a week. For three days a week, the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by power wheelchair to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day. An occupational therapist will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).
Weeks 17 to 20	The Applicant will be supported with transport funding to catch taxis to and from work for 1 day a week. For 4 days a week, the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by power wheelchair to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day. An occupational therapist will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip). An additional 2 hours will be funded for report writing by the occupational therapist After the 20-week period, the Respondent will continue to fund the taxis to and from Hallam Train Station for the remainder of the plan.

This plan has also in fact been funded in Mr Wator’s current SOPS, dated 3 February 2025, which is now part of his application to the Tribunal.[12] I also understand the amount allowed in Mr Wator’s current plan for transport funding is higher than the amount sought by Mr Wator. However, the Agency contends it is nevertheless good value for money as it will build his independence and reduce the cost of transport in future plans.[13]
[12] S 103(2), NDIS Act.
[13] Respondent’s Supplementary SOFIC 3 January 2025, at [15].
Mr Wator’s position is that he requires more time to adjust to the demands of full-time work, and that implementation of the proposed capacity building transport plan should be deferred for a period of at least 6 months from commencement of his employment. He relies on the expert evidence before the Tribunal to the effect that this transition to full-time work is likely to be intensely demanding, fatiguing and stressful for Mr Wator and fatigue management will be critical to his success. Mr Wator has pointed to the additional time and demands associated with the transport plan (when compared with taxi travel from home to work) and contends this will not be feasible for him in conjunction with commencing full-time work and will compromise his ability to succeed in his new job.[14] Mr Wator maintains that 6 months of increased transport funding to support taxi travel should be provided in his current plan, after which time the Agency’s proposed plan could be revisited and trialled.
[14] Applicant’s Response to the Respondent’s Supplementary SOFIC, dated 3/1/25, p 2.
During their closing submissions, the parties essentially maintained these positions. The Agency slightly modified its position as a result of evidence given during the hearing to allow for increased taxi travel. As reflected in the modified plan outlined above, the Agency proposed Mr Wator be funded to catch taxis to work for up to 5 days per week for weeks 1-4, up to 4 days per week for weeks 5-8, up to 3 days per week for weeks 9-12, up to 2 days per week for weeks 13-16 and up to 1 day per weeks for weeks 17-20. After that, the Agency’s position was that it would fund taxis to and from Hallam train station only, with Mr Wator travelling into the city by train.
Prior to finalising my decision, I sought further information from the Applicant as to what his actual work pattern was, given he had now commenced work. Ms Wator advised that Mr Wator was currently (as at 13 March 2025) working 2 days per week, one day in the office and one day from home. She further advised Mr Wator had recently requested to increase his hours to 3 days per week, consisting of 2 days in the office and one day working from home.
Helpfully, Ms Wator also advised that it had proved possible for Mr Wator to travel alone in the taxi, with the drivers assisting him as needed at either end of the journey. She indicated that fatigue remained a major challenge for Mr Wator in coping with the demands of his employment, and he often fell asleep in the taxi on his way home. She explained that difficulties with fatigue and exhaustion were the main reason Mr Wator was currently only working 2 days each week, although he was seeking to extend this to 3 (non-consecutive) days.
In response to this further information, the Agency has suggested further amendments to its modified transport plan as follows, noting that at the time of the submission Mr Wator was in the ninth week of his NEC employment:
Modified 20-week Capacity Building Transport Plan
Weeks 9 to 16
The Applicant will be supported with transport funding to catch taxis to and from work for 1 day a week. For 1 day a week the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by PWC to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day.
An OT will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).
Weeks 17 to 20
The Applicant will be supported with transport funding to catch taxis to and from work for 1 day a week. For up to 2 days a week, the Applicant will be supported by a support worker to catch public transport. This will include catching a taxi to Hallam Train Station, travelling by train to Southern Cross Station and travelling by PWC to the NEC office. He will similarly be supported to undertake the same journey in reverse to return to his home at the end of the day.
An OT will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).
An additional 2 hours will be funded for report writing.
After the 20-week period, the Respondent will continue to fund the taxis to and from Hallam Train Station for the remainder of the plan.[15]
[15] Respondent’s submissions in reply, 4 April 2025.
In my view, the evidence relating to the considerable fatigue experienced by Mr Wator because of his disability, and the impacts on his functioning, are especially relevant to this issue. I consider the further information provided by Ms Wator as to the fatigue Mr Wator has experienced in association with starting work, and the limiting effects of this, is consistent with the weight of the other evidence before me.
