1. It is not in contest between the parties that the following supports are reasonable and necessary and should be funded in Mr Bull's SOPS:

a) $1,500 for low-cost Assistive Technology (to replace the $500 for low-cost assistive-technology in Mr Bull's existing SOPS);[9] > > b) 10 hours of additional capacity building funding to allow for the Selection and/or Manufacture of Customised or Wearable Technology;[10] > > c) A total of 20 hours of physiotherapy.[11]

2. Nor does the Respondent oppose Mr Bull's request to have the entirety of his plan plan-managed.[12]
3. Mr Bull's SFIC indicated he is seeking to have funding for emergency accommodation, yoga, cuddle therapy and speech therapy included in his SOPS.[13] However, Mr Bull has now withdrawn his request for funding for emergency accommodation, yoga and cuddle therapy; and has confirmed he is not seeking funding for speech therapy over and above that which is already included in his existing SOPS.[14]
4. The remaining supports Mr Bull is seeking to have funded in his SOPS are as follows:

a) Music therapy > > b) Art therapy > > c) Lift-recliner chair > > d) Exercise physiology > > e) Occupational therapy > > f) Psychology > > g) Level 3 transport > > h) Assistance with daily living - 6 hours per day.[15]

5. The Respondent's position with respect to each of the supports referred to in paragraph [8] will be set out in more detail below, however at a high level the Respondent contends that what is sought by Mr Bull on review, either in whole or in part, does not meet the requirements in s 34(1) and cannot be funded in Mr Bull's SOPS.[16]
6. The issues on review to be determined by the Tribunal are whether the supports referred to in paragraph [8] are reasonable and necessary, meet the criteria in s 34(1), and are most appropriately funded or provided through the NDIS.[17]
7. Before proceeding further, it is apparent from Mr Bull's evidence, submissions made by and on behalf of Mr Bull, and what he has over time reported to his allied health therapists, that he remains profoundly aggrieved by and focused on his experience with a former NDIS planner with whom he has had no contact since January 2023.[18] Whilst the Tribunal accepts that concern remains very live for Mr Bull, the Tribunal does not have unfettered power on review. On review, the Tribunal stands in the shoes of the decision-maker whose decision is under review and exercises the same power or powers as the primary decision-maker, subject to the same constraints.[19] The scope of the Tribunal's jurisdiction therefore is determined by reference to the internal reviewer's powers under s 100, which is in turn informed by the scope of the power under s 33(2).[20] For this reason, the Tribunal will not consider or make further comment with respect to this.

1. The National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 (Amending Act) commenced on 3 October 2024.[21] The Amending Act made a range of amendments to the NDIS Act. Those amendments included, but were not limited to, the insertion of a new definition of 'NDIS Support' at s 10, an amendment to s 33(5) which prescribes what is required when deciding whether to approve a SOPS, amendments to s 34 which sets out criteria which must be satisfied in relation to reasonable and necessary supports, and amendments to ss 43 and 44 regarding plan management. Those provisions, as amended, apply to the Applicant and any approval or variation of her SOPS.[22]
2. The objects of the NDIS Act, and the principles guiding actions under the NDIS Act, are set out in ss 3 and 4. In giving effect to the objectives of the NDIS Act, regard is to be had to the need to ensure the financial sustainability of the NDIS.[23]
3. Chapter 3 of the NDIS Act provides the statutory framework for individual plans under which NDIS supports will be funded for participants.[24] Section 17A prescribes principles to which regard must be had when performing functions and exercising powers under Chapter 3 of the NDIS Act. The preparation, variation, reassessment and replacement of a participant's plan, and the management of funding for supports under a participant's plan, should so far as reasonably practicable be guided by principles relating to plans set out in s 31. A participant's plan must include the participant's statement of goals and aspirations and SOPS.[25]
4. In deciding whether to approve a SOPS, the CEO or the Tribunal on review, must:

(a) have regard to the participant's statement of goals and aspirations; and

(b) have regard to relevant assessments conducted in relation to the participant; and

(c) be satisfied as mentioned in section 34 in relation to the reasonable and necessary supports that will be funded and the general supports that will be provided; and

(d) apply the National Disability Insurance Scheme rules (if any) made for the purposes of section 35;

(e) have regard to the principle that a participant should manage his or her plan to the extent that he or she wishes to do so; and

(f) have regard to the operation and effectiveness of any previous plans of the participant; and

(g) have regard to whether section 46 (acquittal of NDIS amounts) was complied with in relation to any previous plan for the participant.[26]

For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:

aa) the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements (see section 24) or the early intervention requirements (see section 25);

a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations;

b) the support will assist the participant to undertake activities, so as to facilitate the participant's social and economic participation;

1. the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support;

d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice;

e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide;

f) the support is an NDIS support for the participant.

1. In addition to the matters of which the CEO, or the Tribunal on review, must be satisfied in s 34(1), the Tribunal must also be satisfied that the support is most appropriately funded or provided through the NDIS, and is not more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or systems of service delivery or support services offered as part of a universal service obligation, or in accordance with reasonable adjustments required under a law dealing with discrimination on the basis of disability.[27]
2. Relevant to this application, the Minister has made the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Supports Rules) and the National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 (Transitional Rules). These are an important part of the legislative scheme.[28]
3. Guidelines published on the NDIS website contain information about what the Respondent considers when making decisions under the NDIS. These are essentially policy documents. The Guidelines 'Reasonable and Necessary Supports' (Supports Guideline) and 'What principles do we follow to create your plan?' (Principles Guideline) are relevant to this application. The Tribunal will take these into account unless there are cogent reasons not to.[29]

1. The parties filed a joint tender bundle which included the T-Documents filed under s 37 of the AAT Act, and additional documents relied on by each of the parties. The joint tender bundle was received into evidence at the commencement of the hearing and marked 'Exhibit 1'. At the commencement of the hearing a functional capacity assessment report prepared by Ms Leonie Souter (Ms Souter) dated 15 September 2025 was also received into evidence and marked 'Exhibit 2'.
2. The hearing was conducted by Microsoft Teams on 13, 14 and 15 October 2025. Mr Bull and Mr Glen Dwyer (Mr Dwyer) gave oral evidence at the hearing.
3. Mr Bull filed a Statement of Facts, Issues and Contentions (Mr Bull's SFIC) on 25 August 2025. The Respondent filed a Statement of Facts, Issues and Contentions (Respondent's SFIC) dated 10 September 2025. The parties made oral opening submissions at the hearing. The Respondent filed written closing submissions dated 31 October 2025; and Mr Bull filed written closing submissions on 10 November 2025.
4. The Tribunal has considered the evidence and submissions referred to in paragraphs [20] to [22].

1. The Tribunal understands Mr Bull is seeking to have funding included in his SOPS for weekly music therapy and weekly art therapy. The Respondent contends that the physiotherapy and occupational therapy funded in Mr Bull's SOPS should address what is intended to be addressed by music therapy and art therapy; and in these circumstances the music therapy and art therapy sought on review duplicate other support delivered under alternative funding through the NDIS, and do not meet the requirements in ss 34(1)(c), 34(1)(d) and 34(1)(e).[30]
2. In Mr Bull's SFIC it is submitted that his SOPS previously included funding for both music therapy and art therapy, but due to disruption associated with numerous relocations and a motor vehicle accident (MVA) in 2023 he was unable to engage in those therapies.[31] He contends these supports will give him something to look forward to and assist in rebuilding his confidence and well-being; and requests that funding for these be reinstated in his SOPS so that he can fully benefit from them.[32]
3. There is no evidence before the Tribunal from a music therapist or an art therapist.
4. Ms Vicky Abraham (Ms Abraham) is an occupational therapist, and the managing director of Abraham OT Services (AOTS).[33] In February 2024 Ms Abraham reported:
   • Mr Bull used to be a musician.
   • Mr Bull's SOPS previously included funding for music therapy and art therapy.
   • With the decline in Mr Bull's mental health, music therapy will be of great benefit as it will incorporate one of his passions into his sessions and assist him to continue to strive for an increase in function. She recommended 30 hours per year of music therapy.
   • Mr Bull was involved in art therapy in previous plans and found it assisted with regaining function of his hand and arm. She recommended 30 hours per year of art therapy.[34]
5. Ms Raquel Poyser (Ms Poyser) is a physiotherapist.[35] In March 2024 Ms Poyser recommended 30 hours of music therapy and 30 hours of art therapy be funded in Mr Bull's SOPS.
6. Mr Dwyer is an occupational therapist who was engaged by the Respondent to prepare a functional capacity assessment report during these proceedings. In September 2024, Mr Dwyer noted Mr Bull's goals relating to music involve him wanting to improve his strength and fine motor skills to be able to re-engage in music; and opined participating in physiotherapy and occupational therapy treatment is likely to produce the improvements he is seeking in terms of strength and fine motor skills. Mr Dwyer further opined that whilst participating in music therapy may be interesting for Mr Bull, it is unlikely to build capacity over and above the capacity building that should be achieved through engagement in physiotherapy and occupational therapy. Similarly, with respect to art therapy, Mr Dwyer opined participating in physiotherapy and occupational therapy treatment is likely to produce the improvements Mr Bull is seeking in terms of strength and fine motor skills.[36]
7. Ms Souter is an occupational therapist.[37] In September 2025 Ms Souter recommended music therapy input to optimise verbal communication, singing and left sided physical function.[38]
8. In a statement of lived experience dated August 2025, Mr Bull stated he previously worked with a music therapist, and she was helping him with his speech through singing; and helping him reconnect with music as he can no longer play bass guitar or drums.[39] Mr Bull stated this gave him a small connection with playing live music again.[40]
9. At the hearing the Tribunal raised with Mr Bull that whilst there are recommendations in evidence from Ms Abraham, Ms Poyser and Ms Souter, the hours recommended by Ms Abraham and Ms Poyser fall short of what is sought on review; Ms Souter's recommendation with respect to music therapy is unquantified; and there is no recommendation in evidence from a music therapist or art therapist. Mr Bull commented that the previous planner with whom he is deeply aggrieved previously approved funding for these supports in 3 monthly rollover plans; and Ms Abraham understands the level of support he needs. It was also submitted at the hearing on Mr Bull's behalf that he did not have funding in his NDIS plan to obtain a report or recommendation from a music or art therapist; and the Tribunal accepts this is so.
10. The Tribunal accepts Mr Bull is interested in attending regular music therapy and art therapy; that his previous lived experience of music therapy was such that it provided him with a small connection to live performance; and based on his self-report to Ms Abraham, he felt art therapy was in the past beneficial.
11. Ms Abraham, Ms Poyser and Ms Souter have recommended Mr Bull have funding included in his SOPS for music therapy; and Ms Abraham and Ms Poyser have also recommended Mr Bull have funding included in his SOPS for art therapy. On the face of Ms Abraham's report it appears her recommendation for music therapy and art therapy has been largely, if not entirely, informed by Ms Bull's self-reporting; and it is left to inference whether she has given independent consideration to whether the functional gains Mr Bull is hoping to achieve from his engagement in music therapy and/or art therapy might be obtained within the parameters of his existing funded supports, or those functional objectives might be more readily obtained from other therapies. Documents produced by Ms Abraham under summons shed no further light on this.
12. Ms Poyser has provided no clinical justification or reasoning for why she has recommended music therapy or art therapy. Ms Souter's recommendation is very high level and without clear, clinical justification. Further, in circumstances where neither Ms Abraham or Ms Poyser is a music therapist nor an art therapist, the Tribunal considers it is beyond their expertise to opine in relation to the quantum of music therapy and/or art therapy Mr Bull would benefit from.
13. Mr Dwyer's evidence, which the Tribunal broadly accepts, is that the functional goals of the music therapy and art therapy sought on review will likely be produced by Mr Bull engaging in physiotherapy and occupational therapy.
14. There is no report in evidence from a music therapist or art therapist providing objective measures of what benefit Mr Bull did in fact achieve from either therapy in the past. Nor is there any recommendation in evidence from a music therapist or art therapist that Mr Bull have access to either of these therapies; or an explanation from a music therapist or art therapist as to how they consider Mr Bull will benefit from such therapy, or how such benefits will be measured.
15. On the material before it and having considered those matters referred to in rr 3.1 and 3.2 of the Supports Rules, the Tribunal is not persuaded music therapy or art therapy represents value for money in that the costs of those supports are reasonable, relative to both the benefits achieved and the cost of alternative support; or that those supports will be, or are likely to be, effective and beneficial for Mr Bull, having regard to current good practice; and therefore, the requirements in ss 34(1)(c) and 34(1)(d) are not met. It follows that the music therapy and art therapy sought on review is not reasonable and necessary and cannot be funded in Mr Bull's SOPS.

