(1) Applications may be made to the Administrative Review Tribunal for review of a decision made by a reviewer under subsection 100(6). > > (1A) An application under subsection (1) may be made only by, or on behalf of, a person directly affected by the decision. > > (1B) Sections 266 (decision‑maker to give notice of decision and review rights) and 268 (requesting reasons for reviewable decision from decision‑maker) of the Administrative Review Tribunal Act 2024 apply only in relation to a person directly affected by the decision. > > (2) If: > > (a) an application is made to the Administrative Review Tribunal for review of a decision made by a reviewer under subsection 100(6); and > > (b) the decision relates to a statement of participant supports in a participant's plan; and > > (c) before a decision on the review is made and despite subsection 31(1) of the Administrative Review Tribunal Act 2024: > > (i)the CEO varies the plan under subsection 47A(1) of this Act and the variation is a change to that statement; or > > (ii) a new plan for the participant comes into effect under section 37 of this Act; > > then: > > (d) if subparagraph (c) (i) applies - the application is also taken to be an application for review of the decision to make the variation covered by that subparagraph; or > > (e) if subparagraph (c)(ii) applies - the application is also taken to be an application for review of the decision to approve the statement of participant supports in the new plan. > > (Emphasis added)

1. The remaining contentious issue related solely to the provisions of SDA. The Plan that was approved on 5 February 2025 provided core support and capacity building funding of:

• Consumables: $250.08
• Assistance with Daily Life: 3 hrs/ week domestic activities 2 hrs month of assistance with home. Yard & garden maintenance: $10,252.92
• Assistance with Social Economic and Community Participation: 3 hrs / week of social & community access: $10,539.36

• Choice and Control: Plan Management - Set up Costs - $232.35 - Plan Management - Monthly Fee $104.45 x 12 months $1,485.75
• Improved Daily Living: Occupational Therapy 12 hours $2,327.88

1. Under section 34(1)(f) of the NDIS Act, the NDIS Chief Executive Officer (and the Tribunal standing in their shoes on Administrative Review) must be satisfied that the requested support is a NDIS support. Section 10 of the NDIS Act now provides that:

NATIONAL DISABILITY INSURANCE SCHEME ACT 2013 - SECT 10 > > Definition of NDIS support > > Supports that are NDIS supports > > (1) Subject to subsections (4) and (9), a support is an NDIS support for a person who is a participant or prospective participant if the support is declared by National Disability Insurance Scheme rules made for the purposes of this subsection to be an NDIS support for: > > (a) participants or prospective participants generally; or > > (b) a class of participants or prospective participants that includes the person. > > Note: The National Disability Insurance Scheme rules may declare a support for the purposes of this subsection by identifying a class of supports (see subsection 13(3) of the Legislation Act 2003). > > (2) Before making National Disability Insurance Scheme rules declaring a support for the purposes of subsection (1), the Minister must be satisfied: > > (a) for rules to which paragraph (1)(a) applies--that the support is appropriately funded or provided through the National Disability Insurance Scheme for participants or prospective participants generally; or > > (b) for rules to which paragraph (1)(b) applies--that the support is appropriately funded or provided through the National Disability Insurance Scheme for participants, or prospective participants, in the relevant class. > > (3) National Disability Insurance Scheme rules may declare a support for the purposes of subsection (1) only if at least one of the following applies: > > (a) the declaration of the support implements Australia's obligations under: > > (i) the Convention on the Rights of Persons with Disabilities done at New York on 13 December 2006; or > > (ii) any other agreement with one or more other countries; > > (b) the declaration of the support enables the provision of sickness benefits.

2. Section 10 of the NDIS Transitional Rules then sets out what are supports which are not NDIS Supports. Subsections (4)-(9) provide as follows:

Supports that are not NDIS supports > > (4) The National Disability Insurance Scheme rules may declare that a support is not an NDIS support for: > > (a) participants or prospective participants generally; or > > (b) a class of participants or prospective participants. > > Note: The National Disability Insurance Scheme rules may declare a support for the purposes of this subsection by identifying a class of supports (see subsection 13(3) of the Legislation Act 2003). > > (5) Before making National Disability Insurance Scheme rules declaring a support for the purposes of subsection (4), the Minister must be satisfied: > > (a) for rules to which paragraph (4)(a) applies--that the support is not appropriately funded or provided through the National Disability Insurance Scheme for participants or prospective participants generally; or > > (b) for rules to which paragraph (4)(b) applies--that the support is not appropriately funded or provided through the National Disability Insurance Scheme for participants, or prospective participants, in the relevant class. > > (6) The CEO may determine, in writing, that a support is taken to not be declared under subsection (4) in relation to a participant if: > > (a) the support is prescribed by the National Disability Insurance Scheme rules for the purposes of this paragraph; and > > (b) the support would, apart from subsection (4), be an NDIS support for the participant; and > > (c) the participant applies to the CEO in accordance with subsection (7) for the determination; and > > (d) the CEO is satisfied that: > > (i) the support would replace one or more other supports that are NDIS supports for the participant; and > > (ii) the cost of the support is the same or lower than the total of the costs of the supports it would replace; and > > (iii) the support would provide the same or a better outcome for the participant than the supports it would replace; and > > (iv) any other conditions specified in the National Disability Insurance Scheme rules for the purposes of this subparagraph are met in relation to the support, the participant, or both. > > Note 1: A determination may be revoked under subsection 33(3) of the Acts Interpretation Act 1901. > > Note 2: The National Disability Insurance Scheme rules may prescribe a support for the purposes of paragraph (a) by identifying a class of supports (see subsection 13(3) of the Legislation Act 2003). > > (7) An application under paragraph (6)(c) must: > > (a) be in the form (if any) approved by the CEO; and > > (b) include any information, and be accompanied by any documents, required by the CEO; and > > (c) be made in accordance with any other requirements specified in the National Disability Insurance Scheme rules for the purposes of this paragraph, which may include requirements as to the circumstances in which an application may, or may not, be made. > > (8) The National Disability Insurance Scheme rules may make provision for determining any matter for the purposes of subsection (6), including by prescribing requirements with which the CEO must comply, methods or criteria that the CEO is to apply, or matters that the CEO may, must or must not take into account, in deciding whether to make a determination under that subsection. > > (9) A support is not an NDIS support for a participant or prospective participant if the support consists of the provision of: > > (a) sexual services; or > > (b) alcohol; or > > (c) drugs, the possession of which is a contravention of a law of the Commonwealth, a State or a Territory.

3. As noted, the Transitional Rules provide for what are not NDIS supports.

5 What supports are NDIS supports - general rule > > Supports that are NDIS supports unless otherwise provided > > (1) For the purposes of subsection 10(1) of the NDIS Act, a support covered by column 2 of an item in the table in clause 1 of Schedule 1 to this instrument is an NDIS support (subject to subsections 10(4) and (9) of the NDIS Act and subsection (2) of this section) for: > > (a) participants specified in column 3 of the item who have old framework plans; and > > (b) prospective participants specified in column 3 of the item, other than prospective participants who, if they were participants, would be required to be given notice under subsection 32B(2) of the NDIS Act (participants that are to have new framework plans). > > Note 1: Subsection 10(4) of the NDIS Act allows supports to be declared to not be NDIS supports for participants or prospective participants. Those supports are declared under subsection (2) of this section. > > Note 2: Subsection 10(9) of the NDIS Act provides that a support is not an NDIS support for a participant or prospective participant if the support consists of the provision of: > > (a) sexual services; or > > (b) alcohol; or > > (c) drugs, the possession of which is a contravention of a law of the Commonwealth, a State or a Territory. > > (2) For the purposes of subsection 10(4) of the NDIS Act, a support covered by column 2 of an item in the table in clause 1 of Schedule 2 to this instrument is not an NDIS support for any participant (subject to subsection 10(6) of the NDIS Act) or prospective participant. > > Note 1: Subsection 10(6) of the NDIS Act allows the CEO, on application by a participant, to determine that a support is taken to not be declared under subsection 10(4) of that Act in relation to the participant if, among other things, the CEO is satisfied that the support would replace one or more other supports that are NDIS supports for the participant. > > Note 2: Determinations under subsection 10(6) of the NDIS Act are referred to in this instrument as replacement support determinations. For additional rules about replacement support determinations, see section 7 of this instrument.