While there will clearly be great benefits in increasing Mr Wator’s independence in travelling to work and potentially supporting him to transition to public transport in the longer term, on balance I accept the evidence and submissions on his behalf to the effect this is premature at this stage. I accept Mr Wator’s position that he is currently navigating an enormous life change and challenge which is stressful and exhausting for him. I also accept that fatigue is one of the main factors which limits his work capacity and that it would be counterproductive at this stage for him to attempt a transition to public transport, which would be likely to increase his fatigue and decrease his work capacity. For example, on the evidence, there would appear to be a real risk that Mr Wator could not feasibly increase his days in the office from one to 2 if he was also required to travel to work by train.
In these circumstances, consistently with the position put forward by Mr Wator at the hearing, I have ultimately concluded the modified capacity building transport plan put forward by the Respondent in its recent submissions should be implemented, but not immediately. I consider it should be deferred until 6 months after Mr Wator commenced his employment with NEC and commence on 4 August 2025. I consider Mr Wator should be funded to take taxis to work up to 2 days per until then, on the assumption he is unlikely to travel to the NEC premises more than twice a week during that period. I note that Mr Wator took issue with the timing rather than the content of the capacity building plan, which I consider reasonable and appropriate providing the start date is deferred until 4 August 2025.
INFORMAL SUPPORT TO BE PAID AS FORMAL SUPPORT
On the evidence before the Tribunal, throughout Mr Wator’s life his mother has been a devoted, highly competent, skilled and exceptionally effective source of support for him, both practical and emotional. As they both live in the family home and she is intimately familiar with his support needs and preferences, she is also able to provide specific, targeted support as and when Mr Wator requires it. This is undeniably a highly effective and efficient form of support which also provides exceptional value for money when compared with external supports. It is entirely unsurprising that, at least during this phase of his life, it is Mr Wator’s preference that his mother provide much of his personal care support, in particular that involving more intrusive forms of support. I note this is also Ms Wator’s preference and she appears more than able and willing to do this, noting she works part-time and is available at the times Mr Wator requires support.
The Agency acknowledges the extraordinary support provided by Ms Wator and the fact Mr Wator has effectively thrived under her care, to the extent he has not only completed a University degree but is also commencing employment. However, the Agency contends it is no longer appropriate for Ms Wator to be Mr Wator’s main personal carer.
The Agency acknowledges that supports can be provided by family members in “exceptional circumstances”, which include where the “participant has strong personal views, for example in relation to their privacy or dignity”.[16] In addition, the Operational Guidelines provide that the Agency will not fund family members unless all other options to identify a suitable provider of supports have been exhausted.[17]
[16] Operational Guidelines, Supplementary JHB, p 3.
[17] Supplementary JHB, p 4.
However, the Agency also contends there are a number or “risks and unintended consequences” which may flow from family members being paid to provide formal supports[18], including frustrating the participant’s goal of independent living, monitoring problems and displacing informal supports. The Agency also contends Mr Wator and his mother have developed methods whereby the Mr Wator’s self-care is performed out of “habit and convenience” and this limits his participation and independence.[19] The Agency submits approving Mr Wator’s mother as a paid support would encourage his reliance on his mother to continue, which may not assist him long term or allow him to “reach his full potential as an independent adult”,[20] and would therefore be potentially harmful.
[18] R SOFIC, [59].
[19] R SOFIC, [61].
[20] R SOFIC, [62].
The Agency has also directed attention to the absence of evidence of Ms Wator’s training or qualifications to provide the relevant care to Mr Wator. The Agency contends it does not reflect current good practice for her to be Mr Wator’s paid support, and this may in fact be harmful to Mr Wator. Therefore the “effective and beneficial” criterion in s 34(1)(d) is not met. In addition, the Agency maintains it is reasonable to expect family members to provide some informal support, such as transport and assistance with some domestic activities.[21]
[21] R SOFIC, [60]-[64].
In my view, one of the considerations I should have regard to in assessing the appropriateness of Ms Wator being a formal support for Mr Wator is his current life circumstances and in particular the fact he is currently making a very difficult and demanding transition to employment. I am mindful that this transition will involve enormous changes to his daily routine and many hours per week away from his home environment, during which he will be required to be independent or will be reliant on external supports.