1. In addition to the $1,500 for low-cost AT which the parties agree meets the requirements in s 34(1) and should be included in Mr Bull's SOPS, Mr Bull is seeking funding for a lift-recliner chair.[41]
2. The Respondent contends Mr Bull is independent in transfers and there is no evidence of the cost or type of item being sought, and in these circumstances the Tribunal should not be satisfied a lift-recliner chair is likely to be effective and beneficial for Mr Bull, or value for money.[42]
3. In February 2020, Mr Nick Snowden (Mr Snowden), an occupational therapist, recommended a Seagrove Dual Motor Electric Lift and Recline Chair with Adjustable Head and Lumber (cost $2,299).[43] Mr Snowden opined the recommended lift-recliner chair will maximise Mr Bull's ability to complete chair transfers which are currently difficult for him to complete secondary to physical limitations caused by his stroke and resulting fatigue.[44]
4. In March 2024 and August 2025 Ms Poyser opined Mr Bull would benefit from a lift recliner chair to assist with his sit to stand transfers and provide appropriate postural support when sitting.[45]
5. In February 2024, Ms Abraham reported Mr Bull was independent with all transfers; but that this does not mean he is always safe.[46] In March 2024 Ms Poyser reported Mr Bull is independent with all transfers; however, because of reduced access to physiotherapy and occupational therapy over the past 18 months he is much weaker in his left side than he was and these transfers are no longer as easy and efficient as they were.[47] Interestingly, neither Ms Abraham or Ms Poyser make mention in their 2024 reports that Mr Bull was involved in a MVA in 2023 in which he broke his left leg; he had prolonged infections thereafter; and in March 2024 (only 1 month after Ms Abraham's report and the same month as Ms Poyser's report) he had to have a left hip replacement because of issues arising from his 2023 MVA. Despite the proximity of these reports to Mr Bull's left hip replacement, he was still nevertheless assessed as independent with chair transfers by both Ms Abraham and Ms Poyser at the relevant time.
6. In September 2024 Mr Dwyer reported he observed Mr Bull complete safe and independent chair transfers.[48] In August 2025 Ms Abraham and Ms Poyser both reported Mr Bull can independently transfer on and off chairs.[49] In September 2025, Ms Souter similarly reported Mr Bull is independent with all transfers; and noted he is using an electric lift recliner on loan through the Transport Accident Commission (TAC).[50] The Tribunal understands Mr Bull has an ongoing appeal process underway regarding a decision made by the TAC regarding any ongoing liability arising from Mr Bull's 2023 MVA.[51] It is unclear on the evidence whether this has any bearing on Mr Bull's ongoing access to the electric lift recliner on loan through the TAC.
7. When asked at the hearing whether he could see any clinical justification for a life-recliner chair, Mr Dwyer said not in Mr Bull's case as he can transfer on and off a chair; the recliner may have been required for a period after his hip surgery because there are limitations on hip flexion after such surgery, but now in terms of the baseline underlying stroke related weakness Mr Bull has sufficient strength to transfer for regular chair use a life-recliner chair would only probably serve to add to deconditioning.
8. Ms Poyser was not called to give oral evidence at the hearing, and the Tribunal was therefore unable to ask her questions about why she has recommended a lift recliner chair for Mr Bull in circumstances where she has assessed him to be independent with chair transfers; or to give her an opportunity to comment on Mr Dwyer's evidence that a lift-recliner chair would probably serve to add to deconditioning.
9. Based on the evidence as outlined above provided by Ms Poyser, Ms Abraham, Ms Souter and Mr Dwyer, the Tribunal finds Mr Bull can independently transfer on and off a chair. The Tribunal accepts Mr Dwyer's evidence that in circumstances where Mr Bull is independent with chair transfers and has sufficient strength to transfer from a regular chair, using a lift-recliner chair would only probably serve to add to deconditioning. For these reasons, on the material before it and having considered those matters referred to in r 3.2 of the Supports Rules, the Tribunal is not persuaded a lift-recliner chair will be, or is likely to be, effective and beneficial for Mr Bull, having regard to current good practice; and therefore, the requirement in s 34(1)(d) is not met. It follows that the lift-recliner chair sought on review is not reasonable and necessary and cannot be funded in Mr Bull's SOPS.

1. Mr Bull is seeking to have funding for 80 hours per year exercise physiology (2 x 45 min online sessions per week plus report writing) included in his SOPS.[53] He contends that an exercise physiologist would supervise the implementation of an exercise program and adapt that as needed depending upon his needs.[54]
2. The Respondent contends:

a) The requested 1.5 hours per week of exercise physiology is unlikely to be effective and beneficial for Mr Bull, nor represents value for money.[55] > > b) It is reasonable and necessary to fund 16 hours of exercise physiology.[56] The purpose of this funding would be to develop an exercise plan with disability-related adjustments that Mr Bull can complete in his home or in community settings.[57]

