The decisions of the Agency under review are set aside and remitted for reconsideration in accordance with the direction that reasonable and necessary supports in the applicant's statement of participant supports should include:

1. Funding for 104 hours of physiotherapy treatment for 52 weeks followed by funding for one hour a week physiotherapy treatment for the remainder of the plan;

1. All other supports in the participant's statement of participant supports dated 2 May 2025, excepting any one-off assistive technology supports already used, are to be replicated pro-rata from the date on which the supports specified above are included in the applicant's statement of participant supports.

National Disability Insurance Scheme - reviewable decision of CEO - Statement of Participant Supports - reasonable and necessary supports - Getting the NDIS Back on Track Transitional Support rules - physiotherapy - long-term stroke treatment guidelines - specific characteristics of participant - decision set aside

Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (Cth) Schedule 16, item 24.

National Disability Insurance Scheme Act 2013 (Cth), ss 3, 4, 24, 25, 33, 34, 35

National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 Items 129 of Schedule 1

National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth); rr 3.1, 3.2, 3.3, 3.4, 3.5, 3.6. 3.7

National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 Schedule 2

Drake and Minister for Immigration and Ethnic Affairs (No. 2) 1979 2 ALD 634

Johnstone and National Disability Insurance Agency [2025] ARTA 106

McGarrigle v National Disability Insurance Agency [2017] FCA 308

National Disability Insurance Scheme v KKTB by her litigation representative CVY22 [2022] FCAFC 81

National Disability Insurance Agency v WRMF [2020] FCAFC 79

Scaramella and National Disability Insurance Agency [2025] ARTA 870

Clinical Guidelines, Stroke Foundation MAGICapp - Making GRADE the Irresistible Choice - Guidelines and Recommendations

NDIS Operational Guidelines - Reasonable and Necessary Supports, dated 28 March 2025.

NDIS Pricing Arrangements and Price Limits 2025-26 v1.0 published 16 June 2025.

1. This is a review of a decision of a delegate of the CEO of the National Disability Insurance Agency ('the Agency') to reject Mr Hague's request to include funding for 3 hours per week of physiotherapy treatment in his plan of support.
2. Mr Hague is a 61-year-old man, living in his own home with his wife. The couple live in Oakhurst, Queensland a small rural location located about 10 minutes' drive from Maryborough, a larger town centre with its own hospital.
3. Mr Hague was granted access to the National Disability Insurance Scheme (the Scheme) on the basis of impairments attributable to a stroke sustained in 2018.
4. Since that time Mr Hague has had further stroke incidents and has recently been diagnosed with encephalomacia, softening of the remaining brain tissue. He has also sustained fractures following falls related to his mobility impairments, one of which, a pelvic fracture, has failed to heal and continues to cause pain and hamper mobility.
5. Mr Hague's wife has been, and continues to be, his primary carer since his discharge home from hospital.
6. It is unclear how long Mr Hague has been a participant in the Scheme but I have been provided with copies of participant plans from 2022 and information about a previous plan in 2020.
7. Relying on the Agency's Statement of Facts, Issues and Contentions (SFIC) the background to this application commenced with the Agency making a decision to approve a Statement of Participant Supports (SOPS) on 8 November 2023. Ms Hague requested an internal review of this decision which was varied on 8 November 2023. On 24 May 2024 Ms Hague applied to the Administrative Appeals Tribunal (AAT) for review of that varied decision and in the course of alternative dispute resolution agreement was reached on some further supports in dispute. These agreements were reflected in a new, six-month SOPS issued on 2 May 2025.[1]
8. From 14 October 2024 the AAT became the Administrative Review Tribunal ('the Tribunal'). Under the transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (the Transitional Act), applications for review to the AAT that were not finalised before 14 October 2024 are taken to be applications for review to the Tribunal. The Transitional Act gives the Tribunal the authority to continue and finalise any aspect of the review not already completed by the AAT.[2] This decision and statement of reasons is made by the Tribunal.
9. As set out in the Agency's SFIC and confirmed by Ms Hague at the commencement of the hearing, the only support which remains in dispute is the request for 3 hours per week of physiotherapy treatment.[3]
10. A video hearing was held on 12 June 2025. Ms Hague advised the Tribunal that although Mr Hague had been told of the hearing and had been given an opportunity to attend, he had declined to do so. His behavioural, cognitive and expressive impairments would have made his attendance very difficult. Ms Hague, as his plan nominee, attended on his behalf and gave evidence under affirmation. The Agency was represented by Carmen De Marco of Counsel instructed by Mills Oakley.
11. For the reasons set out below the Tribunal sets aside the decision and remits for reconsideration.

1. The issue before the Tribunal is whether the requested support (3 hours of physiotherapy each week for the duration of a two year plan) is 'reasonable and necessary' for the purposes of sections 33 and 34 of the NDIS Act.
2. In its latest plan, the Agency has included funding for one hour of physiotherapy treatment per week with additional allowance for reports and funding for a level 2 therapy assistant.

1. The NDIS Act sets out the provisions by which the Agency is created and the Scheme and the manner in which it is to be accessed and administered, is described.
2. Chapter 1, Part 2 of the NDIS Act sets out the Act's objects and the principles to be applied when undertaking actions under the Act. The objects describe aspirations aimed at supporting the independence, choice and control and social and economic participation of people with disability. The provision of reasonable and necessary supports will be directed at achieving these objects for participants of the Scheme.[4]
3. The principles stress the rights of people with a disability to dignity, to participation and contribution to social and economic life and to the capacity to realise their potential in pursuit of their goals.[5]
4. Both the objects and the principles state that in giving effect to the objects of the Act, or in exercising powers under the Act, regard is to be had to the need to ensure the financial sustainability of the Scheme.[6]
5. Access issues are dealt with in Chapter 3, Part 1 of the NDIS Act. These provisions set out the criteria an applicant must meet (under either the disability requirements or under the early intervention requirements) in order to become a participant in the Scheme.
6. Part 2 of Chapter 3 sets out matters in relation to the development and administration of participants' plans. Generally, a participant's plan must include:
   1. a statement of participant goals and aspirations which they have prepared; and
   2. a statement of participant supports which includes the general supports that may be provided and the reasonable and necessary supports that will be funded under the Scheme.
7. Section 33(5) provides a list of all the factors the CEO must consider when deciding whether or not to approve a statement of participant supports. These are:
   1. the participant's statement of goals and aspirations;
   2. relevant assessments conducted in relation to the participant;
   3. being satisfied in relation to all the criteria set out in section 34;
   4. having regard to the NDIS Rules made for the purpose of section 35 of the Act;
   5. having regard to the principle the participant should manage his or her plan to the extent they wish;
   6. having regard to the operation and effectiveness of any previous plan of the participant; and
   7. the history of use of NDIS funds in earlier plans.

