Tribunal: Senior Member Josephine Kelly

The applicant was a participant in the National Disability Insurance Scheme (NDIS) with funded supports for her paraplegia. The applicant requested additional funded supports to be included in her NDIS plan. She requested various additional supports including:

sports/exercise physiologist to attend her gym sessions for three one hour sessions per week at a cost of $9,360 per year based on an hourly rate of $60

tennis coaching for three one-hour sessions per week, at a cost of $8,563.50 a year.

The National Disability Insurance Agency (NDIA) administers the NDIS.

The NDIA refused to add the supports and the applicant applied to the AAT for a review of the decision, limiting her request to the two supports listed above.

The NDIS is a new way of providing support for people with a permanent and significant disability with the reasonable and necessary supports they need to live an ordinary life.[1] The main issue in this matter was whether the additional supports requested by the applicant were reasonable and necessary.

There is a list of requirements that the decision maker must be satisfied of when considering if certain supports are reasonable and necessary for NDIS funding.[2] Most relevant to this decision is the requirement that the support represents value for money when compared to the benefits it will achieve and the cost of alternative support.

The AAT was not satisfied that the funding for the two additional supports represented value for money. The AAT stated that the outcome of the training was not clear from the evidence and there was no evidence of the cost of alternative support. The AAT found that the evidence did not demonstrate how either support would substantially improve the applicant’s life stage outcomes or be of long-term benefit.

The AAT affirmed the decision.

Read the full decision on AustLII.

 

[1] Paragraph 4.1 of the National Disability Insurance Scheme Operational Guideline - Overview of the NDIS

[2] Section 34(1) of the National Disability Insurance Scheme Act 2013