I consider I should also have regard to the nature of the support required, and the times of day at which Mr Wator requires support. On the evidence before me, I note on days when he is working in the city, Mr Wator will need to get up by 7.00am in order to leave for work by about 8.00am. He will require intensive support during that one-hour period including assistance with getting out of bed, showering, getting dressed, having breakfast and generally getting ready for his day. Similarly, when he arrives home from work at about 6.00pm, he is likely to be very fatigued and will probably need some support with toileting, getting changed, having dinner and mobilising to access anything he requires from the kitchen or elsewhere in the house. It seems likely this support would be required for about an hour and a half, with further support required for about half an hour when he is ready to go to bed, including assistance with toileting, brushing his teeth and getting changed and into bed.

On days when Mr Wator works from home, the nature of the support required and the times at which it will be needed will be different. On those days, the evidence suggests some additional support may be required at intervals throughout the day. Although this was not specifically addressed by the evidence, my understanding is that Mr Wator may not use his powered wheelchair within his home on those days, and he is likely to benefit from having a break from sitting in the chair for up to 10 hours a day as he will be on days when he is at work in the city. As a result, he is likely to require some assistance and supervision with mobilising, including toileting and accessing things within his home, including obtaining drinks and snacks from the kitchen and preparing lunch. On the evidence, the level of support required is likely to increase as he becomes more fatigued toward the latter part of the day. In addition, although he will ultimately be working full-time, as I understand it Mr Wator will still be attending appointments during the week, including his Kieser appointments which are twice weekly. He will require support to attend in-person appointments, and potentially some on-line appointments such as with his physiotherapist.
On weekends, again the pattern of support required will be similar but different and is likely to involve assistance with outings in an unpredictable pattern depending on Mr Wator’s preferences and social commitments.
From a practical point of view, it is undeniable in my view that Ms Wator is in the best position to provide much of this support, and there are substantial efficiencies and cost benefits in her doing so. As she is “on site” and largely available, she can provide tailored support to Mr Wator as and when required across his day and week and can adapt easily to the different patterns of support required on different days of the weeks. From a cost perspective, as I understand it she would simply claim payment for the time spent, even where this relates to short periods spread across the day, without regard to the need for minimum shift durations. This is likely to be much more cost effective than support workers attending on Mr Wator for set periods at intervals across the day from about 7.00am in the morning until 10.00pm at night.
I acknowledge the force in many of the considerations advanced by the Agency. Clearly, over time it will be necessary for Mr Wator to become less reliant on his mother, and ultimately to transition to full independence from her. She will not be able to sustain the level of support she is currently providing indefinitely, and it will be far better for both of them for this transition to occur gradually rather than suddenly in a crisis situation. However, as I have already alluded to, one of the issues is the extent to which it is appropriate or necessary for this transition to occur at the same time as Mr Wator has commenced work, with a view to potentially working full-time.
With respect to the Operational Guidelines, I note they relevantly provide that the Agency will only fund family members to provide support in “exceptional circumstances”, which include where the participant “has strong personal views, for example in relation to their privacy or dignity”. They also provide that the Agency will “not fund a family member to provide personal care or community access supports unless all other options to identify a suitable provider of supports have been exhausted”.
I also note Mr Wator has repeatedly expressed the view that at this stage he strongly objects to being required to engage support workers for intrusive personal care such as toileting and showering, and requested that his privacy and dignity is preserved by his mother assisting him with these tasks. He has acknowledged it will ultimately be necessary for him to engage support workers to assist with these tasks, but explained he would like to build a relationship with a trusted support worker first before engaging them to assist with these tasks. He and his mother have also described some of their attempts to engage suitable support workers, and the difficulties they have encountered with this.
As I have indicated, I accept there are risks and potential unintended consequences associated with family members acting as formal supports. However, I am also satisfied on the evidence that although she may not have formal qualifications, Ms Wator provides extremely high-quality personal care to Wator which is vastly superior form his point of view to the care which could be provided by any other paid support worker. In addition, the care Ms Wator provides is highly efficient and cost-effective as she is able to provide support as and when it is required, in a targeted and tailored manner across Mr Wator’s week and day.
While it will clearly be necessary for Mr Wator to reduce his reliance on his mother and transition toward independence, the issue currently is largely one of timing. There is a risk in my view that effectively forcing Mr Wator to engage external support workers for personal care tasks at the same time as he is attempting to work, potentially full-time, will be counter-productive and highly detrimental to him. Aside from the emotional toll on him, in the short-term this would also be likely to increase the time required for personal care tasks, making his working days even longer and more demanding than they already are.