1. The National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Act 2024 (the Amending Act) made significant changes to the NDIS Act. This Act commenced on 3 October 2024.

1. Item 129 of Schedule 1 of the Amending Act provides that sections 33, 34 and 35 as amended (all of which deal with the development of participant plans) apply to any old framework plans which are approved or varied on or after the Amending Act's commencement. Mr Hague's plan is an 'old framework' plan for the purposes of the Act.

1. I note that Mr Hague's latest plan was varied and approved on 2 May 2025. This is after the commencement of the Amending Act. Therefore, in conducting its review the Tribunal will apply the relevant sections as amended.

(1) 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;

(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 access 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 the paragraphs (1)(aa) to (f).

1. Section 35 of the Act sets out matters which Rules made in relation to the statement of participant supports may address. These (among other things) include methods or criteria to be applied in deciding supports which will be funded and specifically identifying those supports that will and will not be funded under the Scheme.

1. The relevant rules to be applied in consideration of the funding of reasonable and necessary supports are:

1. the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (the Support Rules); and

1. the National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 (the Transitional Support Rules). These rules were made under Item 138 of the Amending Act and commenced on 3 October 2024.

1. The Agency also publishes Guidelines to assist in making decisions in accordance with the NDIS Act. The Guidelines are policy documents without legislative force and the Tribunal is not bound by them. However, it is generally held they should be applied where there is no conflict with the terms of the Act.[7] The relevant operational guidelines in this matter are:

1. NDIS Operational Guidelines - Principles we follow to create your plan (Plan Principles Guidelines) dated 27 April 2025

1. NDIS Operational Guidelines - Reasonable and Necessary Supports (the Support Guidelines) dated 28 March 2025.

1. NDIS Pricing Arrangements and Price Limits 2025-26 v1.0 published 16 June 2025. (NDIS Pricing Arrangements)

1. The Agency advises that under his current plan Mr Hague has access to capacity building funding for:
   1. 30 hours over six months of physiotherapy supports with an allied health professional;
   2. 13 hours per 6 months of a level 2 therapy assistant (plus 6.5 hours of provider travel);
   3. 8.5 hours per 6 months of occupational therapy;
   4. 5 hours for the development of a manual handling plan by an occupational therapist;
   5. 5 hours speech therapy and
   6. 4 hours of podiatry.

1. It is the Agency's position that on the available evidence, the requested support (funding of 3 hours of physiotherapy per week - 78 hours per six months) is not a reasonable and necessary support as:
   1. the support is not necessary to address the needs of the participant arising from an impairment in relation to which Mr Hague meets the access requirements of the Scheme; and/or
   2. the support is not an NDIS support for the purposes of paragraph 34(1)(f) of the NDIS Act.

1. The basis of this contention is that:
   1. The Agency understands the reports of Thomas Welldon, physiotherapist, to suggest the recommended physiotherapy treatment is at least partly in respect of injuries sustained in falls, rather than just the impairments for which Mr Hague gained access to the scheme.
   2. The Agency considers a therapy regime of 3 hours of in-person sessions per week represents an intensive physiotherapy program which is not appropriate for the long-term stage Mr Hague has reached in relation to his stroke.

1. To the extent the treatment regime is aimed at clinical recovery, rather than functional maintenance or participation, the Agency contends it is more appropriately funded by the public health system. It refers to the Transitional Support Rules in relation to supports that will and will not be funded under the Scheme.

1. Ms Hague is Mr Hague's wife and primary carer. She is deeply involved in all aspects of Mr Hague's care and treatment and committed to giving him the best opportunity to live his life to the fullest.

1. In support of the requested extra hours of physiotherapy, in a letter from August 2023, Ms Hague:

1. Relies on the reports of the current treating physiotherapist, Mr Thomas Welldon;

1. States that without regular and intense therapy Mr Hague's functional capacity will deteriorate;

1. Observes that Mr Hague's spasticity and limited joint movements put him at risk, without regular therapy, of shortening in the right-sided stroke affected muscles of his upper and lower limbs. She believes that this would result in irreversible disabling impairments, similar to club foot, with his right foot turning in on itself making it impossible to weight bear, transfer, stand or walk.

1. States that physiotherapy 2 to 3 times a week has so far prevented this deterioration from happening;

1. Says that because they live remotely it is difficult to find alternative local therapists who do not have long waiting lists.

1. There is a plethora of medical evidence confirming Mr Hague's primary medical condition of stroke resulting in significant impairment across all the relevant activities of communication, social interaction, learning, mobility, self-care and self-management.[8] These documents confirm Mr Hague has loss of sensation in his right side with spasticity, limited joint mobility, significant behavioural and personality changes, progressive cognitive decline, impaired swallowing and expressive and receptive dysphasia.

1. In a letter of Dr Ogiji, dated 25 July 2024, Dr Ogiji sets out the functional difficulties arising from Mr Hague's stroke and expresses the opinion that most, if not all of these are major disabilities with Mr Hague not having shown any improvement for the past 6 years despite intensive therapy. Dr Ogiji goes on to say that Mr Hague's condition is likely to deteriorate with time given the nature and extent of his stroke-induced irreversible brain damage. Dr Ogiji expects Mr Hague's care needs will only increase with time.