3. In a statement of lived experience dated August 2025 Mr Bull states he worked with Michael Bull (Michael Bull) - who he says is a qualified physiotherapist with 'knowledge of exercise science' - during the pandemic via online sessions using his home gym and saw huge gains. He states he went from being able to do 3 push-ups in his first set, to 80 and 90 push-ups in 3 sets, within 18 months; he gained strength and his walking tolerance improved; and his confidence in riding his motorcycle, social and community participation, walking his dogs to the beach, and walking around Melbourne, improved.[58] Mr Bull further states he has been desperate to return to exercise physical therapy with Michael Bull since January 2023.[59]
4. In oral evidence, Mr Bull confirmed that with Michael Bull he did online exercise physiology using his home gym; and he still has an exercise bike, treadmill and weights at home. He considers the Respondent's proposal as set out at paragraph [49] would be inappropriate as his situation is complex. In closing submissions, it was contended Mr Bull's previous engagement with exercise physiology had been extremely successful in promoting Mr Bull's physical and emotional well-being.[60]
5. In February 2024 Ms Abraham reported Mr Bull continues to have the input of a physiotherapist to ensure that his safety, strength and endurance begins to increase. She recommended 20 hours per year of physiotherapy; and explained the physiotherapist will oversee the exercise physiologist to ensure Mr Bull is correctly completing the program set.[61] Ms Abraham opined Mr Bull requires an assessment by an exercise physiologist for a home-based program to be developed; and it would be beneficial for him to have biweekly input with the exercise physiologist throughout the plan so the home program can be devised, completed and assessed on a regular basis. She recommended 120 hours per year of exercise physiology; and opined that due to his recent decline in function it is essential an exercise physiologist complete the exercises with Mr Bull, rather than support workers.[62]
6. In March 2024 Ms Poyser reported Mr Bull had reduced access to physiotherapy and exercise physiology over the past 12 to 18 months, because of which he is much weaker in his left side than he was, his balance has deteriorated, his left foot drop has deteriorated, and his ability to walk distances has reduced.[63] Ms Poyser recommended 20 hours of physiotherapy intervention and 120 hours of exercise physiology over 12 months.[64] In a report dated August 2025 Ms Poyser recommended 20 hours of physiotherapy intervention over 12 months, and an unquantified amount of exercise physiology.[65]
7. In September 2024, Mr Dwyer stated it was outside his scope of occupational therapy to prescribe exercise physiology intervention and deferred to an exercise physiologist to provide guidance in this regard. Broadly speaking, Mr Dwyer considered exercise physiology most likely has a role to play (in combination with physiotherapy) as part of Mr Bull's treatment regime.[66]
8. In August 2025 Ms Abraham reported TAC has approved 1 session a fortnight with an exercise physiologist to support his recovery from surgery; however his physical impairments related to his stroke still require support from a exercise physiologist as it affects his entire left-side, not just his hip which was injured in the MVA.[67] Ms Abraham opined in order for Mr Bull to increase his function and safety when completing daily tasks input from an exercise physiologist will be beneficial; such sessions would focus on endurance, strength, balance and walking skills when in crowds.[68]
9. In September 2025 Mr Souter recommended exercise physiology input to optimise and maintain overall health and wellbeing.[69]
10. Ms Poyser's report in March 2024 includes no clinical reasoning for why she recommended 120 hours of exercise physiology. As was noted in paragraph [43], neither Ms Abraham nor Ms Poyser refer in their respective 2024 reports to Mr Bull's 2023 MVA, his associated injury and infections, and the resultant left side hip replacement in March 2024. This is despite their respective 2024 reports being written around the time of Mr Bull's left hip replacement. It is in these circumstances unclear the extent to which the 120 hours of exercise physiology they each recommend in their 2024 reports, and Ms Abraham's opinion that an exercise physiologist must complete the exercise with Mr Bull, is based upon or contemplates Mr Bull's support needs during the post-surgery rehabilitation phase. Further, in circumstances where neither Ms Poyser nor Ms Abraham are exercise physiologists, the Tribunal considers it is outside their expertise to prescribe a specific number of hours of exercise physiology. For these reasons, to the extent Ms Poyser and Ms Abraham recommended a specific number of hours of exercise physiology in March 2024, the Tribunal gives their evidence no weight.
11. However, consistent across the evidence of Ms Abraham, Ms Poyser, Ms Souter and Mr Dwyer is that exercise physiology has a role to play as part of Mr Bull's treatment regime. The Tribunal finds this consensus of expert opinion persuasive and finds accordingly.
12. Mr Bull is seeking to have 80 hours per year of exercise physiology funded in his SOPS. Whilst the Tribunal acknowledges Mr Bull's purported confidence in the efficacy of the requested support based on his self-reported lived experience of such therapy, there is no clinical recommendation in evidence from an exercise physiologist or appropriately qualified professional for exercise physiology at that intensity. In the absence of any such recommendation and having considered the matters prescribed in r 3.2 of the Supports Rules, the Tribunal is not satisfied 80 hours of exercise physiology over 12 months will be, or is likely to be, effective and beneficial for Mr Bull, having regard to current good practice; and therefore, the requirement in s 34(1)(d) is not met. Nor, in the absence of any such recommendation for exercise physiology at the requested intensity, and having considered the matters prescribed in r 3.1 of the Supports Rules, is the Tribunal persuaded that funding exercise physiology at the intensity sought on review represents value for money in that the costs of the support is reasonable, relative to both the benefits achieved and the cost of alternative support; and therefore, the requirement in s 34(1)(c) is not met. It follows that the quantum of exercise physiology sought on review is not reasonable and necessary and cannot be funded in Mr Bull's SOPS.
13. Nevertheless, the Tribunal has accepted that exercise physiology has a role to play as part of Mr Bull's treatment regime. The Respondent contends 16 hours of exercise physiology to develop an exercise plan with disability related adjustments that Mr Bull can complete in his home or in community settings is reasonable and necessary. Whilst Ms Abraham expressed a view in February 2024 that an exercise physiologist must complete the exercise with Mr Bull, that opinion was expressed at a time when Mr Bull was about to undergo a left hip replacement. It is now approximately 19 months post that surgery. There is no current clinical opinion in evidence to the effect an exercise physiologist must complete exercise with Mr Bull; and in the absence of that the Tribunal is not persuaded that is the case.
14. In these circumstances, and noting the consensus of expert opinion that exercise physiology has a role to play as part of Mr Bull's treatment regime, the Tribunal considers 16 hours of exercise physiology to develop an exercise plan with disability related adjustments that Mr Bull can complete in his home or in community settings (exercise physiology support) is necessary to address needs of Mr Bull arising from his left sided weakness affecting his upper and lower limbs, left sided foot drop, and asymmetrical gait in relation to which he meets the disability requirements in s 24;[70] will assist Mr Bull to pursue the goals, objectives and aspirations included in his statement of goals and aspirations, in particular his goal to build his strength in his left leg and arm;[71] and will assist Mr Bull to undertake activities, so as to facilitate his social and economic participation by building his confidence and strength as Mr Bull contends was his previous experience when he was engaged in an exercise program.[72]
15. Having considered those matters prescribed in rr 3.1 and 3.2, the Tribunal is persuaded the exercise physiology support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support; and will be, or is likely to be, effective and beneficial for Mr Bull, having regard to current good practice.[73] The exercise physiology support is not a support that could reasonably be provided by informal networks or the community; and is an NDIS support pursuant to item 34 to Schedule 1 to the NDIS Transitional Rules.[74] It follows that the Tribunal is satisfied the exercise physiology support meets the requirements in s 34(1). The Tribunal is similarly satisfied the exercise physiology support is most appropriately funded or provided through the NDIS.[75] It follows that the exercise physiology support is a reasonable and necessary support, and the Tribunal finds it should be funded in Mr Bull's SOPS. It will be a matter for Mr Bull, in conjunction with an exercise physiologist, to formulate a plan to ensure those 16 hours are utilised optimally over 12 months.

1. Mr Bull's existing SOPS includes funding for 52 hours of occupational therapy.[76] Mr Bull is seeking an additional 156 hours of occupational therapy for robotic arm therapy to be delivered by Ms Abraham at AOTS.[77]
2. The Respondent contends the Tribunal should not be satisfied an additional 156 hours of occupational therapy for robotic arm therapy is likely to be effective and beneficial for Mr Bull, or value for money, in circumstances where he has and will have funding for 52 hours of home-based occupational therapy.[78]
3. In July 2020, Ms Abraham reported Mr Bull had attended for an initial assessment of his left hand and arm at AOTS; the session was extremely successful and Mr Bull would benefit from attending AOTS regularly.[79] Ms Abraham recommended the following for a 12-month period:
   • 48 weeks x 2 sessions each week x 2 hours per session (192 hours) of robotic therapy
   • 4 x 10-hour block for intensive upper limb sessions
   • Team meeting and report writing - 2 hours
   • Set up of Lusio Mate program - 2 hours.[80]
4. In making the above recommendation Ms Abraham acknowledged this is a very high number of hours; opined Mr Bull needs to have 12 months of such high intensity to see how much function he can regain; and after 12 months this will be reassessed.[81]
5. In February 2024, Ms Abraham reported:
   • Mr Bull's function in his left fingers, hand and arm has greatly deteriorated since he has had occupational therapy input; during the assessment it was observed he did not use his left arm and hand at all, except as a support to his right hand; and when he was attending regular sessions at AOTS he was gaining a significant amount of function in his left hand and arm.[82]
   • The robotic and computer-based devices used within the AOTS are not readily available and require a highly trained occupational therapist to assist during sessions.[83] The robotic devices available at AOTS assist participants to increase strength and movement in arms and fingers, thus assisting participants to increase function.[84] Pablo, a sensor based computer device, promotes active range in joints and limbs; and there is also a board device with Pablo that is used to strengthen a participant's shoulders and elbow.[85] It is known this robotic therapy works for Mr Bull as he was attending AOTS from 2020 to 2022 when he made significant gains.[86]
6. Ms Abraham recommended Mr Bull attend AOTS for 2 x 2-hour sessions per week (208 hours over 12 months) to focus on his upper limb retraining (specifically building his finger and arm movements, strength, endurance, and range to rebuild his function and capabilities). She also recommended an additional 60 hours of occupational therapy to assist Mr Bull with retraining around the house once his hand and arm capacities have increased (which includes monthly at home sessions, travel time, program development and report writing).[87]
7. In August 2025, Ms Abraham reported:
   • In 2020 Mr Bull first presented to AOTS with significantly reduced movement in all his joints on his upper limb as well as spasticity in his fingers.[88] When actively involved in upper limb therapy with AOTS between 2020 and 2022, he made great functional improvements and increased his independence, however when these sessions stopped in 2022 his function deteriorated again reducing his abilities to participate in daily tasks.[89]
   • The robotic devices available at AOTS assisted Mr Bull in the past to increase his strength and movement in his arms and fingers, thus assisting him to increase his function. With regular sessions robotic therapy can do this again.[90] If upper limb robotic therapy via occupational therapy is not approved, then Mr Bull would have no other formal avenue to increase his hand movement and function.[91] There is no other clinic in Victoria that offers the same type of programme as AOTS.[92]
8. Ms Abraham recommended 52 hours of occupational therapy to assist with task retraining around the house once Mr Bull's hand and arm capacities have increased; and 2 x 1.5-hour sessions per week (156 hours over 12 months) of robotic arm therapy to rebuild function.[93]
9. In September 2024, Mr Dwyer noted Ms Abraham had recommended Mr Bull attend her own occupational therapy business (AOTS) for robotics; and that he could not comment on the potential usefulness of this therapy six years post stroke, noting that most improvement occurs in the initial weeks and months post-stroke.[94] He opined that a reasonable allocation for occupational therapy treatment is a one-hour session per week, which equates to 52 hours per year.[95] He further opined that Mr Bull is not presently accessing any regular treatment or therapy, which may explain his recent lack of progress.[96]
10. In September 2025 Mr Souter recommended 40 hours per year (inclusive of travel and reports) occupation therapy input to optimise activities of daily living performance through task modification and assessment, recommendation and provision of orientation and routine assistive technology, low-cost activities of daily living assistive technology, and mid-cost transfer assistive technology (electric lift recliner).[97]
11. In oral evidence, Mr Dwyer opined that with respect to robotic therapy, there are other forms of upper limb function occupational therapy specialists or upper limb specialists, that is upper limb therapy that would be available in the community just like any other type of occupational therapy or things like physiotherapy treatment. Mr Dwyer also stated in oral evidence he could not speak to the potential gains that robotic arm therapy might have now 7 odd years post stroke given most recovery does occur in the early phases. Mr Dwyer opined Mr Bull should be immediately and urgently having community based occupational therapy; and he does not see why Ms Abraham would suggest that occur after she has completed her robotic arm therapy.
12. In a statement of lived experience dated August 2025, Mr Bull stated the goal he was previously working towards at AOTS was gaining fine upper limb and hand motor skills so he could return to his music; and he was making significant improvements with robotic therapy sessions pre-January 2023.[98] He wants to relocate closer to where AOTS is located.[99] He hopes to work with a second occupational therapist to assist getting his daily routine and recovery goals back in place; and to get recommendations regarding home modifications and assistive technology.[100]
13. The Tribunal has several concerns in relation to Ms Abraham's recommendation that Mr Bull be funded for 156 hours of robotic arm therapy at AOTS. Those concerns are as follows:

• Documents produced under summons by Ms Abraham evidence that in addition to providing Mr Bull with robotic therapy in her capacity as an occupational therapist, she has in the past also provided Mr Bull with support and advocacy regarding a range of other matters, including but not limited to finding accommodation, booking accommodation, purchasing various items, and liaising with organisations on Mr Bull's behalf.[101] Ms Abraham's business, AOTS, has also invoiced for some of those services.[102] In circumstances where Ms Abraham has acted as an advocate for Mr Bull, concerns arise regarding the impartiality of her evidence.

a) Ms Abraham has since 2020 recommended extremely intensive robotic arm therapy for Mr Bull to be delivered by her own business. If funding for the 156 hours she has most recently recommended for Mr Bull is included in Mr Bull's SOPS, Ms Abraham's business will directly benefit from this. Of course, this does not of itself mean the robotic arm therapy Ms Abraham has recommended for Mr Bull is not reasonable and necessary, or that she is recommending anything other than what, in her expert opinion, Mr Bull requires. > > b) In Ms Abraham's February 2024 report, she opined it is known robotic therapy works for Mr Bull as he was attending the AOTS clinic from 2020 to 2022 when he made significant gains. In Ms Abraham's August 2025 report she similarly opined the robotic devices available at AOTS assisted Mr Bull in the past to increase his strength and movement in his arms and fingers, thus assisting him to increase his function; and with regular sessions robotic therapy can do this again. However, it is unclear from Ms Abraham's reporting whether, and if so how, Mr Bull's previous gains were objectively measured; and nor is it clear how the effectiveness of the intensive therapy she has recommended will be assessed and measured into the future. The absence of such quantitative data in Ms Abraham's reporting is perplexing when she or her business have delivered intensive therapy to Mr Bull in the past, and further such intensive therapy is being recommended for Mr Bull. > > c) Whilst Ms Abraham opines in relation to the advantage of robotic therapy when compared to traditional upper limb therapy, she is silent with respect to whether traditional upper limb therapy can nevertheless achieve Mr Bull's therapy objectives and goals. Nor has Ms Abraham addressed the typical trajectory of recovery post-stroke, and why in her opinion intensive therapy is appropriate for Mr Bull 7 years post stroke.