With respect to the statutory framework, I am satisfied that the support provided and proposed to be provided by Ms Wator goes well beyond what it is reasonable to expect families to provide pursuant to s 34(1)(e). In addition, I am satisfied that approving Ms Wator as a formal support satisfies each of the criteria specified in s 34(1)(a)-(d), in particular that it will facilitate Mr Wator’s participation in the work force, that it represents good value for money and that it will be effective and beneficial for him.
As to the Operational Guidelines, I am also satisfied that Mr Wator has expressed very strong views in relation to his privacy and dignity, such that the exceptional circumstances criteria are met. With respect to the requirement that “all other options” to identify a suitable provider have been exhausted, I note this is a highly subjective requirement which does not appear to be entirely consistent with the other aspects of the exceptional circumstances criteria, or the statutory framework. I am satisfied that Mr Wator and Ms Wator have made sufficient efforts to source alternate providers such that it is appropriate for Ms Wator to be paid as a formal support for the duration of the plan resulting from my decision.
For completeness, I also note that the Agency did in fact approve and pay Ms Wator as a formal support for 3-6 months for the period 28 April 2023-26 October 2024, and also gave approval for Mr Wator to claim formal supports provided by Ms Wator in the plan period 26 January 2022 to 27 April 2023.[22] This was on the basis that “there is an expectation that you will try and source a pool of independent providers over the plan period in order to facilitate a slow transition away from your mother as your only formal support”.
[22] T7/129.
For the reasons I have explained, I have reached the conclusion that the beginning of this transition should be deferred so that it does not coincide with Mr Wator commencing work. I consider it is reasonable and necessary for Ms Wator to be paid as a formal support as this will enable Mr Wator to focus on successfully transitioning to employment and increase his prospects of making this transition successfully.
However, noting that the main issue from Mr Wator’s point of view relates to intrusive personal care tasks, I also consider it is appropriate to limit the number of hours of personal care provided Ms Wator to 3 hours per day. I note this will cover intrusive personal care together with other personal care tasks which Ms Wator is best placed to assist with in conjunction with those tasks. However, it will also require external providers to be engaged for the additional personal care which is likely to be required.
I note that my decision will only apply for the next plan period of 12 months. For the following plan period, it will be a matter for the Agency in the first instance whether Ms Wator continues to be paid as a formal support. Based on the Agency’s position in this matter, it appears unlikely that the Agency will approve this for the next plan period. Hopefully by then, Mr Wator will have commenced a transition away from reliance on his mother for personal care.
REIMBURSEMENT FOR CARE PROVIDED BY MS WATOR
Mr Wator is also seeking reimbursement for personal care hours provided by his mother across all his plan periods since he became a plan participant in 2018.
However, I only have jurisdiction with respect to the plan the subject of the Application for Review, which I note was dated 28 April 2023 with a review date of 26 October 2024[23] (subsequently extended on 20 December 2024 to 26 October 2025[24]), as well as the current plan dated 3 February 2025 with a review date of 4 August 2025.[25] Therefore, I only have power to consider whether Ms Wator should be paid as a formal support for the period 28 April 2023 until the end of the period covered by the SOPS resulting from my decision.
[23] T 13.
[24] Supplementary Joint Hearing Bundle, p 53.
[25] See s 103(2), NDIS Act.
I note the Agency does not dispute that in the event I concluded (as I have) that it is reasonable and necessary for Ms Wator to be a formal support for that period, it will be potentially liable to reimburse Ms Wator for hours she claims during that period (and for which she has not already been reimbursed).[26] However, I accept the Agency’s submission that it is not open to be me to consider reimbursement for any earlier plan period as I do not have jurisdiction with respect to earlier plans.
[26] Respondent’ Supplementary SOFIC, [17]-[19].
For abundant clarity, it will be a matter for the Agency to assess and determine any claims for reimbursement by Ms Wator, having regard to the material submitted by her in support of her claims. Before paying any claim for reimbursement, it will be necessary for the Agency to be satisfied that support of the relevant kind was provided for the hours claimed. It will also be a matter for the Agency to determine the appropriate hourly rate applicable to support provided by Ms Wator.
I note that in order to give effect to this conclusion, it will be necessary for me to vary the SOPS of 28 April 2023, as well as the current SOPS.