1. In a letter dated 19 March 2025, Dr Kuyler, neurologist, assessed Mr Hague in relation to his post stroke epilepsy. Dr Kuyler noted despite medication Mr Hague was still having 'absent' episodes that were likely to be ongoing seizures. He noted Mr Hague experienced chronic ongoing pain. Dr Kuyler noted that Mr Hague's personality change, with outbursts and aggression made Ms Hague's life difficult at times. Dr Kuyler was concerned about the number of medications Mr Hague was taking and called for a multi-disciplinary approach to review Mr Hague's treatment. He reported radiology was in keeping with an epileptic focus and that it demonstrated increased generalised atrophy of the brain.[9]

1. In a report by Dr Kristin Marvin, clinical psychologist, dated 10 August 2024, Dr Marvin noted that Ms Hague sought to have any impairment arising from Mr Hague's depression accepted as an access impairment. Relying on evidence in various discharge reports and information provided by Ms Hague, Dr Marvin was of the view Mr Hague met sufficient criteria for a DSM-V-TR diagnosis of 'depressive disorder due to a medical condition with depressive features'. She noted medication prescribed for treatment of this but that Mr Hague continued to express suicidal ideation. She recommended increased funding to allow for respite for Ms Hague.[10]

1. In a report by Ms Jenny Boulter, speech therapist, dated 14 August 2024 Ms Boulter noted that Mr Hague had severe word finding difficulty and difficulty swallowing as a result of his stroke. She recommended funding for speech therapy to assist with these difficulties.[11]

1. Ms Sarah Carew, occupational therapist, provided 2 reports dated 4 January 2025 and 20 August 2024. Ms Carew noted that Mr Hague's physical deficits negatively impact every area of his life, including the ability to complete personal care tasks, mobilise, complete activities of daily living and enjoy leisure activities. She made recommendations in the earlier report for assistive technology and personal assistance from support workers. She stands by those recommendations in the later report. Her occupational therapy recommendations included funding to allow her time to work on upper limb rehabilitation for Mr Hague and to teach him compensatory strategies to improve his hand function.

1. Ms Hague provided a carer's statement dated April 2025 which began with a list of the secondary conditions arising from Mr Hague's stroke and other conditions affecting his function. These include brain atrophy, encephalomalacia (brain tissue softening), emerging vascular dementia, muscle paralysis/weakness, spasticity and loss of sensation on the right side of the body, expressive and receptive dysphasia/asphasia, difficulty swallowing, depression, suicidal ideation, epilepsy, temperature regulation difficulties, chronic post-stroke pain and ununited pelvic fracture secondary to a fall.

1. Ms Hague's description of the impact of Mr Hague's disabilities on their life and specifically on her as his primary carer is harrowing. Since 2023 Mr Hague's condition has deteriorated with personality changes, cognitive impairment and volatile verbal abuse directed at Ms Hague. His poor balance and sensory loss means he is a constant falls risk, requiring constant supervision. His decreasing mobility meant increased time in his wheelchair. His swallowing difficulties and sleep apnoea create a safety risk such that Ms Hague is constantly on high alert at night with consequent interruption in her sleep. Mr Hague's insight into his loss of function creates distress which is expressed in suicidal ideation. This is physically and emotionally draining for Ms Hague. She is aware Mr Hague's condition is deteriorating and that there is no treatment which will reverse this process. She requested further supports to give her a break from her caring role.

1. In her oral evidence to the Tribunal, specifically in relation to the need for ongoing physiotherapy, Ms Hague expressed her fear that if physio did not continue at the current level Mr Hague's right leg and foot function would deteriorate significantly to a point he would be permanently wheelchair bound with no independence. She also feared for the loss of function of Mr Hague's right hand.

1. Ms Hague expressed the view that only a physiotherapist could undertake the treatment as she was fearful of Mr Hague being hurt by herself or a support worker undertaking the movements incorrectly. This had apparently happened in the past. She advised the Tribunal she had sought a therapy assistant from nearby physiotherapy practices but had not been able to locate a practice that would release (and insure) their therapy assistant to practice under the supervision of another physiotherapist. Mr Welldon, the current physiotherapist, does not have a therapy assistant in his practice.

1. Ms Hague advised the Tribunal that it was best if physiotherapy was undertaken in their home gym as it was very painful and fatiguing for Mr Hague to get in and out of a car to travel to treatment. She noted that Mr Hague felt comfortable with Mr Welldon which was an important consideration to her given Mr Hague's behavioural issues. She reported that on occasion Mr Hague had been agitated and violent towards new supports that he did not like.

1. Ms Hague also gave evidence that she was aware the three hours of physiotherapy treatment she was requesting was not aimed at improving Mr Hague's function given the length of time since Mr Hague's stroke but was aimed at minimising the speed of deterioration. Ms Hague advised that the three hours incorporated amounts for Mr Welldon's travel, with two hours for treatment and one disbursed on travel costs. In her view, anything less would provide insufficient time for treatment. She advised the Tribunal that two hours allowance would allow only one hour treatment with the other hour taken up with travel.

1. Ms Hague advised the Tribunal the current level of physiotherapy had previously been funded under the NDIS. Mr Hague is currently only funded for one hour of physiotherapy treatment a week so Ms Hague has been using funds from the other capacity building funding to pay for physiotherapy. She advised that Mr Hague has been receiving this level of physiotherapy treatment for some 4 or 5 years now. She acknowledged that there were sometimes weeks where no treatment occurs, such as when Mr Hague is unwell or during holiday periods. She reported an occasion where deterioration occurred after several weeks of no physiotherapy. In general Mr Hague usually received physiotherapy treatment around 48 weeks in a year.

1. Ms Hague reiterated that travelling to physiotherapy is very difficult for Mr Hague due to his level of pain and fatigue. It is more efficient for him to receive treatment in their home gym. He has done this since his pelvic fracture in 2021. Ms Hague advised that as Mr Hague's condition has deteriorated, he has been able to do less in each session. This is partly due to his communication difficulties and partly due to his increasing fatigue.

Three early reports of Mr Thomas Welldon, physiotherapist

1. The Tribunal has been provided with four reports of Mr Thomas Welldon, physiotherapist. I will address the first three below.

1. Mr Welldon operates a physiotherapy service prepared to travel to clients from its base in North Burnett. It is unclear to the Tribunal where Mr Welldon's travel charges to the Hagues commence and end. Noting the township of Maryborough, wherein there are a number of physiotherapy practices, is around 10 minutes away, the utilisation of NDIS funding for travel costs is a consideration Ms Hague might wish to review.