14. Ms Souter and Mr Dwyer are the occupational therapists who have most recently assessed Mr Bull. Neither have recommended robotics therapy at AOTS or anywhere else. Nor have they recommended Mr Bull requires occupational therapy more than that which is already funded in his SOPS for the purposes of community based occupational therapy to optimise activities of daily living performance. Given the collective force of those concerns identified in paragraph [75] regarding Ms Abraham's evidence, the Tribunal prefers and gives more weight to Ms Souter's and Mr Dwyer's evidence as it relates to Mr Bull's occupational therapy needs.
15. Whilst the Tribunal accepts Mr Bull remains confident in the efficacy of intensive robotic therapy as has been recommended by Mr Abraham, the Tribunal is not persuaded on the material before it that any such therapy, or any occupational therapy over and above what is already funded in Mr Bull's SOPS, will be, or is likely to be, effective and beneficial for Mr Bull, having regard to current good practice; and therefore, the requirement in s 34(1)(d) is not met.
16. Further, on the material before it, the Tribunal is not persuaded the intensive robotic therapy recommended by Ms Abraham, or any additional occupational therapy over and above what is already funded in Mr Bull's SOPS will substantially improve the life stage outcomes for, and be of long-term benefit to, Mr Bull; that funding such support is likely to reduce the cost of the funding of supports for Mr Bull in the long-term or will increase Mr Bull's independence and reduce his need for other kinds of supports. For these reasons, Tribunal is not satisfied the intensive robotic therapy recommended by Ms Abraham, or any additional occupational therapy over and above what is already funded in Mr Bull's SOPS, represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support; and therefore, the requirement in s 34(1)(c) is not met.
17. It follows that the additional 156 hours of occupational therapy for robotic arm therapy sought on review, or any additional occupational therapy than is already funded in Mr Bull's SOPS, is not reasonable and necessary and cannot be funded in Mr Bull's SOPS.

1. Mr Bull is requesting that funding be included in his SOPS for psychology.[103] In Mr Bull's closing submissions, he indicated the psychology support sought on review is for assistance with both his stroke-related cognitive impairments and his psychosocial disability; and he is seeking 23 hours of psychology in addition to the 10 hours for a psychological assessment proposed by the Respondent.[104]
2. The Respondent contends Mr Bull's psychosocial and cognitive impairments appear to be multifactorial; and for the purposes of s 34(1)(aa), the majority of those impairments do not satisfy ss 24 and 25.[105] The Respondent contends it would be open to the Tribunal to find 10 hours of psychology for a psychological assessment meets the requirements in s 34(1) and should be included in Mr Bull's SOPS on the basis there is some degree of cognitive impairment attributable to Mr Bull's stroke impairments and some psychosocial disability.[106] The purpose of the proposed assessment would be to identify the respective impairments, report on permanency and provide quantified treatment and therapy plans.[107] In the alternative, the Respondent contends that given their contention Mr Bull requires psychiatric review, has had a relatively recent neuropsychological assessment and will be able to access some psychological therapy through a mental health care plan, it is open to the Tribunal to find that a further assessment does not satisfy s 34(1).[108]
3. As was noted in paragraph [1], Mr Bull was granted access to the NDIS based on impairments arising from a stroke he suffered in 2018. It is not in contest between the parties that for the purposes of s 34(1)(aa), Mr Bull meets the disability requirements in s 24 based on the following impairments arising from his stroke: left sided weakness affecting the upper and lower limbs; left sided foot drop; asymmetrical gait; dysarthria (slow and slurred speech); dysphagia (difficulty swallowing); right sided facial droop; diminished dexterity and fine motor function of the left (non-dominant) hand; and fatigue.[109] As is evident from paragraphs [80] and [81], what is in contest between the parties, and relevant to the psychology support sought on review, is whether for the purposes of s 34(1)(aa) Mr Bull also meets the disability requirements in s 24 or the early intervention requirements in s 25 based on additional stroke-related cognitive impairments and/or psychosocial impairments.
4. The disability requirements in s 24 are as follows:

(1) A person meets the disability requirements if:

(a) the person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or the person has one or more impairments to which a psychosocial disability is attributable; and

(b) the impairment or impairments are, or are likely to be, permanent; and

(c) the impairment or impairments result in substantially reduced functional capacity to undertake one or more of the following activities:

(d) the impairment or impairments affect the person's capacity for social or economic participation; and

(e) the person is likely to require NDIS supports under the National Disability Insurance Scheme for the person's lifetime.

(2) For the purposes of subsection (1), an impairment or impairments that vary in intensity may be permanent, and the person is likely to require NDIS supports under the National Disability Insurance Scheme for the person's lifetime, despite the variation.

(3) For the purposes of subsection (1), an impairment or impairments that are episodic or fluctuating may be taken to be permanent, and the person may be taken to be likely to require NDIS supports under the National Disability Insurance Scheme for the person's lifetime, despite the episodic or fluctuating nature of the impairments.

1. The early intervention requirements in s 25 are as follows:

(1) A person meets the early intervention requirements if:

(i) has one or more identified intellectual, cognitive, neurological, sensory or physical impairments that are, or are likely to be, permanent; or

(ii) has one or more identified impairments to which a psychosocial disability is attributable and that are, or are likely to be, permanent; or

(b) the CEO is satisfied that provision of early intervention supports for the person is likely to benefit the person by reducing the person's future needs for supports in relation to disability; and

(c) the CEO is satisfied that provision of early intervention supports for the person is likely to benefit the person by:

(i) mitigating or alleviating the impact of the person's impairment upon the functional capacity of the person to undertake communication, social interaction, learning, mobility, self‑care or self‑management; or

(ii) preventing the deterioration of such functional capacity; or

(iv) strengthening the sustainability of informal supports available to the person, including through building the capacity of the person's carer; and

(d) the CEO is satisfied any early intervention supports that would be likely to benefit the person as mentioned in paragraphs (b) and (c) would be NDIS supports for the person.

(1A) For the purposes of subparagraph (1)(a)(i) or (ii), an impairment or impairments that are episodic or fluctuating may be taken to be permanent despite the episodic or fluctuating nature of the impairments.

(2) The CEO is taken to be satisfied as mentioned in paragraphs (1)(b) and (c) if one or more of the person's impairments are prescribed by the National Disability Insurance Scheme rules for the purposes of this subsection.

