Young and National Disability Insurance Agency

This matter concerned an application by the Applicant to the Administrative Appeals Tribunal (AAT) for review of a decision made by the National Disability Insurance Agency (NDIA) regarding funding for supports under the National Disability Insurance Scheme (NDIS). The Applicant contended that the funding provided was insufficient to maintain her quality of life, a primary objective of the NDIS. The NDIA had commissioned a report from Emeritus Professor Stewart Einfeld, a clinical psychiatrist, to assess the Applicant's needs.

The Tribunal was required to determine which of the Applicant's claimed supports were reasonable and necessary within the meaning of the NDIS legislation. This involved assessing the evidence presented, including the Applicant's own testimony and Professor Einfeld's report and oral evidence, and considering whether certain supports were properly before the Tribunal for review. The Tribunal also had to consider the NDIA's reasons for declining certain supports, which were primarily based on insufficient evidence of their reasonableness and necessity.

The Tribunal found that Professor Einfeld's report had limitations, noting that his expertise was primarily in child and adolescent psychiatry and that his assessment of the Applicant was based on a single, brief telephone interview. While Professor Einfeld expressed reservations about the efficacy of certain therapies such as yoga, pilates, horse therapy, and arts therapy, the Tribunal specifically rejected his characterisation of the evidence for these interventions as "weak." The Tribunal referred to extensive literature and policy documents, including the NSW Health and the Arts Framework, to support the value of arts-based therapies in managing health conditions. Consequently, the Tribunal set aside the NDIA's decision and substituted it with a decision that the Applicant should be funded for specific personal care, counselling, support coordination, and continence products. Furthermore, the Tribunal ordered that assistive technology assessments be considered or conducted for various items, including a hoist and sling system, shower commode, door wedge, wheelchair power add-on, motor vehicle adaptations, and the trial of one alternate therapy from a specified list.