1. In his report dated 30 September 2023 Mr Welldon notes the following:

1. Mr Hague's original stroke occurred in April 2018 and impacted the function of his right side. Although Mr Hague regained some use of his upper limb, his right leg function remained an issue[12];

1. Mr Hague sustained two further strokes after the initial event;[13]

1. Primary symptoms include reduced muscular control of lower and upper limbs, especially peripherally, reduced active range of motion of all joints in the right side, with hand, ankle and shoulder the most affected and poor hand and finger manipulation.[14]

1. Mr Hague is noted to have been engaging in physiotherapy three times a week as part of a structured regimen aimed at 'preserving and augmenting his functional capacity'. This is noted to be directed at gait, strength, balance and hand function and designed to 'rectify identified deficits and address emerging issues stemming from compensatory movement or suboptimal muscle activation.' Mr Welldon states there have been notable improvements in muscle strength, co-ordination, core stability and post-activity discomfort.[15] How this has been determined has not been described and there is no comparative testing data provided.

1. Mr Welldon noted that muscle strength has been declining in both the upper and lower limb on Mr Hague's right side despite continual physiotherapy input and independent exercise. Mr Hague's capacity for both aerobic and muscular endurance is notably diminished.[16]

1. Mr Welldon noted Mr Hague's capacity is also impacted by chronic post stroke pain and pain from a fractured pubic ramus which has failed to heal.[17]

1. Goals for future treatment included improving strength and endurance generally, improving upper limb function, ensuring deterioration of function does not occur by avoiding falls, improving gait and preventing impulsive behaviour and ensuring Mr Hague is able to maintain and improve his mobility.

1. Mr Welldon noted physiotherapy treatment three times a week included 60 minute sessions for implementation of a targeted therapeutic exercise regimen focussing on strength maintenance, reclamation of upper and lower limb function and prevention of falls, with 20 minutes travel allowance for each session totalling 1 hour weekly. It is not clear if this travel allowance is in addition to the three hours treatment or included.[18]

1. In his report dated 24 May 2024 Mr Welldon noted the following:

1. He disagreed with NDIA's decision to limit funding for Mr Hague's physiotherapy treatment;[19]

1. Specifically in relation to the value for money criteria Mr Welldon stated that Mr Hague requires intensive physiotherapy to maintain and improve his co-ordination, strength, endurance, lower limb function, upper limb function and exercise habits;[20]

1. Specifically in relation to the delegated model in which untrained workers or therapy assistants are funded to manage Mr Hague's exercise program, Mr Welldon felt this created a safety risk for Mr Hague due to those practitioners' inability to adjust exercises based on Mr Hague's differing presentation each day;[21]

1. The funding of one hour per week over 104 weeks was not considered sufficient to achieve desired outcomes (as set out in paragraph 51(b) above).[22]

1. Mr Welldon advised his recommendations reflected current best practice recommended by the Australian Stroke Foundation, including therapy in the chronic phase (one year onwards) of 45 minutes of therapy per discipline per day for a minimum of 2-3 days a week. I was unable to locate this recommendation in relation to long term community care patients on the website link provided.[23]

1. In his report dated 30 March 2025 Mr Welldon reiterated the 'critical and ongoing need for regular physiotherapy for [Mr Hague], particularly in light of significant new neurological diagnoses and observed functional decline'. The new diagnoses were cerebellar atrophy and liquefactive necrosis which conditions were expected to result in permanent and progressive deterioration of neurological function.[24]

1. Mr Welldon also noted that over a recent holiday period, Mr Hague had had no physiotherapy for several weeks, resulting in a 'distinct and concerning loss of function in Mr Hague's balance and movement co-ordination'. The specific nature of Mr Hague's decline was not described.

Report of Dr Saba Asif, Consultant Rehabilitation Physician, dated 16 May 2025[25]

1. Dr Asif was asked by the Agency to give an 'on the papers' assessment of Mr Hague's situation and likely physiotherapy treatment needs based on the stage of his recovery and her experience as a rehabilitation physician.

1. Dr Asif provided general information about the various post-stroke stages and the usual recommended requirement for physiotherapy treatment at each stage. These stages included the acute and subacute (or rehabilitation phase) and the long term/community phase.

1. For the long-term care stage Dr Asif advised that in the initial discharge phase, the intensity of therapy is significantly reduced (from inpatient two sessions a day) to outpatient 1-2 sessions a week. In her opinion this treatment should be goal directed with a focus on community reintegration. Duration of treatment should depend on attainment of functional goals as assessed by the tools available and be ceased or reduced once those were achieved.

1. In Dr Asif's opinion a request for 3 hours of physiotherapy treatment per week in the long-term phase was not reasonable and there was no evidence this would produce improved outcomes in a stroke patient. She noted the following:

1. The vast majority of recovery for ambulation, upper extremity function and higher cerebral function occurred within 12 weeks of stroke;

1. Neurological recovery peaks within the first three months post-stroke and may continue at a slower pace in the following months;

1. Overall function remains relatively stable between six months and three years, although there may be differential shifts in performance of specific functions;

1. Considering the MRI scan of Mr Hague's brain in September 2023, with a large region of gliosis/encephalomalacia, she was of the view he did not require three hours of therapy a week.

1. There appeared to be no difference in outcomes between home based and clinic -based therapy during outpatient treatment.

1. Dr Asif expressed the view that Mr Hague would not benefit from ongoing intensive physiotherapy. She was of the view issues with his balance, mobility and falls were not just related to his diminishing muscle strength. Other contributors included Mr Hague's cognitive and communication deficits and his ongoing significant pain.

1. Dr Asif noted that 20% of stroke survivors experience decline in mobility three years post stroke. It was important, in Dr Asif's view, for intermittent physiotherapy assessment of a patient's mobility, to see if there were contributing factors in any deterioration which could be improved with a short burst of goal directed intensive treatment. The prerequisite for this approach would be an identified functional decline with the relevant functional limitation deemed modifiable through therapy. In her view this had not been done in Mr Hague's situation.