4. Supports that generally are not NDIS supports are set out in Schedule 2 of the Transitional Rule. Schedule 1 of the Transitional Rules provides a list of what supports generally are NDIS Supports.
5. In opening, the Respondent submitted that the section 34 requirements as set out at [11] above needed to be met in order to enable the application for SDA to succeed. If the criteria in section 34(1)(f) was not met, whether the support was an NDIS Support, then it was submitted that the six other section 34(1) criteria do not need to be met.
6. The Applicant gave evidence at hearing, as did the Occupational Therapist T Angel. Both witnesses were subject to cross examination.

1. In evidence in chief, the Applicant confirmed that he had been engaged in a career as an archaeologist. He lived in Ballarat in regional Victoria and had a diagnosis of level 3 Autism as well as a vestibular issue which meant that he had great difficulty moving at times. He said that the diagnosis was not clear.
2. The Applicant said that at times he cannot move his head including his eyes. The applicant said that 'it is not like I cannot move all of the time, but when I do it hurts'. The Applicant said that he had gotten used to the sensory issues arising from his Autism, but he described the pain form the vestibular issue as like punching in the face and having a migraine.
3. In respect of his current supports, the Applicant said that the cleaner only comes every three to four months when the Landlord tenancy inspection is due. He said that he spends most of his time in bed, averaging approximately 17 hours per day.
4. The Applicant told the Tribunal that clinicians seem to believe that he has a 'vertigo like' condition without identifying a formal diagnosis. In respect of the SDA application, the Applicant said that it was significantly based on the fact that the current house/dwelling was unsuitable. He said that the main difference between the current house and his former house was that the old house had a long hall whereas the new house was open plan. He described one of the issues being that in his current house it required him to turn his head more often than in his previous house.
5. The Applicant told the Tribunal in evidence in chief, that his own Occupational Therapist 'Andrew' was going to be doing an assessment for the housing provider to see if he could get some change through that process.
6. The Applicant said that when he joined the NDIS in 2018 his vestibular issue was not nearly as pronounced as it is now. The Applicant advised that it was now bad, in respect of both pain and other impairments and that it was getting worse.
7. In cross examination the Applicant was asked to describe what sort of things he could do in 2018 (when he joined the Scheme) that he was no longer able to do. The Applicant said that in 2018 he could go to the supermarket independently and that his ex-wife did not drive. Now the Applicant himself is unable to drive a car and he can't use his left arm. The Applicant added that in 2018 he was able to perform cooking and some cleaning. He was also able to effectively use computers, but his evidence was that now in 2025 scrolling is extremely difficult for him. He also said that sensorily he is intolerant of touching oil or sticky things and has to have paper towel everywhere just in case.
8. The Applicant was asked about treatment and advised that he has had appointments with a neurologist who checked his ears in respect of balance issues. The Applicant said that the physiotherapist recommended exercises as this was the type of thing that they recommended for people who had undergone brain surgery. The Applicant also advised that he sought for the Neurologist to come to the hearing and give evidence but apparently, she did not wish to come. (The Tribunal notes that no summons procedure was undertaken by any party concerning attendance of witnesses at hearing in the pre-hearing processes).
9. The Applicant said in evidence that he was advised that his sensory and physical issues were neurological in nature. The Applicant gave some evidence around not moving his head and said that the physical pain was too much, and his exercises did not include head movements wherever possible.
10. The Applicant also gave evidence that he cannot tolerate bright lights. He had been located in the current dwelling since he moved there in May 2022. The Applicant said that he had been diagnosed with Autism in 2017/2018 at 34 to 35 years of age. He said that he was initially diagnosed by his GP and later confirmed by a diagnosis at the University of Melbourne in 2019/2020. The Applicant said that the clinicians also made a reference to a sensory processing disorder in their diagnosis.
11. The Applicant was asked what the clinicians at the University of Melbourne said in respect of the Applicant's disabilities. He was unsure other than referring to Michael Henry who provided the opinions. The Applicant advised that he cannot stand and cannot cook as he is unable to cut up and cook food.
12. The Applicant was asked what he thought of the suggestion/opinion of the Independent Medical Expert (IME) Mr Angel, an OT, that he should take up swimming as a form of exercise and rehabilitation. The Applicant said that at present this was not practical.