SUPPORT WORKER HOURS
Assessing the precise amount of support currently required by Mr Wator is made more difficult by the fact that, at the conclusion of the hearing and evidence, Mr Wator had not yet commenced work and it was unclear what his work pattern would be, including how many days he was likely to work from home.
Mr Wator’s position at the hearing was that he required 6 hours per day of support worker assistance, including community engagement. However, the Agency contended that 3 hours per day of self-care support plus a further 1.5 hours per week for assistance with domestic tasks such as cleaning and laundry would be sufficient.
The difference between the position of the parties on this issue was largely attributable to differences between the opinions of the respective occupational therapists, Ms Chan, who is Mr Wator’s treating occupational therapist, and Mr Mate, who was engaged by the Agency to provide an assessment and opinion.
Ms Chan has been Mr Wator’s occupational therapist for 6 years and has a deep understanding of his needs and limitations and a very detailed knowledge of precisely what forms of assistance he requires and why. Currently, she sees Mr Wator fortnightly. Most appointments are via telehealth, though she visits him at home quarterly. She has provided a detailed report dated 8 August 2023,[27] together with letters dated 6 November 2023[28] and 6 December 2023.[29]
[27] T1E/83.
[28] JTB, C6/199.
[29] JTB, C8/203.
During her oral evidence, Ms Chan gave a detailed and persuasive explanation of why she considers Mr Wator currently requires 6 hours of support worker assistance each day. She explained that approximately 3 hours of this time is required for personal care. In particular, Mr Wator requires extensive assistance at the beginning and end of each day. In the morning, he needs assistance to get out of bed, and with toileting, showering and dressing. She explained that Mr Wator has a very limited range of movement in his upper arms and is unable to bend over or wash his lower half. He is also unable to enter the shower area unassisted, as he is unable to mobilise without his AFOs. Currently, he sits on a commode chair to enter the shower and his mother moves the commode chair into the shower for him, after running the tap to ensure the water will not be too cold when it’s first turned on. Mr Wator washes his upper body and his mother then washes his lower half, and other areas he is unable to reach. Mr Wator is able to brush his teeth in the shower once his mother hands him the toothbrush. Ms Wator also assists Mr Wator with dressing as he is unable to do this independently.
Ms Chan also explained that Mr Wator requires assistance with toileting. Although he has the benefit of a bidet at home, he still requires assistance to mobilise to the toilet, and with pulling his pants down and up, and adjusting his clothing as required. She emphasised this was not an activity he could safely perform independently.
Similarly, with meal preparation, Ms Chan explained that Mr Wator’s balance was very precarious, he was at moderate risk of falling and would have difficulty getting up if he did fall. As I understand it, at home Mr Wator will generally mobilise on crutches, which I infer is important for his strength, stamina and conditioning, and therefore to maximise his overall independence. However, as Ms Chan explained, while balancing on crutches he is not able to safely remove a meal from the microwave or easily access utensils or things from the fridge, let alone carry these to the table to eat. She also made clear that Mr Wator fatigues very easily and managing physical demands was a crucial part of his overall fatigue management.
For these reasons, Ms Chan’s opinion was that Mr Wator required at least 3 hours of support with personal care each day. She also indicated that if this care was to be provided by external support workers rather than Mr Wator’s mother, additional time would be required. She explained that even with her, Mr Wator would frequently become anxious and overwhelmed when being directed to perform tasks and would sometimes “freeze”. Her expectation was that there would be considerable stress and anxiety for Mr Wator associated with the introduction of external support workers, and at least initially, considerably more hours would be required to complete the same personal care tasks.
As to Mr Wator’s specific support needs across the week, on days when he was working in the city, Ms Chan considered he would require at least one hour of personal care in the mornings to assist with getting ready for work. However, she qualified this by reference to who was providing the care. Her initial estimate was that 2 hours would be required, however when asked she accepted Mr Wator’s estimate that she could get Mr Wator ready for work in one hour, noting the efficiencies involved in her providing this assistance when compared with an external support worker. Ms Chan also considered that Mr Wator would require a further 2 hours of support with personal care at the end of the working day, noting he would be likely to be very fatigued. He would require assistance with snack and meal preparation, getting changed, toileting, and going to bed, as well as a degree of supervision and assistance with mobilising around the home given his likely level of fatigue, and attending to anything else necessary at the end of his working day as well as any preparations required for the following day.