1. In Dr Asif's opinion, Mr Hague is suffering from chronic and extensive left hemispheric stroke and ongoing therapy is unlikely to translate into functional improvement at this point. The current frequency and intensity of therapy will not change the outcome for his function, his ability to undertake activities of daily living or the impact on his ability to live in the community. Dr Asif was of the view ongoing functional maintenance could be best achieved with a home exercise program and by being active.[26]

'Mr Hague has well passed the stage of rapid and functional recovery. The severity and size of the stroke, cognitive deficits and communication impairment will not change the fact that it is not the lack of physiotherapy which is causing the falls and deterioration in his condition, but that limited physical mobility and deconditioning is playing an important role. The physiotherapy need for Mr Hague is for chronic health management and should be on an as-required basis.'

1. In response to direct questioning Dr Asif agreed telehealth services were sometimes useful for rural patients.

Report of Thomas Welldon dated 11 June 2025[27]

1. Mr Welldon provided a fourth report in response to the report of Dr Asif.

1. He confirmed that the request for physiotherapy services was to allow for two sessions of treatment a week with 'adequate provision for travel', and not for three hours of treatment.

1. Mr Welldon reminded the Tribunal that pathways for individuals and their long-term care are highly variable and should be assessed on a needs basis considering the entire healthcare of the individual.

1. Mr Welldon suggested the Tribunal should give equal weight to his reports and that of Dr Asif. He notes that as the treating professional with knowledge of Mr Hague's condition, he is better placed to assess Mr Hague's needs. He suggested Dr Asif's experience as a rehabilitation physician did not commonly extend to long term community care of stroke survivors.

1. Mr Welldon also relied on a statement of Dr Asif at paragraph 15 of her report to suggest Dr Asif agreed with his opinion about the appropriateness of the proposed treatment. This paragraph in Dr Asif's report included an opinion that the physiotherapy the applicant sought (three times a week) could be considered 'on a time limited assessment and management of general health, to prevent post-stroke complications and maintain general health'. I do not consider this statement supports Mr Welldon's opinion that the intensive physiotherapy should continue indefinitely.

1. Mr Welldon re-interated that improvement of function is not the aim of his treatment of Mr Hague at this stage of his care. The primary goal is to maintain his current level of function. He indicated that Mr Hague is at risk of significant functional decline without the recommended treatment. No objective data was provided to buttress this opinion.

1. Mr Welldon felt that Dr Asif had not made allowance for the importance of specific, tailored physiotherapy in the management of spasticity and maintaining function. No information about the specific treatment being given was provided to explain this.

1. I have considered information provided by the Agency in relation to the therapy funding provided in previous plans. I reproduce this below but note that there is an error in the allowances recorded for the current plan. By reference to the actual plan (JTB2 of exhibit 1) the current plan is a six-month plan with hourly allowances for the six months being half of those recorded below.

• Assessment Recommendation Therapy And/or Training (Incl. AT) -Psychology - 18 hours per year
• Exercise Physiology - 1 hours per week
• Training For Carers/Parents - 10 hours per year
• Assessment Recommendation Therapy And/or Training (Incl. AT) -Physiotherapy - 2 hours per week
• Assessment, Recommendation, Therapy And/Or Training (Incl. AT) - Other Therapy - 118 hours per year

• Assessment Recommendation Therapy And/or Training (Incl. AT) -Psychology - 18 hours per year
• Exercise Physiology - 1 hours per year
• Training For Carers/Parents - 10 hours per year
• Assessment Recommendation Therapy And/or Training (Incl. AT) - OtherTherapy - 118 hours per year
• Assessment Recommendation Therapy And/or Training (Incl. AT) -Physiotherapy - 2 hours per week

• Assessment Recommendation Therapy or Training - Physiotherapist x 1hours/week x 104weeks
• Assessment Recommendation Therapy or Training - Occupational Therapist x 17hours/year x 2 years
• Assessment Recommendation Therapy or Training - Speech Pathologist x 10hours/year x 2years
• Assessment Recommendation Therapy or Training - Podiatrist x 8hours/year x 2years

• Assessment Recommendation Therapy or Training - Physiotherapist x 1hours/week x 104weeks
• Assessment Recommendation Therapy or Training - Occupational Therapist x 17hours/year x 2 years
• Assessment Recommendation Therapy or Training - Speech Pathologist x 10hours/year x 2years
• Assessment Recommendation Therapy or Training - Podiatrist x 8hours/year x 2years

• Assessment Recommendation Therapy or Training - Occupational Therapist -27 hours over six months
• Assessment Recommendation Therapy or Training - Speech Pathologist - 10 hours over six months
• Assessment Recommendation Therapy or Training - Podiatrist - 8 hours over six months
• Assessment Recommendation Therapy or Training - Physiotherapist - 60 hours over six months
• Therapy Assistant - Level 2 - 39 hours over six months

1. From this I can see that at no time has 3 hours of physiotherapy per week ever been considered a reasonable and necessary support. In the early stages there was funding for an exercise physiologist and a physiotherapist, but this did not continue past 2023. Reasonable and necessary physiotherapy funding has been assessed at one hour a week since 2023. An increase in the May 2025 budget allowed for 1.25 hours per week for 6 months along with approximately 1 hour a week funding for a therapy assistant.

1. In the matter of National Disability Insurance Agency v WRMF[28] (WRMF) the Full Court discussed the following which may be considered principles to be applied:

1. Supports to be provided to a person who qualifies as a participant are intended to accommodate an individual's particular impairments and to assist that particular individual to be a participating member of the Australian community and to do so on the basis of the values set out in the objects and guiding principles of the Act;[29]

1. Whether, in a given case, the requested support is a 'reasonable and necessary support' will...generally be a question of fact on the evidence before the decision-maker. Subject to matters such as rationality and legal unreasonableness, there may be an area of decisional freedom in the conclusion reached by a decision maker about whether a support is properly characterised as a 'reasonable and necessary' support. The phrase has a qualitative aspect;[30]

1. The phrase 'reasonable and necessary' 'is a composite phrase and each limb should be given work to do. While both words qualify the word 'support' they do so as a composite phrase and it is not fruitful to split them off and consider them separately;[31]

