WJCG and National Disability Insurance Agency

The applicant, WJCG, sought reimbursement from the National Disability Insurance Agency (NDIA) for the purchase and installation of a domestic hydrotherapy pool. The applicant suffers from Osteogenesis Imperfecta (OI), a condition causing bone fragility and frequent fractures, including spinal fractures. The NDIA had previously refused to include funding for a hydrotherapy pool in the applicant's NDIS plan. The matter came before the Tribunal for review of the NDIA's decision.

The primary legal issue before the Tribunal was whether the purchase and installation of a domestic hydrotherapy pool constituted a "reasonable and necessary support" under the National Disability Insurance Scheme Act 2013. This required the Tribunal to consider if the proposed support was value for money and the most appropriate way to fund the applicant's rehabilitation and ongoing management needs.

The Tribunal considered evidence from medical specialists, including an occupational therapist, a consultant surgeon, and a paediatric endocrinologist. It was accepted that hydrotherapy is beneficial for the applicant's rehabilitation and ongoing management, particularly in reducing the risk of re-injury and promoting function. However, the Tribunal found that while hydrotherapy itself is a valuable support, the purchase of a domestic hydrotherapy pool was not the most cost-effective or appropriate solution. The Tribunal noted that hydrotherapy is typically provided in supervised settings during rehabilitation phases and that various forms of exercise, not solely hydrotherapy, can contribute to bone strengthening and muscle support in the maintenance phase. The NDIA's role is not to fund the provision of rehabilitation facilities for general use.

The Tribunal concluded that the NDIA was not the appropriate source of funding for the provision of a domestic hydrotherapy pool. The applicant's claim for reimbursement was therefore dismissed.