On days when he was working from home, Ms Chan considered he would require the same amount of personal care support hours. However, in addition, he would also require a degree of assistance and supervision across the day, including with toileting, meal preparation, accessing and snacks and drinks, setting up for work and mobilising around the home. In addition, she suggested it would be appropriate to use some of the time on these days to attend to household tasks Mr Wator was not able to complete himself such as making his bed, cleaning and tidying his room, washing and other household tasks. In total, she considered he would require 6 hours of support worker assistance on these days. I would add that on days when he is working from home it appears Mr Wator will also be attending necessary appointments, in particular Keiser and any other in person appointments potentially including with Mr Fanning. Therefore, he will also require assistance with attending these appointments on those days.
On weekends, in addition to the 3 hours of personal care, Ms Chan considered Mr Wator would require on average 3 hours of support to access the community, which was a high priority goal for him. She suggested this support would enable him to attend activities tailored to his disability, but also social activities more generally such as going to the movies or meeting up with friends.
Despite the differences in his patterns and activities across the week, Ms Chan was therefore of the opinion that Mr Wator would require 6 hours of support worker assistance on each day of the week, albeit the specific nature of the support required would vary from day to day.
Mr Mate’s assessment of Mr Wator’s support needs was somewhat different from Ms Chan’s. He conducted an assessment at Mr Wator’s home on 3 April 2024 and provided a detailed report on 7 May 2024.[30] In his report he recommended that Mr Wator be provided with support workers for 9 hours per week for community access, travel and attending appointments, which he acknowledged may need to be increased when Mr Wator commenced working in the city. In addition, he recommended Mr Wator have support for 1.5 hours per week for cleaning and 3 hours per day for dressing, meal preparation and showering.[31] In note the overall total hours recommended by Mr Mate was approximately 31.5 hours, or 4.5 hours per day.
[30] JTB, D1/268.
[31] JTB, D1/303.
During his oral evidence, Mr Mate was taken to a table compiled by Ms Wator consisting of a detailed summary of assistance provided by her to Mr Wator on a typical day.[32] Significantly, the total of support hours recorded in the table amounted to approximately 3 hours per day of personal care. In addition, the table also recorded 9 hours per week for participating in/attending appointments and related activities, 4 hours per week of cleaning, cooking, shopping and animal care, 4 hours per week for administration and 1 hour per week for maintaining Mr Wator’s equipment, giving an overall total of approximately 5.5 hours per day on average.
[32] JTB, F3/665.
When provided with additional details, Mr Mate made some concessions as to the assistance required by Mr Wator, in particular with some personal care tasks including showering. However, he did not accept that Mr Wator required 9 hours per week of support to attend appointments and other medical needs, 4 hours of support for administration including liaison with his care team or 1 hour per week for maintaining his equipment, including cleaning and charging it. He considered Mr Wator had capacity to attend to most of these matters himself and should be encouraged to do so, albeit he accepted 9 hours per week was required for community access, including attending appointments.
In the event therefore, it is apparent that both occupational therapists essentially agree that Mr Wator requires 3 hours of support per day with his personal care needs. The difference between them relates more to the additional support hours required for other activities, including community access, household chores and administration.

As discussed at the hearing, a relevant consideration in assessing Mr Wator’s current support needs is the impact on him of commencing employment. It is clear this will affect many aspects of his support needs, including the hours he spends at home and his fatigue levels and capacity. As I understand the evidence before me, on the days he travels into the city, Mr Wator is likely to leave home between 7.30-8.00am in the morning and arrive home between 6.00-6.30pm in the evening. On those days, personal care support is likely to be required for approximately 1 hour in the morning and 2 hours in the evening. However, on those days, Mr Wator will not require support during the day and is very unlikely to be attending appointments.
As I have noted above in the context of assessing Mr Wator’s transport needs, further information with respect to Mr Wator’s work pattern was provided after the hearing. As already discussed, he is currently working 2 days per week with one of those days at the workplace, although he is seeking to increase this to 3 days overall with 2 in the workplace.