1. In evidence in chief, the witness adopted his report of 6 May 2025 as set out in the Joint Tender Bundle (JTB pages 279-302) as true and correct. He outlined how his experience has been gleaned from working across a number of work regimes such as Workers Compensation and NDIS. The witness said that he had a large amount of experience with individuals with multiple diagnosis.
2. The witness also referred to his Autism experience and working in the Autism community from adolescents to adults. The witness said that he has delivered training for individuals with sensory processing disorders. The witness noted that most persons with an Autism diagnosis have sensory processing disorder (SPD) of some level.
3. The witness advised that a functional assessment is usually used as the starting point for interventions. He said that he had been involved with delivering treatment options in these types of matters. The witness said that the assessment starts as an appointment meeting the individual. Most of the work involves verifying maters based on functional observations of the subject and their environment.
4. The witness stated that he was not certain that sensory processing disorder is actually part of the Autism assessment criteria but noted that it was regularly present. Reference was made to Thoracic Outlet Syndrome which appeared in the OT report at page 292 of the JTB, relating to the compression of nerves and blood vessels in the neck and armpit. This was the fourth of four conditions that the Occupational Therapist identified in his report. In respect of self-care, the witness was asked to explain the context. The witness said this covered what the Applicant was able to do, what he has the capacity to complete. The witness said that the Applicant has the capacity to do most things the issue being that it takes longer for him to complete these matters than an average or unaffected person.
5. The witness referred to the Applicant telling him that he has problems standing for extended periods of time and that a shower chair was recommend for showering. In respect of dressing the witness said that the Applicant told him that he could dress his lower body but that he had difficulty with the upper half which took extra time and which he put down to his vestibular issues.
6. In respect of toileting the witness said that he believed that the Applicant would benefit from the installation of a toilet rail on the left side of his toilet at home. Further questions ensued around the utility of the Applicant utilising assistive technology. These were outlined as being assistive technology, environmental modification and extra time to do things as being sufficient supports to enable the Applicant as suitable to meet his needs. The witness noted that the Applicant had arranged his kitchen with items arranged at waist height.
7. In respect of the Applicant's ability to manage himself, the witness said that the Applicant has sufficient ability to make decisions impacting on his life and capacity for life administration, including sufficient intelligence to think through all practical tasks and responsibilities even if he had limited ability to carry out or practically implement those matters due to his impairments.
8. The witness referred to the observations and findings recorded in his report at pages 286 and 287 of the JTB. The Applicant was observed and assessed to have the physical capacity for walking independently and for typical body joint movements. The witness reported that surgery had been suggested and recommended for the Applicant in respect of his vascular issues, but that the Applicant reported that he believes he is unsuitable for surgery and would thereafter have the home rebuilt to meet his needs and avoid undergoing surgery. This was a theme that the Tribunal returned to in reviewing the plan/SOPS. This one solution approach by the Applicant was not considered conducive to meeting the Applicant's needs with the witness opining that the Applicant is only able to consider one approach as his method of managing his situation and was not open to considering other options this being consistent with his Autism and rigidity of thinking.
9. The witness however, agreed that some assistive technology and possible home modification would assist the Applicant.
10. The witness referred to consideration of sensory intervention and if that was not working then an examination of the medical issue would be appropriate. The witness gave evidence that reframing needs to occur before any other interventions. In addition, there should be a concerted effort to reduce the Applicant's exposure to 'triggers' and develop this as a coping strategy, rather than the current responses. An example was given of using noise cancelling headphones in respect of noise issues.
11. The witness advised that an 'avoidance strategy' by the Applicant is a short-term response or strategy for any patient. The witness said that one of the issues arising from the evidence was around re-engaging the Applicant with a psychologist.
12. The witness referred to the table on page 296 of the JTB and noted that the Applicant had functional capacity in some of the domains in the Table, such as self-care self-administration, mobility, community access, social interaction and communication. His high support needs were mainly in the areas of self-management.
13. The witness advised that the Applicant does not qualify at present for SDA housing nor is it recommended that he receive SDA housing. In the opinion of the witness, what the Applicant requires is suitable housing for his needs. This opinion was based on the preferences that the witness said that the Applicant outlined to him, these preferences not necessarily aligning with the features of SDA.
14. The witness noted that the Applicant continues to hold fixed views on matters associated with his disabilities, views not necessarily evidence based. Views concerning what foods he can tolerate, avoiding walking as it would cause him to need to drink water, and that his physical shoulder recovery is directly contingent on obtaining SDA.
15. In cross examination the witness was asked what medical material he had access to other than the material dated more than three years ago, concerning the Applicant. The witness said that other than accessing the T Documents he had no medical material.
16. In respect of the test administered to the Applicant, the witness confirmed that the MOCA assessment (Montreal Cognitive Assessment) had been administered first.
17. When asked what he thought was the main barrier to the Applicant, the witness advised that the barrier is not around the nature of housing provided but is psychological in nature and that is both what the issue is and how the issue is to be addressed.
18. Reference was made to the report of M Henry which appeared in the JTB at pages 40-57. The witness said that whilst the Henry Report mighty have been commissioned for SDA eligibility, it does not address some of the necessary NDIA SDA assessment criteria and requirements.
19. The witness was asked by the Applicant 'what can I (the Applicant) do?' The witness said that the Applicant's mindset is that once he has accessed SDA then he will be able to do anything. The witness said that before the Applicant can achieve anything significant, the psychological matter, the mindset, needs to be overcome.
20. The witness was also asked about the recommendations concerning a low stimulation environment. The witness said that he agreed that would assist the Applicant. However, he advised that any progression in that area cannot and will not stay that way forever. The witness said that ultimately the Applicant will need to lift himself out if this situation and rise above a dependency on SDA as being a panacea for his impairments and how those matters can be overcome.

