ZCPY and National Disability Insurance Agency

This matter concerned an application by the Applicant, a 17-year-old with Autism Spectrum Disorder (ASD) and significant literacy impairments, for review of a decision by the National Disability Insurance Agency (NDIA). The dispute centred on whether a proposed intensive literacy program, "Seeing Stars: Symbol Imagery for Phonological and Orthographic Processing in Reading and Spelling" (SI program), constituted reasonable and necessary support under section 34 of the National Disability Insurance Scheme Act 2013 (Cth). The Applicant sought funding for this program, which was recommended by LBLP, to be delivered via one-on-one video conferencing over 8-10 weeks.

The Tribunal was required to determine whether the proposed SI program met the criteria for reasonable and necessary supports as outlined in section 34(1) of the Act. Specifically, the court had to consider whether the support would assist the Applicant to pursue his goals, objectives, and aspirations; whether it would facilitate his social and economic participation; and whether it would be, or be likely to be, effective and beneficial for him, having regard to current good practice. The NDIA contended that the program would not be effective or beneficial, citing expert opinion and the Applicant's previous response to a different literacy program.

The Tribunal reasoned that if the SI program successfully improved the Applicant's reading and writing abilities, it would directly assist him in achieving his stated goals, such as obtaining part-time employment and increasing his independence in daily activities. This improvement, in turn, would facilitate his social and economic participation. The Tribunal considered the evidence presented, including the Applicant's significant literacy deficits and the proposed intensive delivery method of the SI program, which differed from a previously undertaken program. The Tribunal was satisfied that the mandatory requirements of section 34(1)(a) and (b) were met.

Although the Plan Under Review had been replaced by subsequent NDIS plans, rendering the Tribunal's decision without practical effect on that specific plan, the NDIA provided an undertaking to reflect any findings in the Applicant's pending new plan. The Tribunal's jurisdiction was limited to the decision concerning the Plan Under Review, but the parties agreed to narrow the focus to the reasonableness and necessity of the SI program to allow for an expeditious decision before the Applicant's summer school holidays.