1. Nevertheless, there 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;[32]

1. The phrase 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;[33]

1. The task of determining the contents of a participant's plan and what are the reasonable and necessary supports is a fact-intensive exercise.[34] The circumstances of each participant will vary greatly... and the exercise will be highly individualised. There will be an area of 'decisional freedom' for the decision-maker, about what supports fall within this description, given the circumstances of the particular individual. Provided no substantive legal error attends the choices made, it is possible for reasonable minds exercising that power under section 33(2) to differ;[35]

1. The matters set out in section 34(1) (of the Act) are more than mandatory considerations, because in terms section 34 requires that a decision maker be positively satisfied about each matter. They are more in the nature of criteria of which the decision-maker must be satisfied on the material. That satisfaction must be reasonably and rationally formed, not taking into account irrelevant considerations, and taking into account any relevant considerations, but otherwise it is for the decision-maker to form the requisite state of satisfaction on the given material;[36]

1. ...participant plans are not complex documents, but they may specify a large number and wide range of supports. The inquiry required of the decision-maker is therefore a targeted one, but it is not necessarily a complex one. The criteria are straightforward and pragmatic. The decision-maker's approach is entitled to be of the same kind.[37]

1. The starting point is section 33(5) of the NDIS Act.

1. Per the requirements of section 33(5)(a) I have had regard to Mr Hague's goals and aspirations which include:

1. feeling safe in his home and being able to safely access the community;

1. being able to re-connect with his trade (as a carpenter) and work in the building industry;

1. being able to increase his independence at home and in the community.

1. In line with section 33(5)(b), I have had regard to the relevant assessments conducted in relation to the participant (as set out above) with particular notice given to the reports of Dr Asif and Mr Welldon.

1. I do not consider sections 33(5)(e) to (f) necessary to consideration of this matter but will set out my consideration of section 33(5)(c) below.

1. Section 33(5)(c) provides that I must be satisfied of all the criteria in section 34(1) of the NDIS Act (as amended) in relation to the requested support. Section 33(5)(d) requires that I apply the NDIS Rules made for funding of reasonable and necessary supports.

Section 34(1)(aa) - Is the support necessary to address needs arising from the impairments for which Mr Hague gained access to the Scheme?

1. Section 34(1)(aa) of the Act requires that I be satisfied the support is necessary to address the needs of the participant arising from an impairment in relation to which the participant meets the disability requirements or the early intervention requirements.

1. These two requirements are the threshold requirements set out in section 24 and 25 of the NDIS Act and which govern access to the Scheme. The note to section 34(1) provides that the time at which these requirements must be met is the time the CEO (or the Tribunal as decision-maker) decides on the participant's plan. In this circumstance, that time is now.

1. The medical condition underlying Mr Hague's access to the scheme is his significant stroke sustained in 2018 and extended by further incidents in 2020 and 2021. I consider the impairments arising from that condition include cognitive, neurological (muscle weakness, pain and loss of sensation), physical and psychosocial impairments.[38]

1. I consider the evidence[39] suggests these impairments are or are likely to be permanent in that there are no known, available and appropriate evidence based clinical, medical or other treatments that would be likely to remedy the impairments.[40]

1. I consider the evidence[41] confirms these impairments substantially reduce Mr Hague's functional capacity to undertake all six of the relevant activities in section 24(1)(c)[42] and that they affect his capacity for social and economic participation.[43]

1. I consider the evidence[44] suggests Mr Hague is likely to require NDIS Supports under the Scheme for his lifetime.[45]

1. My assessment is that Mr Hague does meet the disability requirements for access to the Scheme on the basis of his stroke-related impairments at this point in time.

1. I do not consider Mr Hague's circumstances would fit within the early intervention requirements given the chronic stage of his condition.

1. I have considered the evidence in relation to the role of physiotherapy in management of a long-term stroke survivor. I am satisfied on the basis of the evidence of Dr Asif and Mr Welldon that physiotherapy has a role to play in the management of post-stroke complications and to maintain general health status. I have also had regard to the clinical guidelines of the Stroke Foundation to which I was directed by Dr Asit and Mr Welldon.

1. On the basis of this evidence, I am satisfied that physiotherapy support is necessary to address the needs of Mr Hague arising from the stroke related impairments in relation to which he meets the disability requirements. This includes in the setting of an exercise plan to be managed by support people and in the treatment of post-stroke complications.

1. Remaining for my determination is the number of hours of physiotherapy treatment that ought to be funded.

Section 34(1)(a) and (b) criteria - Will the support assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations and to undertake activities so as to facilitate the participant's social and economic participation?

1. feeling safe in his home and being able to safely access the community;

1. being able to re-connect with his trade (as a carpenter) and work in the building industry;

1. being able to increase his independence at home and in the community.

1. It is Mr Welldon's evidence that the physiotherapy treatment recommended is directed at maintenance of mobility and increasing hand and finger function

1. I note that there is a document produced by the occupational therapist, Sarah Clarkin, to assist Mr Hague and his support people with his mobilisation and transfers.[46] It is noted that the guidelines be reviewed if there is significant change in Mr Hague's mobility levels. This suggests that reduced mobility would reduce Mr Hague's capacity to achieve his goal to be safe and independent at home and in the community.

1. Mr Welldon advises that physiotherapy treatment is focussed on improving gait, strength, balance and hand function.[47]

1. He notes that in relation to the hand, treatment has focussed on improving Mr Hague's ability to grasp and isolate movement of his fingers.[48] If achieved, this improvement would assist in improving Mr Hague's capacity for independence and in completing projects in his workshop..

1. In relation to mobility Mr Welldon seeks to improve strength and endurance generally and ensure deterioration of function does not occur. He states he is focussed on improving Mr Hague's gait to take account of the limitations in Mr Hague's joint movement.[49] There is no data as to specific outcomes of this treatment but improved gait is likely to assist in achieving Mr Hague's goal of greater independence.