1. The Respondent took the Tribunal to the reference to SDA in the Disability Accommodation Rule arising from section 34(1)(a) - (f). The Respondent submitted that the eligibility criteria under Rule 11A indicated that extreme impairment of significant support needs were required for approval. In respect of the Applicant's mobility, the Respondent submitted that the evidence showed that the Applicant was able to walk around the home. Reliance was placed on these findings at page 286 and 287 of the JTB in respect of Mr Angel's (Occupational Therapist) report. The Occupational Therapist had recommended an alternative management strategy to manage the Applicant's hypersensitivity to light.
2. The Respondent submitted that in the IME, Mr Angel had found that the Applicant experienced some difficulties with self-care in the area of dressing but was able to manage using greater time to complete the task. Some difficulty shaving was identified and in the area of eating and food preparation, the Applicant's focus was on his view of significant food intolerance. Whilst sensory issues were at play such as the smell of food 'triggering', he already nominated a preference for outdoor cooking.
3. In self-management, reference was made to limitations due to the impact of the vestibular issues, as well as the previously mentioned fixated or single view/inflexible manner of thinking. In regard to mobility, only quick or rapid transfers or changes were problematic arising again from vestibular issues. There were no communication or learning deficits but there were some difficulties maintaining social relationships. There were some difficulty with social cues, maintaining eye contact and understanding the behaviours and emotions of others were evident.
4. The Respondent also submitted that the observation of the IME, that the Applicant's hypersensitivity is a barrier but is only a temporary or curable barrier was relevant. The impact as a result is not at an extreme level. In this regard he does not qualify for SDA.
5. The Respondent also noted in oral submissions that the Applicant has been living without supervision for many years. The Respondent noted that whilst the Applicant has funded supports these were in the main not being taken up because the Applicant was currently unable to tolerate support workers. They submitted that consistent with previous observations of the Tribunal, a very high level of support or a very high need for person to person supports required at least 10 hours per day one to one, person to person support.
6. The Respondent calculated that the Applicant's support needs at present, were he to take them up, equated to 5.5 hours per day on average. As the Tribunal has previously found the threshold to be 10.5 - 11 hours per day and as a result the Respondent submitted that the Applicant cannot satisfy Rule 12(1)(c) of the relevant Rule for SDA - National Disability Insurance Agency (Specialist Disability Accommodation) Rules 2020 (Cth).
7. In addition, the Respondent submitted at hearing that in order to satisfy Rule 13, the Applicant must show that he has a very high level of needs for a significant part of the day (10.5 - 11 hours). The Respondent submitted that 5.5 hours per day (when engaged) does not demonstrate a significant part of the day or significant needs.
8. The Respondent submitted that at present the Applicant was not utilising everyday supports and was only having cleaning done quarterly due to wishing to meet the real estate inspection lease requirements.
9. The Respondent submitted that the IME was clear in his expert opinion that changing the (domestic) environment would not be an effective quick fix for the Applicant.
10. The Respondent submitted that the Applicant cannot satisfy the SDA criteria rules at present on eligibility. They also submitted that housing and community infrastructure is not generally a NDIS support and therefore it does not satisfy section 34(1)(f).
11. The Applicant in oral submissions in reply, stated that the NDIS came with something that he could use but never most of what he could use. He had limited his stimuli in order to limit his neurological pain. The Applicant submitted that he was prepared so far to experience physical pain in lieu of psychological pain.