Therefore, assuming Mr Wator travels into the city 2 days per week to work, it appears for those days he will only require 3 hours of personal care, as well as any additional time which may be required for matters which can be attended to in his absence, including household chores and administration. As to Mr Wator’s capacity to attend to administration tasks such as organising appointments, paying bills, filling scripts, liaising with his care team, at the same time as commencing full-time employment, on balance I prefer the evidence of Ms Chan. In the short to medium term therefore, I accept that Mr Wator will require support with these tasks while he focusses on adjusting to the demands of his employment. Doing the best I can on the evidence, I consider Mr Wator will require approximately 1.5 hours per day of support with administration and household chores on days when he travels to the city to work, giving an overall total of 4.5 hours for those 2 days.
On weekdays when Mr Wator remains at home (whether he is working or not), it is clear on the evidence that his support needs are likely to be higher. I accept Ms Chan and Ms Wator’s evidence that on those days, Mr Wator will require support, assistance and supervision intermittently throughout the day. Presumably, he will also need to attend his Keiser appointments and any other appointments on those days and will still require some assistance with administration and household chores including clearing and tidying. On weekdays when Mr Wator is at home, I am satisfied he is likely to require support for 6 hours per day for both personal care and his other support needs.
On weekends, again clearly 3 hours of personal care support will be needed, together with some support and supervision across the day, assistance with household chores and support to access the community. Allowing for the likelihood of outings of between 1.5 – 3 hours on each of the weekend days, I am also satisfied that on average Mr Wator is likely to require support for 6 hours per day on the weekend for the short to medium term.
Noting my assessment that Mr Wator requires 4.5 hours support on days when he is working in the city, and 6 hours on each of the other days, I have therefore concluded that he currently requires an allowance for support workers of 39 hours per week, being 7.5 hours more per week than Mr Mate’s assessment.
CONCLUSION
With respect to each of the relevant issues, I have therefore concluded the following changes should be made to Mr Wator’s current SOPS:
(a)The allowance for psychology should be increased to 22 hours;
(b)The allowance for physiotherapy should be increased to 104 hours per year for the Keiser program, plus 24 hours of standard physiotherapy;
(c)20% of the insurance premiums on Mr Wator’s modified vehicle are to be paid as a support;
(d)Transport funding is to be provided for taxi travel to and from Mr Wator’s workplace for up to 2 days per week until 1 August 2025;
(e)The modified capacity building transport plan most recently proposed by the Agency is to be implemented from 4 August 2025;
(f)Ms Wator is to be approved to be paid as a formal support for her son for up to 3 hours per day from commencement of the SOPS originally under review, dated 28 April 2023;
(g)The allowance for support worker hours is to be increased to 39 hours per week.
I consider the most appropriate way to give effect to my conclusions is to set aside the current SOPS and remit the matter to the Agency with directions that a new SOPS be put in place for a 12-month period, which reflects the above changes and otherwise replicates Mr Wator’s existing supports on a pro rata basis. I will also vary the SOPS of 28 April 2023 to enable Mr Wator to seek reimbursement for care provided by his mother during that plan period for which she has not already been reimbursed.
DECISION
The internal review decision of 13 July 2023 is set aside and in substitution for that decision it is decided that the SOPS of 28 April 2023 is varied such that Ms Wator is approved to be paid as a formal support for her son for up to 3 hours per day from 28 April 2023 to 2 February 2025.
The SOPS of 3 February 2025 is set aside, and the matter is remitted to the Respondent for reconsideration with orders that:
(a)The review date of the SOPS is to be in 12 months’ time;
(b)22 hours per year is to be included for psychology supports;
(c)The allowance for physiotherapy is to be 104 hours per year for the Kieser program and 24 hours of standard physiotherapy;
(d)Ancillary to his capital supports, Mr Wator’s supports are to include 20% of the cost of the insurance premiums on his modified vehicle;
(e)Core supports are to include the cost of taxi travel from Mr Wator’s home to his workplace for up to 2 days per week until 1 August 2025;
(f)From 4 August 2025 the following capacity building transport plan is to be implemented:

Weeks 1 to 8

An OT will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).

Weeks 9 to 12

An OT will be funded to travel with the Applicant and the support worker once a week during this period (a one-way trip).

An additional 2 hours will be funded for report writing.

After the 12-week period, the Respondent will continue to fund the taxis to and from Hallam Train Station for the remainder of the plan.
(g)Ms Wator is approved to be paid as a formal support for her son for up to 3 hours per day from 3 February 2025;
(h)Core supports are to include 39 hours per week for support worker assistance; and
(i)All other supports in Mr Wator’s SOPS dated 3 February 2025 are to be replicated on a pro rata basis.