Tribunal: Senior Member K Parker
Primary Government decision
The National Disability Insurance Agency (NDIA) cancelled a claim for payment made by Lifeful Coordination and Management (Lifeful C&M), the participant’s plan manager, for reimbursement of an NDIS participant’s (participant) rental payment.
AAT decision
The Tribunal decided that Lifeful C&M was not ‘a person whose interests are affected’ by a decision made by the NDIA. Therefore, Lifeful C&M did not have the standing to bring a valid application for review to the AAT. The Tribunal also decided that even if Lifeful C&M had standing, there was no reviewable decision before the Tribunal because no internal review decision had been made by the NDIA under section 100 of the National Disability Insurance Scheme Act 2013 (Cth).
Details
Lifeful C&M is a registered National Disability Insurance Scheme (NDIS) service provider and provided plan management services to the participant.
The participant made a rental payment for accommodation, and Lifeful C&M reimbursed this payment to the participant. Lifeful C&M then made a claim to the NDIA for reimbursement of the rental payment. However, the NDIA decided not to pay the claim.
Lifeful C&M appeared before the Tribunal to challenge the NDIA’s approved statement of participant supports (SOPs) in the participant’s plan because the NDIA did not approve funding for the rental amount.
Issue
Before considering the claim, the Tribunal needed to decide whether Lifeful C&M could appear as an applicant. To do so, Lifeful C&M would have to be recognised as a person whose interests were affected by the decision made by the NDIA regarding the participant’s SOPs.
The Tribunal also had to decide whether it has the power to review the decision by the NDIA to refuse the claim for payment.
Summary of reasons for decision
Lifeful C&M had unilaterally decided that the company would not seek reimbursement from the participant. The Tribunal found at the hearing that this was a private matter between Lifeful C&M and the participant. Therefore, any loss incurred because of that private arrangement does not mean Lifeful C&M’s interests have been affected by the decision of the NDIA to approve the participant’s SOPs.
The Tribunal was satisfied that Lifeful C&M’s role was to manage the participant’s funding in accordance with his NDIS plan. This did not include Lifeful C&M having any interests in whether certain supports were not included in their client’s plan.
Further, as the participant had not sought an internal NDIS review of the decision not to approve the claim for payment, and no internal review decision had been made by the NDIA, the Tribunal did not have the power to review the decision.
Full decision
Read the full decision on AustLII.
Glossary and other notes
Standing: Standing is the legal capacity for someone to commence or be involved in legal proceedings.
Statement of Participant Supports (SOPS): The statement of participant supports specifies, amongst other matters, the general supports (if any) that will be provided, and the reasonable and necessary supports (if any) that will be funded under the NDIS (section 33(2)).
Disclaimer
Every case before the AAT is determined on its individual facts. These summaries may not include all information considered by the AAT and do not constitute legal advice. You should read the full decision to ensure you understand the basis of our decision.