1. In a consideration of the issues in the administrative review, it is relevant to place the legislative regime in context. In this regard the objects and purpose of the NDIS Act is of relevance. As the Tribunal has previously observed, the NDIS was established under the NDIS Act and its objectives are set out in section 3 and its general principles guiding actions taken under the NDIS Act are set out in section 4. Section 3(1)(c) and (g) relevantly states the objectives of the Act are to support the independence and social and economic participation of people with disability and to promote the provision of high quality and innovative supports that enable people with disability to maximise independent lifestyles and full inclusion in the community. This is consistent with the Charter of Rights of the Disabled where persons with disabilities should be free to choose and to the greatest extent possible be free to live a life in a manner of their own choosing.
2. As this review concerns a Plan and SOPS rather than access, the matter as noted above is to be determined under the current law, not the law in force at the time of the decision under review. This law is set out below.
3. The National Disability Insurance Scheme Amendment (Getting the NDIS back on Track No. 1) Act 2024 (Cth) came into force on 3 October 2024, changing several provisions. The Act introduced a new section 10 regarding a definition of NDIS support and amended section 34(1)(f). These changes apply to the Applicant's SOPS and must be considered by the Tribunal. The changes apply retrospectively to Plan matters not finalised by the Tribunal at 3 October 2024 irrespective when their internal review and Tribunal matters were lodged.
4. As noted above at [11], section 34(1) of the NDIS Act now provides changed criteria around supports. When conducting the administrative review, the Tribunal must be positively satisfied about each of the matters set out in section 34(1) of the Act on order to make a finding that the requested support is a reasonable and necessary support. The Applicant carries a practical rather than a strict onus to adduce sufficient evidence to satisfy the Tribunal the criteria are met. However, the provisions are to be interpreted beneficially.

(a) 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;

(c) 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.

(a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports; and

(b) a participant's disability support needs arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements may be affected by a variety of factors, including environmental factors or the impact of another impairment in relation to which the participant does not meet either of those requirements.

(2) The National Disability Insurance Scheme rules may prescribe methods or criteria to be applied, or matters to which the CEO is to have regard, in deciding whether or not he or she is satisfied as mentioned in any of paragraphs (1)(aa) to (f).

1. As the Tribunal has previously observed, the term 'reasonable and necessary support' is not defined in the NDIS Act. As observed in the case of McGarrigle v National Disability Insurance Agency [2017] FCA 308 ('McGarrigle') the following observations at [91] are relevant (applying prior to the October 2024 amendments):

Whether a support is "reasonable" requires a different assessment to whether a support is "necessary". Again, it is not necessary in the context of this proceeding to be definitive about the nature and extent of the meaning of the phrase, or its components. It is enough to observe that using the concept of necessity would appear to tie one aspect of the CEO's assessment to an evaluation of the kinds of factors set out in s 34(1)(a) and (b) and (d). The word "reasonable" would appear to be directed at factors such as those set out in s 34(1)(c) and (f). That is not to say the meaning of each word is exhausted by the factors set out in s 34(1): rather, it is to illustrate the different work that each concept does as an adjective in the phrase "reasonable and necessary supports".