1. The Minister has issued the National Disability Insurance Scheme (Becoming a Participant) Rules 2016 (Access Rules). The Operational Guideline 'Applying to the NDIS' (Access Guideline) is also relevant.
2. In evidence are documents prepared by a psychologist and 2 neuropsychologists.
3. Ms Jillian Trinca (Ms Trinca) is a psychologist.[110] In October 2011 Ms Trinca reported that Mr Bull was first referred to her by his general practitioner for counselling to assist with the treatment of anxiety, depression and pain issues associated with a motor vehicle accident; at the commencement of counselling his Depression Anxiety Stress Scale (DASS) results indicated depression and anxiety in the severe range, and stress in the moderate range; and as at September 2011 his DASS scores indicated depression and stress in the severe range, and anxiety in the mild range.[111] Ms Trinca opined Mr Bull experiences brief periods of remission from symptoms, however depression, stress and anxiety continue to be problematic with symptoms generally ranging from mild/moderate to severe.[112] Ms Trinca opined Mr Bull's mood has severely hampered his ability to socialise as his self-worth has been markedly affected by his depressed mood; and depression, anxiety and stress can make engagement in domestic tasks on any given day seem insurmountable.[113]
4. In October 2011 Mr Trinca also reported that at the commencement of counselling the PTSD Checklist-Civilian Version (PCL-C) was administered; that on this scale scores range from 17 to 85 with a score of 50 and above being a good predictor of PTSD when administered to individuals in civilian motor vehicle accidents; and Mr Bull's PCL-C score was 60.[114] Ms Trinca reported Mr Bull continues to experience symptoms of PTSD including flashbacks to his motor vehicle accident and heightened levels of arousal when confronted with stressful situations.[115]
5. Ms Trinca further opined in October 2011 that whilst Mr Bull remains physically incapacitated and unable to access suitable medical care for his physical injuries, his psychological prognosis is not good; and the effects of his workplace injuries have been very considerable in all aspects of his life and the consequences of his injuries will continue to challenge him into the future.[116]
6. Documents produced under summons by Ms Trinca evidence her having provided Mr Bull with psychological counselling 3 times in 2015, 10 times in 2016, 7 times in 2017, and 4 times in 2018.[117]
7. It was in October 2018 that Mr Bull suffered a stroke.
8. A referral from Dr David Awburn (Dr Awburn) to Ms Trinca in November 2018 was for ongoing psychological counselling in relation to chronic pain and PTSD because of a work-related injury. This letter notes recent events have exacerbated Mr Bull's need for ongoing support.[118] In November 2018 Ms Trinca reported Mr Bull presents with complex issues related to trauma experienced in the workplace and subsequent chronic pain as a result of a MVA he experienced whilst at work; his symptoms of PTSD and comorbid depression and anxiety fluctuate and are often associated with his pain experiences; and he recently suffered a stroke which is a further stressor which has exacerbated his underlying symptoms, particularly in relation to his major depressive disorder.[119] Documents produced under summons by Ms Trinca evidence her having provided Mr Bull with psychological counselling once in 2019.[120]
9. There are records produced under summons in evidence from Belinda Renison (Dr Renison), a neuropsychologist and an occupational therapist.[121] Those records include a service agreement for the period 18 April 2020 to 18 July 2020 to provide 10 hours of neuropsychology; an email in which she states she provided 18.25 hours of input from 17 April 2020 until 19 September 2020; and 5 further consult records in 2020.[122] These records also evidence the following:
   • An intake form dated April 2020 refers to Mr Bull having had a psychiatrist 10 years ago named Peter Heffernan.[123]
   • In April 2020 Dr Renison suggested Mr Bull contact his psychiatrist about his medication; and in May 2020 she recorded Mr Bull had increased his dexamphetamine.[124]
   • A session note dated 15 August 2020 indicates at that time Mr Bull's psychiatrist was Dr Cooke.[125]
   • In August 2020, Dr Renison opined the aetiology of Mr Bull's current presentation is multifactorial; and it is not possible to separate out the respective contributions of his dual disabilities (ABI and mental health) on his daily functioning.[126] Dr Renison recommended 20 hours of neuropsychology for 12 months.[127]
   • A session note dated November 2020 records Mr Bull is not taking his medication reliably; that addressing this is a priority; and he needs to book an appointment with both his GP and psychiatrist.[128]
   • In November 2020 Dr Renison recommended that with respect to Mr Bull's mental health he have a psychiatry review and a clinical psychology appointment as soon as possible; and regarding the clinical psychology stated she does not have the skills required to support him with his complex trauma issues and recommended other professionals she understood could work with him regarding that.[129]
   • In December 2020 Dr Renison opined Mr Bull needs additional mental health support; and encouraged him to book an appointment with Ms Trinca.[130]
10. In May 2021, Ms Jillian Trinca (Ms Trinca) recommended 20 hours of psychological counselling.[131] Documents produced under summons by Ms Trinca evidence her having provided Mr Bull with psychological counselling 16 times in 2021,17 times in 2022, and 3 times in 2023.[132]
11. In evidence is a report prepared by Ms Alexandra Armstrong (Ms Armstrong) a clinical neuropsychologist, dated July 2025.[133] Ms Armstrong assessed Mr Bull on 6 June 2024 and 26 June 2025.[134] Ms Armstrong reported that findings of standardised neuropsychological assessment indicated Mr Bull has cognitive strengths; and cognitive weaknesses in planning and organisation, divided attention, difficulties managing impulses and with poor self-monitoring; he descried significant fatigue and difficulties with managing emotions; and he reported symptoms of depression, anxiety and stress on a self-report measure.[135] Ms Armstrong opined those results are consistent with Mr Bull's diagnosis of a subcortical stroke, ADHD and possible previous traumatic brain injuries.[136]
12. Ms Armstrong recommended psychology input to address Mr Bull's mental health challenges; and opined he will continue to have difficulty implementing psychological interventions outside of 1:1 therapy given his executive impairments. Ms Armstrong also recommended Mr Bull continue sessions with a psychiatrist for ongoing mood and medication management; and opined a psychiatrist or mental health occupational therapist may be able to comment on the impact of Mr Bull's psychosocial disability on his daily functioning.[137]
13. There is also evidence relevant to Mr Bull's request for psychology support from various other allied health therapists.
14. In February 2024, Ms Abraham opined having regular involvement from a neuropsychologist will ensure Mr Bull has the support required throughout the year to assist him to recognise triggers, determine strategies that are suitable and work through ways to rebuild his mental health so he can rebuild his capacities.[138] Ms Abraham recommended 40 hours per year of neuropsychology for fortnightly sessions, travel, assessment and report writing.[139] In March 2024 Ms Poyser recommended 40 hours of neurophysiology.[140]
15. In September 2024, Mr Dwyer stated that whilst difficult to be certain of the aetiology of Mr Bull's psychological distress, given he has not been in receipt of any meaningful support in this regard since his 2018 stroke he would likely benefit from access to psychological treatment, the goals of which would be to provide Mr Bull with coping mechanisms to deal with the psychological impact of his various life circumstances that are presently causing him psychological distress.[141] Mr Dwyer recommended assessment by a fully qualified psychologist in the first instances and then defer to recommendations that arise from that assessment.[142] Mr Dwyer gave oral evidence that Mr Bull self-reported issues such as in the community (for example, people not understanding him, or thinking he is drunk); he has certainly heard that before and they are classic post stroke issues; Mr Bull does need to come up with an armoury of tools, this is precisely what psychological intervention could work with.
16. In August 2025, Ms Abraham reported Mr Bull has experienced an enormous change in his world, his life roles and his abilities since his stroke; opined it is extremely important he has the opportunity to work through how his life has changed, how his future now looks and how he can remain motivated to increase his engagement in daily activities; and recommended funding for ongoing sessions with a neuropsychologist.[143] Ms Abraham opined that having regular involvement from a neuropsychologist will ensure Mr Bull has the support required throughout the year to assist him to recognise triggers, determine strategies that are suitable and work through ways to rebuild his mental health.[144]
17. In September 2025 Ms Souter recommended psychology input to address mental health and wellbeing within the context of Mr Bull's disability.[145]
18. In a statement of lived experience dated August 2025, Mr Bull reported he previously received psychological support which helped him to develop strategies to manage his psychological well-being, and he found this very helpful;[146] and he was about to embark on EMDR therapy with his previous psychologist when his funding was cut in January 2023.[147]
19. Consistent across the evidence is a shared opinion Mr Bull will benefit from psychology support; and the Tribunal accepts this is so.
20. What is clear from the evidence of Ms Trinca and Dr Renison is that Mr Bull has a long history of depression, anxiety and PTSD which predates his stroke in 2018; and historically arising from those conditions he has experienced psychosocial impairments which include persistent low mood, anxiety, difficulty concentrating, flashbacks, and heightened levels of arousal when confronted with stressful situations (psychosocial impairments). Based on Ms Trinca's, Dr Awburn's and Dr Renison's evidence, the Tribunal accepts that those psychosocial impairments have been exacerbated by Mr Bull's stroke.
21. With respect to Mr Bull's current clinical presentation, Ms Armstrong's assessment identified Mr Bull has cognitive impairments which include difficulty planning, organising, concentrating, managing impulses and managing emotions (cognitive impairments); and he reported symptoms of depression, anxiety and stress on a self-report measure. Ms Armstrong opined, and the Tribunal accepts, those results are consistent with Mr Bull's diagnoses of stroke, ADHD and possible previous traumatic brain injuries.
22. Based on Ms Trinca's, Dr Renison's and Ms Armstrong's evidence, the Tribunal is satisfied Mr Bull has a disability that is attributable to one or more cognitive impairments as identified in paragraph [105], and one or more impairments to which a psychosocial disability is attributable as identified in paragraph [104]. Accordingly, the requirement in s 24(1)(a) is met.
23. Based on Ms Trinca's, Dr Renison's and Ms Armstrong's evidence, the Tribunal agrees with the Respondent's contention that the aetiology of Mr Bull's cognitive and psychosocial impairments is multifactorial.
24. Based on Ms Trinca's and Dr Renison's evidence, the Tribunal accepts Mr Bull had intermittent psychological and neuropsychological input between 2011 and 2023; however, it appears he has had no psychological input since 2023, excluding Ms Armstrong's assessment in July 2025. There is no evidence before the Tribunal of Mental Health Treatment Plans having been made pertaining to Mr Bull in recent years; and this is despite the weight of evidence he needs psychology support.
25. Dr Renison refers to Mr Bull having had some engagement with 2 psychiatrists, those being Dr Heffernan and Dr Cooke, however the extent of that engagement is unclear. In April 2020 and November 2020, Dr Renison recommended Mr Bull consult with and be reviewed by a psychiatrist. More recently in July 2025 Ms Armstrong recommended Mr Bull have ongoing sessions with a psychiatrist for ongoing mood and medication management. There is no evidence from Dr Heffernan, Dr Cooke or any other psychiatrist in evidence; and there is no evidence to suggest Mr Bull has consulted with and been reviewed by a psychiatrist in recent years. It is also unclear on the evidence what medications Mr Bull has previously been prescribed or trialled in relation to his psychosocial impairments; although in 2020 Dr Renison recorded Mr Bull was not taking his medication reliably which suggests a degree of non-compliance with his treatment regime.
26. It is unclear on the evidence before the Tribunal which of Mr Bull's cognitive impairments are attributable to ADHD; there is no medical evidence before the Tribunal to confirm the treatment history of Mr Bull's ADHD; and Mr Bull's oral evidence with respect to his ADHD medication is that he has in the past ceased taking that of his own accord. Whilst Ms Armstrong's evidence refers to possible previous traumatic brain injuries, and Mr Bull's evidence is that he experienced his cognitive impairments before having his stroke in 2018, there is a complete absence of medical evidence from any doctor or specialist relevant to this.
27. In the circumstances as described in paragraphs [107] and [110], on the material before it, the Tribunal is not persuaded there are no known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy Mr Bull's psychosocial and/or cognitive impairments; and further, the Tribunal considers Mr Bull's psychosocial and cognitive impairments require review by a psychiatrist before a determination can be made about whether the impairments are permanent, or likely to be permanent. Accordingly, the Tribunal is not satisfied Mr Bull's psychosocial and/or cognitive impairments are, or are likely to be, permanent; and therefore, the requirement in s 24(1)(b) is not met. It follows that for the purposes of s 34(1)(aa), Mr Bull does not meet the disability requirements in s 24 in relation to his psychosocial or cognitive impairments.
28. The meaning of 'permanent' in s 25(1)(a)(i) is consistent with that in s 24(1)(b). The Tribunal has already determined that Mr Bull's psychosocial and cognitive impairments are not, or are not likely to be, permanent for the purpose of s 24(1)(b). For the same reasons provided in relation to that determination, the Tribunal is not satisfied Mr Bull meets the requirement in s 25(1)(a)(i) in relation to his psychosocial or cognitive impairments. It follows that for the purposes of s 34(1)(aa), Mr Bull does not meet the early intervention requirements in s 25 in relation to those impairments.
29. In circumstances where the psychology support sought on review is necessary to address needs of Mr Bull arising from his psychosocial and cognitive impairments, and he does not meet the disability requirements in s 24 or the early intervention requirement in s 25 in relation to those, the Tribunal is not satisfied the psychology support sought on review, or any psychology support, meets the requirement in s 34(1)(aa). It follows that psychology support is not reasonable and necessary and cannot be funded in Mr Bull's SOPS.