1. Despite this, Mr Welldon also notes that there has been a gradual decline in Mr Hague's limb strength and control, in his capacity for both aerobic and muscular endurance[50] and in his muscle strength.[51]

1. Dr Asif is of the view that at this stage in Mr Hague's post-stroke recovery there is little that physiotherapy will do which will improve Mr Hague's function. This is based on research findings in relation to the usual progress of stroke patients that she refers to.[52]

1. It is Dr Asif's view that there is a lack of evidence to support the likelihood of functional improvement with intensive therapy in chronic stroke patients. This includes in the areas of function, mobility and movement and community living. In Dr Asif's view, ongoing functional maintenance can best be achieved with a home exercise program and by Mr Hauge being active.[53]

1. Dr Ogiji is of the view that Mr Hague has shown no improvement in the past 6 years of intensive therapy and expects his function to decline.[54]

1. In response Mr Welldon notes that each patient should be assessed as an individual in relation to their own specific stroke experience.[55] He states that improvement is not the goal at this point, rather the primary goal is to halt or slow any further deterioration in Mr Hague's function.[56] Both Mr Welldon and Ms Hague refer to an undescribed deterioration in Mr Hague's function when he was unable to undertake physiotherapy treatment for some weeks.[57]

1. I have considered Ms Hague's concerns about increasing contractures and spasticity and the impact this would have on Mr Hague's safety and her ability to manage his care at home. I have no evidence from either Mr Welldon nor Dr Asif in relation to whether this level of physiotherapy might effectively address these conditions.

1. I have considered the clinical guidelines provided by the Stroke Foundation to which I was directed by Mr Welldon and note that botox in conjunction with rehabilitation therapy, electrical stimulation, casting and taping are recommended treatments for spasticity, and casting and active therapy are recommended for contracture. Regardless, these are thought unlikely to improve motor function or walking.[58] I have no evidence before me that Mr Welldon's treatment is directed at these approaches.

1. On balance I find that physiotherapy generally may assist Mr Hague towards his goals in slowing the deterioration in his function. I am not satisfied the evidence establishes that three hours of treatment a week is required.

Section 34(1)(c) and (d) - Is the support, or is it likely to be, effective and beneficial for the participant having regard to good practice and does it represent value for money in that the costs are reasonable relative to the benefits to be achieved and the costs of alternatives?

1. In relation to value for money, Rule 3.1 of the Support Rules requires me to consider the following:

1. Whether there are comparable supports which would achieve the same outcome at a substantially lower cost.

An example in this situation would be the use of a delegated model of care with a level 2 therapy assistant undertaking supervision of some of the physiotherapy exercises. On the basis of Ms Hague's oral evidence, I am satisfied that in the rural area the Hague's are located, there are no available level 2 therapy assistants they can access.

A further alternative would be the use of telehealth services as suggested by Dr Asif. I am satisfied on the basis of the medical evidence that Mr Hague's cognitive decline and receptive and expressive dysphasia mean he would be unable to benefit from telehealth services.

1. Whether there is evidence the support will substantially improve the life stage outcomes for Mr Hague and be of long-term benefit to him.

It is doubtful whether any amount of physiotherapy treatment will 'substantially improve life-stage outcomes' or be 'of long-term benefit' to Mr Hague in the ordinary sense those phrases might be understood. However, in the circumstance of this participant who has experienced a significant left hemispheric stroke in 2018 with deteriorating function, the definition of 'substantially improve life stage outcomes' must take what is possible into consideration.

Mr Hague's condition is reflected in an MRI which demonstrates significant injury to the brain and progressive softening of the remaining brain matter, in emerging vascular dementia, progressive cognitive decline, loss of sensation and spasticity of the right side of the body, the constant pain of an united pelvic fracture and communication significantly interrupted by combined expressive and receptive dysphasia,

Mr Hague's life stage outcomes are significantly worsened with each further deterioration. In this context, it might be considered that maintenance of function, or the avoidance of further loss, even for a short period, counts as 'substantial improvement' for him. Unfortunately, we have little objective data to support a finding that three hours of physiotherapy a week has resulted in such an outcome.

1. Whether funding of the support will reduce the cost of funding of supports for the participant in the long term or reduce the participant's needs for other kinds of supports.

In all likelihood, given Mr Hague's progressively deteriorating condition, it is unlikely that physiotherapy, including 3 hours of physiotherapy a week, would reduce Mr Hague's need for supports. Dr Ogiji notes Mr Hague's care needs will continue to increase with time.[59]

1. On balance, considering the evidence of Dr Asif, and the clinical guidelines issued by the Stroke Foundation, I find that three hours of physiotherapy at this stage in Mr Hague's recovery is unlikely to result in substantial improvement or reduce costs of other supports. There is no evidence before me on which I can be positively satisfied that this level of treatment will reduce the risk of future deterioration for Mr Hague.

1. In deciding whether the support will be or is likely to be effective and beneficial for a participant, having regard to current good practice, Rule 3.2 requires that I consider the available evidence of the effectiveness of the support for others in like circumstances, including:

1. published and refereed literature and consensus of expert opinion; and

1. the lived experience of the participant or their carers.

Dr Asif relied on her experience and research literature in expressing her opinion that there was no evidence-based reason why on a general basis, a stroke patient in the long-term phase of their recovery would benefit from three hours of physiotherapy a week.[60]

To the extent that Mr Welldon and Ms Hague understand Dr Asif to have agreed that intensive physiotherapy for 2-3 times a week may be appropriate, it is my understanding of section 15 of Dr Asif's report that this was considered only for a time-limited period to address a specific functional issue.

Mr Weldon's opinion is that the current treatment has assisted in maintaining Mr Hague's function and improving his gait to reduce the risk of falls. He notes that due to Mr Hague's fatigue, he is obliged to allow for rest breaks during treatment. For this reason he is of the view that two sessions are required each week.[61]

Ms Hague maintains her very strong belief that the current level of physiotherapy has maintained function and slowed the rate of deterioration. Any further deterioration would be devastating to them both, and it is understandable she would wish to do what she may to avoid this.[62]

On balance I prefer the evidence of the peer reviewed research relied upon by Dr Asif, in relation to the usual needs of long-term stroke patients at this stage in their recovery. However, I take account of the specific experience of Mr Welldon and Ms Hague in relation to Mr Hague, particularly as it relates to his inability to fully utilise an hour long physiotherapy session due to stroke-related fatigue.

1. Rules 3.4 and 3.5 require me to consider whether it is reasonable for families, informal networks or carers to provide the support and whether the support should be more appropriately funded through another Scheme.

