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Tribunal: Senior Member R Cameron

In order to receive funding from the National Disability Insurance Agency (NDIA), an applicant must demonstrate how they meet the “access criteria”. These criteria are designed to impose a number of thresholds on access to the National Disability Insurance Scheme (NDIS). This includes whether the applicant has a disability, whether the impairment is permanent, whether their social and economic participation is affected by the impairment and whether the person is likely to require support under the NDIS for their lifetime.

The NDIA found the applicant did not meet the “access criteria” and was therefore ineligible to participate in the NDIS. The AAT was asked to review this decision.

The applicant was a policeman who described an emotional downfall following his work at a rail crash scene. He also became a widower when his children were young. He was solely dependent on the Disability Support Pension for daily living. The conditions suffered by the applicant included PTSD, Anxiety Disorder and Major Depressive Disorder.

A number of reports from medical professionals were submitted as evidence to the AAT. They had recommended the applicant consult a psychiatrist. The AAT found that before a conclusion could be reached about the permanency of the applicant’s psychological condition, a psychiatrist would need to be consulted. The psychiatrist would need to have reached a conclusion that there are no known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy the impairment.

When considering the other access criteria, the AAT found the applicant’s psychological condition did not have a substantial impact on his functional capacity. He still maintained a circle of family friends and attended church and the gym. The AAT affirmed the decision not to grant the applicant access to the NDIS.

Read the full decision on AustLII.