Tribunal: Deputy President Dr P McDermott RFD
The applicant requested access to the National Disability Insurance Scheme (NDIS) for chronic back pain, spinal conditions, clinical depression and post-traumatic stress disorder (PTSD). The applicant claimed his back conditions had been affecting his life since at least 1990 and this resulted in his deteriorating mental health.
The National Disability Insurance Agency (NDIA) found that the applicant did not meet all of the relevant criteria for access to the NDIS, and decided not to grant access to the scheme.
The AAT affirmed the NDIA’s decision.
In its decision, the AAT outlined the criteria a person needs to meet to get access to the NDIS. The criteria are found in sections 21, 22, 23, 24 and 25 of the National Disability Insurance Scheme Act 2013 (NDIS Act) and these sections are included in the full written decision.
The majority of the AAT’s decision focused on if the applicant met section 24(1)(c) of the NDIS Act. This section lists a number of activities and states that a person must have a “substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking” at least one of the activities.
The Operational Guideline – Access to the NDIS (the Guideline) provides guidance on how to determine if a person has a “substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking” the activities.
The AAT used the Guideline, along with guidance from other cases, to discuss the circumstances when a person can be found to meet subsection 24(1)(c).  The AAT then considered if the applicant’s circumstances met this threshold.
The AAT found that there was no convincing evidence that the applicant’s conditions result in a “substantially reduced capacity to undertake, or psychosocial functioning in undertaking any of the activities”.
The AAT set out its reasons for why the applicant did not satisfy the criteria for each activity. The AAT referred to the evidence of a number of doctors, including general practitioners and clinical psychologists.
The AAT also found that the applicant did not meet other parts of the criteria, including sections 24(1)(d), 24(1)(e), and 25. It was found that the applicant did not meet section 24(1)(d) as the applicant had some capacity for social and economic participation. It was found that the applicant did not meet sections 24(1)(e) and 25 because the AAT was unable to find that he was likely to require support under the NDIS for his lifetime, and there was no evidence that the applicant would benefit from early intervention.
The AAT concluded that the applicant did not qualify for support under the NDIS.
Read the full written decision on AustLII.