1. I am satisfied that both of these issues should be answered in the negative. Ms Hague is able to (and does) assist with Mr Hague's basic exercise program but does not have the skills to manage his physiotherapy treatment. I do not consider the treatment provided is a general health support, aimed at addressing an acute issue, but rather has been directed towards addressing the physical and neurological impairments attributable to Mr Hague's stroke. It is appropriate it be funded through the NDIS and not the health system. I do not consider that funding is barred by Item 12 of Schedule 2 of the Transitional Support Rules.

1. In WRMF the Full Court noted that the determination of what may be 'reasonable and necessary supports' for inclusion in a plan is a highly individualised exercise dependent on the circumstances of each participant.[63] This is particularly relevant in this circumstance.

1. This participant is a young man, significantly impaired. His capacity to understand and express himself is impaired. His sensation related to his right side is impaired if not missing completely. His capacity to intentionally move his body is impaired, requiring hands-on movement and direction in order to complete movements correctly and to activate muscles correctly.[64] His cognitive capacity is impaired. His capacity to regulate his emotions and behaviour is impaired. He has reduced endurance and fatigues easily. He has insight into his losses resulting in distress and suicidal ideation.

1. I am satisfied that these matters are relevant in that:

1. Mr Hague would be unable to benefit from telehealth services. He could not comprehend instructions and apply them without hands on support and direction. He could not reliably express his difficulty, pain or ask questions when unsure;

1. Mr Hague has limited endurance and needs to rest during physiotherapy treatment or risk suffering increased pain later. As his condition deteriorates his capacity to persist through a physiotherapy treatment is reduced and he would likely do better with shorter sessions;

1. Mr Hague needs directed movement in order to activate his muscles properly and alter unhelpful compensatory movements which interfere with his gait. Given the stiffness of his muscles and joints, and his lack of right sided sensation, this movement must be completed carefully so as to avoid further injury;

1. Mr Hague's cognitive decline impacts on his ability to retain information in the short term, requiring repetition;

1. Mr Hague lives in a rural setting with limited options for treatment, including no access to level 2 therapy assistants;

1. The impact of further deterioration would be devastating to Mr Hague's independence and mental state.

1. On balance I am satisfied and find that the evidence set out above does not support a finding that three hours of physiotherapy a week constitutes a reasonable and necessary support in the manner contemplated by section 34 of the NDIS Act. By this I also include the proposed use of funding for two hours a week treatment and one directed to travel costs.

1. However, equally I am satisfied and find that based on the evidence from Mr Welldon and Ms Hague related specifically to Mr Hague, there is continued benefit in terms of impairment management in Mr Hague continuing to receive regular physiotherapy. While neurological function may not improve, repetitive retraining of muscle activation and gait are likely to benefit Mr Hague in reducing his falls risk.

1. Dr Asif's evidence would suggest that only adhoc physiotherapy is reasonable and necessary for long term stroke survivors. The Agency has agreed that in this circumstance it is reasonable and necessary for Mr Hague to be funded for at least one hour of physiotherapy treatment per week.

1. In light of Mr Hague's unique situation, however, (as set out in paragraph 108 above) I find that at this point one hour a week (including an allowance for Mr Welldon's travel) is insufficient. I have formed the view it would be reasonable to fund physiotherapy treatment for 2 hours a week, allowing for two sessions of 40-45 mins a week plus provider travel, over the next year, with a step down to one hour a week thereafter.

1. I have considered the funding rules in the NDIS Pricing Arrangements and note that although this guide allows for funding of a provider's travel costs, these costs are to be charged at half the hourly rate allowed for treatment, in addition to a kilometre allowance. I also note that in his letter dated 30 September 2023, Mr Welldon noted that travel of 20 minutes per session was being charged. I have factored this information into my finding above.

1. In time Ms Hague may wish to consider whether the use of public funds provided for Mr Hague's treatment to cover provider travel constitutes the best use of Mr Hague's funding. It may be that an alternative, local option could be sourced over the next year.

1. Given I have reached a different conclusion to that of the Agency I will set aside the decision and remit it back to the Agency for reconsideration.

The decisions of the Agency under review are set aside and remitted for reconsideration in accordance with the direction that reasonable and necessary supports in the applicant's statement of participant supports should include:

1. 104 hours of physiotherapy treatment for 52 weeks followed by one hour of physiotherapy treatment a week for the remainder of the plan;

1. All other supports in the participant's statement of participant supports dated 2 May 2025, excepting any one-off assistive technology supports already used, are to be replicated pro-rata from the date on which the supports specified above are included in the applicant's statement of participant supports.

[1] Paragraphs [5], [6].[7] and [12] of JTB21 of Exhibit 1

[2] Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (Cth) Schedule 16, item 24

[3] Agency SFIC [13] JTB21 of Exhibit 1

[6] Section 3(3)(b) and 4(17) of the NDIS Act.

[7] Re Drake and Ministrer for Immigration and Ethnic Affairs (No. 2) (1979) 2 ALD 634

[8] Medical report of Dr S Jenkins dated 27.09.201, p12, Patient Health Summary p25, 28, Letter of Dr Ogiji, GP dated 25 July 2024, p 285 of Exhibit 1

[28] [2020] FCAFC 79

[34] WRMF at [152]; McGarrigle v National Disability Insurance Agency [2017] FCA 308

[35] WRMF at [152]; National Disability Insurance Scheme v KKTB by her litigation representative CVY22 [2022] FCAFC 81 at [26]

[39] Report of Dr Ogiji dated 8 April 2025 page 346 of Exhibit 1

[40] Section 24(1(b) of the NDIS Act and Rule 5.4 of the Access Rules

[41] Reports of Ms Sarah Carew, Ms Jenny Boulter and Dr Kristin Marvin at page 333, 327 and 315 of Exhibit 1

[42] Section 24(1)(c) of the NDIS Act and Rule 5.8 of the Access Rules

[44] Report of Dr Ogiji dated 8 April 2025 page 346 of Exhibit 1

[46] Mobility and Transfers document, pages 13 to 20 of Exhibit 1

[54] Letter of Dr Ogiji, GP dated 25 July 2024, p 285 of Exhibit 1

[58] Clinical Guidelines, Stroke Foundation MAGICapp - Making GRADE the Irresistible Choice - Guidelines and Recommendations