2. In addition, the full Federal Court in National Disability Insurance Agency v WRMF [2020] FCAFC 79 ('WRMF') considered the meaning of reasonable and necessary supports:

[T]here is no doubt that the contextual use of the phrase in this Act links it to public funding to be provided to a participant. In that context, the phrase connotes supports which meet a threshold which justifies - by reference to the context, objects and guiding principles of the Act and the facts of the case - the expenditure of public funds for that support, for a particular participant. As we have already explained, the phrase also needs to be understood taking into account what has qualified a person as a participant, and the links between a person's impairment and their full participation in the community, in the same variety of ways as persons without a disability might choose to participate.[1]

3. Under section 209(1) of the Act, the Minister may make rules prescribing certain matters. Relevant rules in the Applicant's case include the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth) ('the Supports Rules').
4. I note that the Specialist Disability Accommodation Rules 2020 (SDA Rules) apply to the application. Section 11 of the SDA provides that a participant is eligible for SDA under the NDIS if the CEO is satisfied that the participant has an extreme functional impairment or has very high-level support needs and the participant meets the SDA requirements.
5. Section 12 of the SDA Rules concerns what the CEO may have regard to arising from an extreme functional impairment. In this context the impairment must result in extremely reduced functional capacity to undertake, or psychosocial functioning in undertaking, one or more of activities in the domains of: mobility, self-care, self-management and that the participant has a very high need for person to person support in undertaking activity even with assistive technology equipment or home modifications in place.
6. Section 13 of the SDA Rules then refers to what the CEO may take into account if high support needs are met. The matters include a history in SDA, the existence of very high person to person supports either immediately available (on call) or constant for a significant part of their day. The Rules provide that in determining very high support needs the CEO may rely on any assessment tool (as specified). The CEO usually relies upon OT reports form am IME to determine eligibility for SDA.

13 When a participant has very high support needs > > (1) A participant has very high support needs if: > > (a) the participant has lived in specialist disability accommodation for extended periods and living in that accommodation has impacted on the capacity of the participant to transition to alternative living arrangements and support; or > > (b) the participant has a very high need for person‑to‑person supports, either immediately available or constant, for a significant part of the day and either: > > (i) there are limitations in the availability, capacity or capability of the participant's informal support network or risks to its sustainability; or > > (ii) the participant is at risk or poses a risk to others, and that risk could be mitigated by the provision of specialist disability accommodation, having regard to the participant's response to risk and the interaction of the participant with the environment. > > (2) For the purposes of assessing whether a participant has very high support needs, the CEO may have regard to: > > (a) any assessment or examination conducted in relation to the participant, including any assessment or examination requested by the CEO under paragraph 36(2)(b) or 50(2)(b) of the Act; and > > (b) the daily support requirements of the participant; and > > (c) any assessment tool specified by the CEO for the purposes of this paragraph; and > > (d) any other matters that the CEO considers appropriate.

7. I also note that a participant meets the SDA requirements if the evidence establishes under section 14 that the support would:

14 When a participant meets the SDA needs requirement > > (1) A participant meets the SDA needs requirement if, when compared to other supports alone, combined specialist disability accommodation and other supports would: > > (a) better assist the participant to pursue the goals, objectives and aspirations set out in the participant's statement of goals and aspirations; and > > (b) be more effective and beneficial, where possible, in: > > (i) mitigating or alleviating the impact of the participant's impairment upon the participant's functional capacity; and > > (ii) preventing the deterioration of the participant's functional capacity; and > > (iii) improving the participant's functional capacity; and > > (iv) maintaining or promoting the participant's ability to build capacity, including in the medium or long term; and > > (v) maintaining or promoting the participant's opportunities to develop skills; and > > (c) if the participant has very high supports needs - be more effective and beneficial, where possible, in: > > (i) reducing the participant's future needs for supports which might be required due to inappropriate accommodation; and > > (ii) assisting the participant to pursue goals related to life opportunities and life transitions; and > > (d) if the participant has an extreme functional impairment - be more effective in providing the participant with stability and continuity of support; and > > (e) represent better value for money. > > (2) For the purposes of paragraph (1)(e), regard must be had to the following matters if the participant has very high support needs: > > (a) whether combined specialist disability accommodation support and other supports would be likely to substantially improve the life stage outcomes for, and be of long‑term benefit to, the participant; > > (b) the cost of providing the participant with supports needed to live in accommodation other than specialist disability accommodation, taking into account: > > (i) whether those supports may be shared with other participants; and > > (ii) limitations of the participant's informal support network.