1. On review, Mr Bull is seeking to replace his existing funding for Level 2 Transport, with funding for Level 3 Transport.[148] Mr Bull contends he does not have the capacity to use public transport and requires the requested transport assistance to engage in his funded capacity building supports.[149]
2. The Respondent contends Mr Bull has a demonstrated capacity to drive, benefit from online therapy programs, and equipment available to him at home; and in these circumstances the Tribunal should not be satisfied funding for Level 3 transport is likely to be effective and beneficial for Mr Bull, or value for money.[150]
3. In February 2024 Ms Abraham opined Level 3 transport is required to ensure Mr Bull can access the community to attend medical appointments, shopping, and other outings; and that he mainly uses his formal supports to transport him during the day.[151] Ms Abraham suggested this was due to the location that Mr Bull lives in; his specialised occupational therapist is located a 1 hour drive away from where he lives; and he enjoys going into the city which is 1.5 hours from his home.[152] This reporting was repeated by Ms Abraham in August 2025; and at that time she recommended transport funding to support Mr Bull to reengage in community activities.[153]
   1. In September 2024, Mr Dwyer reported Mr Bull can drive a car independently; had recently returned from a road trip to New South Wales, although had his licence suspended during that trip; and has partial capacity for using public transport, which is likely limited to trains and taxis or Ubers; and bus travel likely exceeds his functional tolerances.[154] Mr Dwyer opined Mr Bull's walking capacity, when combined with his driving capacity, provides him with access to all essential community services.[155] On this basis, Mr Dwyer opined there is no requirements for transport support.[156]
4. In September 2025 Ms Souter reported Mr Bull is currently driving an unmodified vehicle, but limits his driving as required due to pain, fatigue and mental health reasons; and recommended access to transport assistance to complete community-based activities and appointments when he is unable to drive his own vehicle.[157]
5. In oral evidence, Mr Bull confirmed his driver's licence is currently suspended. The Tribunal accepts Mr Bull's evidence that his licence has been suspended, however finds this is because of the imposition of a penalty or the like rather than a reduction in his functional capacity resulting from his impairments. To the extent Mr Bull's licence disqualification bears upon his community access and social participation, the Tribunal finds this is not disability related.
6. The fact Mr Bull lives a significant distance from his preferred robotics arm therapy and may experience fatigue after such intensive therapy does not of itself mean Level 3 transport support is reasonable and necessary for the purposes of the NDIS Act; and in any event the Tribunal has determined such therapy is not a reasonable and necessary support for Mr Bull at this time. Further, whilst Mr Bull may choose to utilise his existing transport funding to travel very long distances from his home to attend preferred therapists or activities, this is a choice he makes regarding how he will utilise his transport funding.
7. The evidence overwhelming demonstrates Mr Bull has the functional capacity to independently mobilise; and he has the functional capacity to drive, although he may need, on occasions, to drive at particular times and not others due to fatigue arising from his stroke. Based on Mr Dwyer's evidence, which the Tribunal accepts, Mr Bull also has partial capacity for using public transport, which is likely limited to trains and taxis or Ubers. In all these circumstances, the Tribunal is not persuaded on the material before it that Mr Bull's existing Level 2 transport funding, used optimally, is insufficient to meet his current disability related transport needs. Based on Mr Dwyer's evidence, which the Tribunal accepts, the Tribunal is also concerned that to include funding for transport in Mr Bull's plan which exceeds his current disability related supports needs could undermine his independence to access the community independently.
8. For these reasons referred to in paragraphs [119] and [121], and having considered the matters referred to in rr 3.1 and 3.2 of the Supports Rules, the Tribunal is not persuaded Level 3 transport funding represents value for money in that the costs of those supports are reasonable, relative to both the benefits achieved and the cost of alternative support; or that Level 3 transport funding will be, or are likely to be, effective and beneficial for Mr Bull, having regard to current good practice; and therefore, the requirements in ss 34(1)(c) and 34(1)(d) are not met. It follows that the Level 3 transport funding sought on review is not reasonable and necessary and cannot be funded in Mr Bull's SOPS.

