Tribunal: Professor Ron McCallum AO, Member

The applicant applied to the National Disability Insurance Agency (NDIA) to become a participant in the National Disability Insurance Scheme (NDIS). The applicant was seeking supports for her connective tissue disorder, which had a range of effects including pain, tenderness and joint dislocations. The NDIA decided that the applicant did not meet the requirements to access the NDIS. The applicant requested an internal review and the NDIA affirmed the original decision. The applicant applied to the AAT for a review of this decision.

The applicant had two possible avenues for access to the NDIS. The first avenue relates to ‘disability requirements’ and involves, among other things, that an applicant’s impairment led to a substantially reduced functional capacity to undertake one or more of a number of activities.[1] The applicant stated that her condition substantially reduced her functional capacity to undertake social interaction, mobility and learning. The AAT discussed what a ‘substantially reduced functional capacity’ meant in the context of the NDIS and, after reviewing all the evidence, was not satisfied that the applicant met the required threshold.[2] The AAT therefore found that the applicant did not satisfy the ‘disability requirements’.

The second avenue relates to ‘early intervention requirements’, which are designed to provide early support in order to reduce a person’s future need for support.[3] This entails a number of criteria that the applicant must meet, including a requirement that the applicant’s impairments are not more appropriately funded or provided through the general health system.[4] This question largely concerned the nature of the applicant’s treatment for her condition and, after considering all the evidence, the AAT found that the treatment was more appropriately funded by the general health system and not the NDIS.[5] 

The AAT concluded that the applicant did not meet the access criteria and affirmed the decision under review.

Read the full decision in AustLII.

 

[1] Section 24 of the National Disability Insurance Scheme 2013 (Cth).

[2] See the discussion from paragraphs 24 to 26 of the full decision.

[3] Section 25(1)(b) of the National Disability Insurance Scheme Act 2013 (Cth).

[4] Section 25(3) of the National Disability Insurance Scheme Act 2013 (Cth).

[5] See the discussion from paragraphs 68 to 75 of the full decision.