8. In my view it is clear that the evidence before the Tribunal does not establish matters to the thresholds required by the SDA Rules. The evidence of Mr Angel, which was subject to brief cross examination, but also accompanied by a detailed report, is quite clear.
9. The Applicant, whilst a participant in the scheme and whilst clearly impaired, especially by his vestibular issues, and a long standing and worsening intolerance to light, is currently coping with minimal in person supports, predominantly because his impairments are said to make him largely intolerant to having others in the house.
10. The Applicant believes that he needs SDA because it could be designed with low level lighting and 'way-finding features'. Mr Angel opines that the Applicant's belief that SDA will be a panacea for his reduced functioning due to his impairments is not evidence based and an example of his rigidity of thinking.
11. The Applicant's OT Mr Henry recommends SDA (via a 24-hour support model) to enable the Applicant to improve his functioning. Mr Angel has an alternative approach as referred to in his evidence above. The Applicant, in part, believes that approach will not achieve any satisfactory outcome, which in the Tribunal's view appears in part due to his rigidity of thinking rather than any qualified opinion or expert evidence.
12. Having considered the evidence before the Tribunal, I find that the evidence of Mr Angel that the primary reason for the Applicant's reduction in capacity in recent times relates to his strategy of avoiding triggers associated with vestibular disturbance at all costs.
13. Like Mr Angel's opinion, the evidence strongly suggests that if the Applicant attempted some new and appropriate strategies, he may well be capable of improving his level of functioning. At present the evidence does not demonstrate that he meets the thresholds and criteria under the SDA Rules, for SDA .
14. The Applicant does not currently have the very high support needs required, and his current and projected future support needs hours do not meet the relevant threshold. In addition, the IME report of Mr Angel establishes that the Applicant's support needs at present, even at their highest, are well below the threshold for SDA.
15. In respect of the second eligibility criteria under Rule 14, the Tribunal is required to determine whether SDA in combination with other supports as referred to at [76] above. It appears that the SDA would not necessarily maintain or improve the applicant's functional capacity over and above his access to public housing. His evidence being that he is seeking to move to another location further away from noise with less light. It was for this reason that he commissioned his own OT report. The existing support of public housing is significant. There were other properties referred to in the evidence but again the position seems to be that the Applicant is focused on SDA.
16. I have closely reviewed the evidence including the Applicant's detailed 4-5-page document/statement of 10 October 2025. I have also applied that evidence to the legislation and regulations that apply to the application.
17. A matter that arose during the adducing of evidence concerned whether, notwithstanding the central SDA prong of the application, in reviewing the most recent SOPS should the Tribunal vary the SOPS in some way based on the evidence at hearing.
18. Under capacity building criteria the Applicant has approval for $2,327.88 for Improved Daily Living through the provision of 12 hours of OT. In order to allow the remedies proposed by the IME to be properly developed, as referred to at [82] and elsewhere above, so there is a balance between the supports for the Applicant and the value for money requirement concerning supports, I believe that the following is appropriate.
19. 12 hours per annum of psychology are reasonable and necessary supports pursuant to s 34 of the NDIS Act 2013, and should be considered and incorporated into the Applicant's SOPS.
20. On that basis, the matter will be remitted to the Respondent, noting that the central prong of the Administrative Review, the decision in respect of SDA and not to include funding for it in the SOPS, will be affirmed.
21. Having regard to all of the matters in the SDA Rules, coupled with the evidence and material before the Tribunal, I find that the Applicant does not meet the criteria as set out in the Rule, for SDA.

1. As a result of the findings above, pursuant to section 105(c)(ii) of the ART Act, the Tribunal will remit the matter, on the discrete issue of funding for psychological assistance, to the Respondent for reconsideration in accordance with the orders below. The rest of the decision in respect of the SOPS will be affirmed.

1. The Tribunal, pursuant to section 105 of the Administrative Review Tribunal Act 2024 (Cth) remits the decision under review for reconsideration in accordance with the following directions:

(1) That 12 hours per annum of Psychology are reasonable and necessary supports pursuant to s 34 of the NDIS Act 2013.

(2) The remaining aspects of the decision under review remain and so the decision is otherwise affirmed.

Solicitors for the Applicant: E Elms Disability Advocate (Agent)