1. Mr Bull's existing plan includes funding for 15 hours of support worker assistance per week, broken down as follows:
   • 2 hours per week for house and/or yard maintenance
   • 8 hours per week for personal domestic activities
   • 5 hours per week for social, economic and civic participation.[158]
2. On review the applicant is seeking an additional 6 hours of support worker assistance per day for assistance with daily living.
3. The Respondent contends funding 6 hours per day for assistance with daily living would likely be detrimental to Mr Bull and will pose a risk of dependence, rather than independence; and will not be value for money, having regard to the potential benefits of re-engagement in therapies.[159] The Respondent contends that Mr Bull's existing funding for 2 hours per week for house and/or yard maintenance should be replaced with the following:
   • 6 hours once off clean to get Mr Bull's house in order.
   • 2 hours per week for assistance with cleaning
   • 2 hours every 3 weeks for yard maintenance.[160]
4. In evidence are reports from 3 occupational therapists, those being Ms Leonie Souter (Ms Souter), Ms Vicky Abraham (Ms Abraham), and Mr Glen Dwyer (Mr Dwyer).
5. In May and June 2020 Ms Souter recommended 15 hours per week for a support worker to assist Mr Bull to attend face to face appointments, complete heavy domestic tasks, assist with weekly shopping, complete gardening, and help him attend the community and social outings.[161] Those 15 hours comprised 3 hours per week for shopping, 4 hours per week for social/community participation, 5.5 hours per week to attend disability related appointments, 0.5 hours per week for gardening, and 2 hours per week for domestic tasks.[162]
6. Ms Abraham prepared a report in February 2024.[163] Ms Abraham reported Mr Bull's function had greatly deteriorated over the last 2 years; as had his level of NDIS funding.[164] With respect to Mr Bull's function, Ms Abraham reported:
   • He mobilises unaided, however is not always steady when mobilising. Due to his decline in function, his endurance level can alter day to day. He is independent with all transfers; however, this doesn't mean he is always safe. [165]
   • He is independent with personal care tasks and toileting.[166]
   • He cannot complete tasks such as washing dishes, meal preparation, laundry, house cleaning, or changing bed sheets; and he requires support to complete all domestic tasks until he can rebuild his skills.[167]
7. With respect to community and leisure, Ms Abraham reported that due to the location of where Mr Bull lives the 5 hours he is currently funded for community and social activities are used up within 1 day; and this does not provide him with the opportunity to attend therapy sessions, shopping, visit the city, go out for a meal, or complete errands in the community.[168]
8. Ms Abraham opined Mr Bull requires an increase in core supports to ensure he has 1:1 care for all various domestic and community activities throughout the day; and he needs to be well supported at home, for both his physical and mental wellbeing.[169] Ms Abraham recommended 79 hours per week support worker assistance over 12 months broken down as follows:
   • Personal care - 4 hours per weekday; 3 hours per Saturday; 3 hours per Sunday (26 hours per week)
   • Domestic assistance - 3 hours per week
   • Yard maintenance - 2 hours per week
   • Community access - 27 hours per week Monday to Friday; 11 hours per Saturday; 10 hours per Sunday (48 hours per week).[170]
9. Mr Dwyer was engaged by the Respondent to complete a functional capacity assessment report dated September 2024.[171] Mr Dwyer noted Mr Bull's primary disability relates to his 2018 stroke; however, he is reported to also have unspecified psychosocial disorders.[172] At the time Mr Dwyer assessed Mr Bull, he had telehealth appointments monthly with his general practitioner but was not otherwise engaged in any other regular treatment or therapy.[173] Mr Dwyer reported:
   • Mr Bull's home presented in a dire state of disrepair and neglect; despite having NDIS funding for various supports, Mr Bull advised he is not currently accessing any supports in the home; and it was clear there had been no form of domestic or yard maintenance for quite some time.[174] Photographs taken inside Mr Bull's home were consistent with Mr Dwyer's description.
   • Mr Bull is functionally independent in the domain of communication; however, given his low speech volume he may have difficulty being understood in busy/noisy environments.[175] He experiences logistical barriers to social interaction activities, noting he presently lives a considerable distance away from his usual place of residence. Leaving aside logistical barriers to social interaction and that his low speech volume can affect social interaction in busy/noisy environments, Mr Bull is otherwise independent in social interaction activities.[176] Mr Dwyer opined it is possible Mr Bull's psychosocial condition may impact on his capacity for social interaction, however given he had no medical evidence of a psychosocial condition he was unable to say with certainty whether psychosocial function impairs functioning in this domain.[177]
   • Mr Bull can safely mobilise throughout all rooms in his house; is not assessed as being a high falls risk; was observed to complete safe and independent chair transfers; and can independently complete other transfers.[178] He can drive a car independently, had recently returned from a road trip to New South Wales, although had his licence suspended during that trip.[179] He has partial capacity for using public transport, which is likely limited to trains and taxis or Ubers; and bus travel likely exceeds his functional tolerances.[180] His walking capacity, when combined with his driving capacity, provides him with access to all essential community services.[181]
   • Mr Bull is independent with toileting, showering, dressing, grooming, and short sessions of light cleaning of accessible surfaces.[182] His walking and driving capacity allow him to complete shopping independently; he completes the task in several small shops to reduce the functional demands of the task.[183]
   • Mr Bull is currently managing basic meal preparation using modified techniques that simplify meal preparation tasks. With use of simple assistive equipment, he is expected to further increase his participation in meal preparation tasks. He does not currently require formal meal preparation support. Mr Bull is currently managing his laundry tasks, albeit with some difficulty.
10. Mr Dwyer recommended the following support worker assistance:
    • House cleaning - 6 hours (once off) for an initial deep clean to address the current state of neglect; and 2 hours per week for ongoing service for vacuuming, mopping, bathroom scrubbing and window cleaning.
    • Lawn mowing/yard maintenance - 2 hours every 3 weeks.[188]
11. Mr Dwyer opined that overprescribing care for tasks Mr Bull is capable of undertaking himself is detrimental as it creates dependency on support; the core goal of occupational therapy is to facilitate independence, not dependency. He does not know why Ms Abraham recommends so many support hours, nor how Mr Bull would use such care.[189] He opined Mr Bull's current plan exceeds his needs as yard maintenance doesn't need to be completed every week.[190]
12. Ms Abraham prepared a further report in August 2025, Ms Abraham reported:
    • Mr Bull was involved in a motor vehicle accident in 2023; his left leg was injured in that accident; resulting in him having a total hip replacement in 2024.[191]
    • His Care and Needs Scale (CANS) assessment in August 2025 indicates he can be left alone for part of the day and overnight but he needs to be supported each day.[192]
    • His WHODAS 2.0 scores were 16 percent understanding and communicating; 10 percent getting around; 9 percent self-care; 20 percent getting along with other people; 20 percent life activities; and 30 percent participation in society.[193]
    • Mr Bull mobilises unaided; completes his bathing, dressing, grooming, toileting tasks independently; is independent with medication management; and drives his own car (local driving only).[194] Mr Bull struggles to prepare meals and change sheets; has great difficulty washing dishes; can complete light cleaning tasks; is unable to complete heavy taxing cleaning tasks or any yard maintenance tasks.[195]
    • Mr Bull has had no formal support with meal preparation for 3 years and so he has had to determine techniques to cook for himself, the result being unbalanced meals and a limited diet.[196] He would benefit from low-cost AT.[197]
    • Mr Bull's house is dirty, unkept and in disarray.[198]
    • Mr Bull continues to live in public housing and there is much stress around this; until he can relocate it will continue to take a significantly increased amount of time to travel to various community or social activities that he enjoys.[199]
    • Mr Bull will drive to his local shops to purchase a small number of items but will not do a full shop as he has difficulty bringing the items home due to reduced upper limb function.[200]
    • It is not recommended Mr Bull drive when cognitively or physically fatigued, and to ensure he can return home safely from medical or therapy sessions it is recommended he have formal support.[201] Mr Bull can physically access a taxi and this would be a suitable mode of transportation to a medical appointment or therapy session, but cost is an issue.[202]
13. Mr Abraham recommended approximately 50 hours per week of support worker assistance over 12 months broken down as follows:
    • Assistance with daily living - 10 hours per week Mon to Fri, 2 hours per week Sat, 2 hours per week Sunday (14 hours per week).
    • Domestic cleaning - 2 hours per week
    • Garden maintenance - 3 hours per week
    • Community and social participation (assistance with shopping, running errands, attending appointments, social engagement) - 20 hours per week Monday to Friday, 6 hours per week Saturday, 6 hours per week Sunday (32 hours per week).[203]
14. Ms Souter prepared a report dated 15 September 2025.[204] Ms Souter noted Mr Bull has a current TAC claim for his left leg fracture and subsequent total hip replacement; and that recommendations within her report are made in relation to Mr Bull's NDIS recognised disability only.[205] Ms Souter reported:
    • Mr Bull's WHODAS 2.0 scores were 33.33 percent understanding and communicating; 55 percent getting around; 50 percent self-care; 70 percent getting along with other people; 87.5 percent life activities; and 90.63 percent participation in society. His overall score was 64.41.[206]
    • Mr Bull is independent with mobility indoors and outdoors and all transfers; showering/bathing, dressing, grooming, toileting, medication management and eating; light meal preparation; light cleaning and tidying; ad hoc shops for small purchases; and is currently driving an unmodified vehicle. Mr Bull requires moderate assistance with meal planning, grocery shopping, main meal preparation, laundry, domestic cleaning, and financial management; and he requires physical assistance with heavy cleaning, washing pots and pans, mowing grass, and cleaning gutters.[207]
    • He would benefit from low-cost AT in relation to light meal preparation.[208]
    • He requires assistance to participate in previous leisure activities (such as attending live music) due to his impaired speech and cognition; can independently access the community for short periods requiring limited social interactions; and has no access to informal supports to assist with community participation.[209]
15. Ms Souter recommended 41 hours per week of support worker assistance over 12 months broken down as follows:
    • Assistance with personal domestic activities - 3 hours per day
    • Assistance with household tasks - 4 hours per month (regular gardening and mowing, bi-annual external home maintenance) and 4 hours per week (weekly heavy cleaning, assistance to unpack heavy items from boxes since moving to residence).
    • Participation in community, social and civic activities - 15 hours per week.[210]
16. Mr Dwyer's oral evidence was to the effect:
    • He has read Ms Souter's report September 2025 report which postdates his report. Although in reading that some of the diagnoses have become clearer, medical diagnosis do not in and of themselves necessarily define function. This is one of the benefits of a functional assessment, as that takes a person as you find them; and whether a diagnosis or a label was available at the time of the assessment didn't change how he was and how he presented and what he could and could not do. He also noted that Ms Souter's observations of what Mr Bull can do were not inconsistent with his own.
    • He did not undertake standardised testing with Mr Bull. He noted it is critical when using standardised testing that one considers for example WHODAS 2.0 results and compares those to own observations; consider whether they are consistent, do they add value to the assessment; and if inconsistent, it is not appropriate to lean on WHODAS 2.0 to justify more support than one would say someone needs based on direct observations.
    • What concerns him is that Mr Bull does seem to be surrounded by various therapists who are encouraging dependency on support workers for tasks he is independent with and can do; and opined that is quite detrimental, that would not just be a neutral outcome, that would be a negative outcome to start having people do tasks for him that he can actually do and has been doing himself.
17. In August 2025, Ms Poyser reported Mr Bull is independent with all transfers; is fully independent with his personal care; requires assistance for daily living tasks (including shopping for food and general items, meal preparation, house cleaning and general tidying, bed sheet changing, and garden maintenance); requires support to go into the community to do grocery shopping, attend medical and therapy appointments, and to participate in community activities.[211]
18. In July 2025, Ms Armstrong reported that findings of standardised neuropsychological assessment indicated Mr Bull has cognitive weaknesses in planning and organisation, divided attention, difficulties managing impulses and with poor self-monitoring.[212] Based on Mr Bull's difficulties with planning and organisation, Ms Armstrong recommended he have support worker assistance to organise and attend appointments; develop routines for completing weekly activities (including assisting with grocery shopping, cleaning etc); implement strategies developed by an occupational therapist to help develop routines for completing weekly activities; and encourage participation in other meaningful activities.[213]
19. In oral evidence Mr Bull explained that many of his belongings are in his garage, he has not been able to go through them, and there is still a bedroom that is not set up and is full of things that are not organised.
20. The Tribunal raised with Mr Bull at the hearing that there are in evidence several different recommendations regarding what level of support worker assistance he currently requires; and invited him to comment on those different recommendations. Mr Bull commented that Mr Dwyer paints a picture of a person that he could only wish to be.
21. The Tribunal raised with Mr Bull it was concerned there is no clear plan in evidence as to how he will use the significant hours of support worker assistance sought on review; and asked whether there is a plan for how such hours would be implemented. Mr Bull stated he would return to his regular multidisciplinary rehabilitation which means he would be returning to robotic therapy twice a week and he would need assistance to get there because of where he lives; and as he doesn't have friends where he lives, for him to do anything social requires him traveling to and from Melbourne, and that takes 4 hours, plus then 2 hours to actually do something in Melbourne upon arrival. He said he would also use support for meal preparation, shopping and other daily support.
22. The Tribunal raised with Mr Bull the opinion expressed by Mr Dwyer that it is important he does not use a support worker to do things he is in fact able to do himself, so he retains his capacity to do those things and does not create a dependency on more support worker assistance than is in fact required; and invited Mr Bull to comment on this. Mr Bull commented to the effect that he is a heavily misunderstood person and he hides the stroke reasonably well; and over the last 3 years he has found himself in situations that could have been avoided had he had adequate support during that time. With respect to that car accident in May 2023, in a statement of lived experience dated August 2025, Mr Bull stated he broke his leg in that MVA, experienced prolonged infections, and eventually had a hip replacement in March 2024 after 3 surgeries.[214]
23. With respect to assessing a person's functional capacity to undertake activities of daily living, the Tribunal considers this most appropriately falls within the expertise of an occupational therapist. As is apparent from the evidence as outlined above, 3 occupational therapists have each assessed Mr Bull's functional capacity and each have made very different recommendations with respect to the level of support worker assistance he requires. In summary, those recommendations have been as follows:

Sep 2024 Mr Dwyer approx. 2 hours per week; plus 6 hours (once off)

1. Ms Souter, Ms Abraham and Mr Dwyer each reported that Mr Bull mobilises unaided; can complete all transfers independently; is independent with toileting, showering, grooming, dressing, and medication management; can complete light cleaning tasks; can drive; and can complete small shops. They have each reported that Mr Bull requires assistance with heavy cleaning tasks and yard maintenance. Ms Souter and Mr Dwyer both report Mr Bull can complete meal preparation, albeit it with some difficulty or in a modified way; and Ms Abraham reports that Mr Bull has determined some techniques with respect to meal preparation although she notes he has an unbalanced and limited diet. Ms Souter, Mr Dwyer and Ms Abraham all opine Mr Bull would benefit from low-cost AT with respect to meal preparation. In circumstances where there is significant overlap between what each of these 3 occupational therapists have reported Mr Bull's functional capacity to be, the variation in their recommendations with respect to support worker assistance is perplexing.
2. Ms Souter recommended 15 hours per week of support worker assistance in May 2020; and 41 hours per week of support worker assistance in September 2025. Despite the very significant increase in the number of support worker hours Ms Souter has recommended for Mr Bull in 2025, when compared to her 2020 recommendation, what was reported in her respective reports with respect to his functionality with individual tasks was not drastically different. Indeed, in her 2025 report it appears Mr Bull could complete tasks, or aspects of tasks, that he could not complete in 2020. For example, it appears in 2025 Mr Bull's capacity with respect to tasks such as laundry and main meal preparation had slightly improved. Consistent with the Respondent's closing submissions, the Tribunal also notes the tasks Ms Souter recommended support worker assistance be assigned for in 2020 and 2025 are not significantly different; and in these circumstances it is unclear why the hours of support worker assistance she recommended in 2025 were so much greater than those recommended in 2020.[215]
3. In her 2025 report, Ms Souter indicated her report was informed by interview, clinical observations of performance in the home and community environments; and a range of assessment tools including standardised testing . It is however unclear on the face of Ms Souter's 2025 report exactly what tasks and activities she directly observed Mr Bull perform; the extent to which her assessment relied on Mr Bull's self-report; and how or if at all she weighed the results of standardised testing and Mr Bull's self-reporting with her own clinical observations of his functionality.
4. Ms Abraham recommended 79 hours per week of support worker assistance in February 2024; and approximately 50 hours per week of support worker assistance in August 2025. These recommendations are, by any measure, significant. In addition to those concerns referred to at paragraphs [75(a)] and [75(b)], the Tribunal makes the following observations with respect to Ms Abraham's evidence:
   • Ms Abraham's first report is dated February 2024. This is the month before Ms Bull states he had a full left-hip replacement after his leg was fractured in the 2023 MVA and he had been experiencing infections arising from that. Ms Abraham makes no mention of Mr Bull's 2023 MVA and associated leg fracture, nor the infections that followed from that or the impending left hip replacement. As was noted by Mr Dwyer in oral evidence, this is a very significant omission from Ms Abraham's report and it is entirely unclear to the Tribunal why an occupational therapist would not have made mention of this in an assessment report regarding the impact of impairments upon Mr Bull's functional capacity at that point in time; particularly in circumstances where she was reporting a decline in Mr Bull's function over the preceding 2 years.
   • It is unclear on the face of Ms Abraham's February 2024 or August 2025 report what tasks and activities she directly observed Mr Bull perform; the extent to which her assessment relied on Mr Bull's self-report; and how or if at all she weighed Mr Bull's self-reporting with her own clinical observations of his functionality. Ms Abraham has not explained the methodology she employed when forming the opinions expressed in her February 2024 report; and whilst Ms Abraham completed various standard assessments with Mr Bull as part of her August 2025 assessment, it is unclear on the face of her report how or if she weighed the results of those assessments with her own direct observations when forming opinions with respect to what Mr Bull can and cannot do.
5. In contrast to Ms Souter's and Ms Abraham's reporting, Mr Dwyer has very clearly identified in his report what he directly observed with respect to Mr Bull's functional performance; what Mr Bull reported to him with respect to his functional capacity; his clinical reasoning for his conclusions with respect to what Mr Bull can and cannot do, and why he did and did not recommend support worker assistance for particular tasks or activities. At the hearing, Mr Dwyer provided clear, clinical reasoning for the recommendations he made in his report; and he gave his evidence in a measured and objective manner consistent with the Administrative Review Tribunal's (Expert Evidence) Practice Direction 2024. The Tribunal also found Mr Dwyer's evidence, with respect to the risk associated with Mr Bull relying on support workers to complete tasks he can in fact do himself, persuasive.
6. For the reasons outlined in paragraphs [146] to [150], to the extent opinions expressed by Ms Abraham and Ms Souter differ from those expressed by Mr Dwyer, both with respect to Mr Bull's functional capacity to complete particular tasks and activities, and the extent of his requirement for support worker assistance, the Tribunal prefers and has given more weight to Mr Dwyer's evidence.
7. With respect to Ms Poyser's evidence as outlined in paragraph [139], it is unclear from her reports whether she has ever provided Mr Bull with therapy in his home and therefore whether she would have had any opportunity to observe his functioning with respect to performing activities of daily living. It is also unclear from Ms Poyser's report the extent to which she has relied on Mr Bull's self-reporting and / or Ms Abraham's assessments of Mr Bull's functional capacity, when reporting what Mr Bull requires support worker assistance for. Further, whilst the Tribunal accepts it is within Ms Poyser's expertise as a physiotherapist to opine in relation to Mr Bull's physical function and movement; it is arguably outside her expertise to opine in relation to his broader ability to participate in activities of daily living or the extent to which he may require support worker assistance for that. For these reasons, to the extent Ms Poyser's evidence relates to Mr Bull's functional capacity to undertake activities of daily living and his need for support worker assistance, the Tribunal gives Ms Poyser's evidence very limited weight.
8. With respect to Ms Armstrong's evidence, whilst the Tribunal broadly accepts that findings of standardised neuropsychological testing indicate Mr Bull has cognitive weaknesses, and because of those cognitive weaknesses he finds some tasks more difficult, this does not mean he cannot complete those tasks and therefore needs support worker assistance to do so. To the extent Ms Armstrong recommends support worker assistance with tasks which involve planning and organisation based on cognitive weaknesses, rather than what Mr Bull can and cannot do of those tasks, the Tribunal gives Ms Armstrong's evidence very limited weight.
9. Having considered the evidence before it, and the weight that can appropriately be given to that evidence:

a) The Tribunal accepts Ms Abraham's and Mr Dwyer's evidence that Mr Bull's home is at present in a state of disarray and based on Mr Dwyer's evidence finds he requires a block of support worker assistance to bring the cleanliness and organisation in his home up to an acceptable baseline which can then be maintained. > > b) Based on the consensus of opinion expressed by Mr Dwyer, Ms Abraham and Ms Souter, the Tribunal accepts Mr Bull cannot complete heavy domestic tasks, lawn mowing or yard maintenance and finds he requires routine support worker assistance for these tasks. Based on Mr Dwyer's evidence, which for the reasons outlined above the Tribunal has preferred and given more weight, the Tribunal does not accept Mr Bull otherwise requires support worker assistance with activities of daily living within the home, community access, or social interaction.

10. In the above circumstances the Tribunal is not persuaded Mr Bull requires additional support worker assistance funded in his SOPS; is persuaded Mr Bull's existing funding for support worker assistance, used optimally for those tasks he does in fact require physical assistance with (which includes using a block of his existing funding for support worker assistance to bring the cleanliness and organisation in his home up to an acceptable baseline which can then be maintained), comfortably meets his support needs; and is persuaded that increasing Mr Bull's existing funding for support worker assistance will undermine his independence by promoting his reliance on support worker assistance for tasks he can in fact complete himself, and would therefore be detrimental for him. For these reasons, the Tribunal is not satisfied any increased support worker assistance will be, or is likely to be, effective and beneficial for Mr Bull, having regard to good practice; and the requirement in s 34(1)(d) is not met.
11. In circumstances where the Tribunal is persuaded Mr Bull's existing funding for support worker assistance, used optimally for those tasks he does in fact require physical assistance with, comfortably meets his support needs, the Tribunal finds his existing funding for support worker assistance is a comparable support which would achieve the same outcome at a substantially lower cost. Further, in circumstances where the Tribunal is persuaded funding additional support worker assistance will promote Mr Bull's dependence on formal support and be detrimental for him, the Tribunal finds the requested support will not substantially improve the life stage outcomes for, and be of long-term benefit to, Mr Bull; it will not increase Mr Bull's independence and reduce his need for other kinds of supports; and nor is it likely to reduce the cost of funding of supports for Mr Bull in the long-term. For these reasons, the Tribunal is not satisfied any increased support worker assistance represents value for money in that he costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support; and the requirement in s 34(1)(c) is not met.
12. In circumstances where the support worker assistance sought on review, or any additional support worker assistance, does not meet the requirements in ss 34(1)(c) or 34(1)(d), it is not reasonable and necessary and cannot be funded in Mr Bull's SOPS.

1. The Tribunal sets aside the decisions under review and remits the matter for reconsideration in accordance with the order that:
   1. The statement of participant supports specifies the reasonable and necessary supports include:

a) Low-cost assistive technology - $1,500 > > b) 10 hours of additional capacity building funding to allow for the Selection and/or Manufacture of Customised or Wearable Technology > > c) 20 hours of physiotherapy > > d) 16 hours of exercise physiology

2. The supports at paragraph 1(a) replace the Applicant's existing funding for low-cost Assistive Technology

1. The supports at paragraph 1(c) replace the Applicant's existing funding for physiotherapy.

1. All other supports in the Applicant's existing statement of participant supports are to be replicated pro-rata from the date on which the supports specified in paragraph [1] above are included in the Applicant's statement of participant supports.

1. The management of funding for reasonable and necessary supports in the Applicant's statement of participant supports is to be plan-managed.

1. The date by which the Respondent must reassess the Applicant's plan is to be 12 months after the date on which the supports in paragraph [1] above are included in the Applicant's statement of participant supports.

[2] Respondent's Statement of Facts, Issues and Contentions (Respondent's SFIC), [3].

[6] All sections referred to in this Statement of Reasons, including in the footnotes, are sections in the National Disability Insurance Scheme Act 2013 unless otherwise stated.

[7] Administrative Review Tribunal Act 2024, s 8.

[8] Part 5 to Schedule 16, item 24 of Administrative Review Tribunal (Consequential and Transitional Provisions No.1) Act 2024.

[9] Mr Bull's Statement of Facts, Issues and Contentions (Mr Bull's SFIC), 8; Respondent's opening submissions; Respondent's closing submissions, [53], [73]; Mr Bull's closing submissions, 7.

[10] Respondent's closing submissions, [55]; Mr Bull's closing submissions,

[11] Respondent's SFIC, [53]; Respondent's closing submissions, [65]; Mr Bull's closing submissions, 6.

[12] Mr Bull's SIFC, [2]; Mr Bull's closing submissions, 4; Respondent's closing submissions, [3].

[14] This was confirmed in Mr Bull's opening submissions; Mr Bull's closing submissions, 9.

[16] Respondent's SFIC, [18], [19], [32], [42], [46], [50], [53],[54], [59], [62]; Respondent's closing submissions,

[17] Public Trustee of South Australia (as litigation representative for Isherwood) v National Disability Insurance Agency (No 2) [2023] FCA 852, [29], [33]; s 34(1); National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1)(Miscellaneous Provisions) Transitional Rules 2024 (Transitional Miscellaneous Rules), s 7.

[18] E1, 280, 282; Mr Bull's closing submissions.

[19] Frugtniet v Australian Securities and Investments Commission [2019] HCA 16, [51].

[20] QDKH, by his litigation representative BGJF v National Disability Insurance Agency [2021] FCAFC 189, [7]-[8].

[21] National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 (Amending Act), s 2.

[22] Items 124, 129 and 132 of the Amending Act.

[27] Transitional Miscellaneous Rules_,_ s 7.

[28] McGarrigle v National Disability Insurance Agency [2017] FCA 308, [43].

[29] Drake and Minister for Immigration and Ethnic Affairs (1979) 46 FLR 409, 420.

[30] Respondent's SFIC, [62]; Respondent's opening submissions; Respondent's closing submissions, [72].

[42] Respondent's closing submissions, [54].

[55] Respondent's closing submissions, [69].

[56] Respondent's opening submissions; Respondent's closing submissions, [65]

[57] Respondent's opening submissions; Respondent's closing submissions, [66].

[75] Transitional Miscellaneous Rules_,_ s 7.

[77] Mr Bull's SFIC, 8; Mr Bull's closing submissions, 7.

[78] Respondent's SFIC, [46]; Respondent's closing submissions, [58].

It[101] Respondent's closing submissions, [38]; E1, 719, 809-810, 816-818, 830-833, 841, 849-850,

[104] Mr Bull's closing submissions, 8.

[105] Respondent's closing submissions, [61].

[106] Respondent's opening submissions; Respondent's closing submissions, [62].

[108] Respondent's closing submissions, [64].

[109] Respondent's closing submissions, [13]-[15].

[148] Annexure A to Respondent's SFIC; Mr Bull's SFIC, 7-8.

[149] Mr Bull's closing submissions, 6.

[150] Respondent's SFIC, [30], [31], [32]; Respondent's closing submissions,[48], [49], [52].

[158] Annexure A to Respondent's SFIC.

[159] Respondent's closing submissions, [46]-[47].

[160] Respondent's opening submissions; Respondent's closing submissions, [73].

[215] Respondent's closing submissions, [42].