1. The Act sets down the law that underpins the scheme.
2. Individuals who are granted access to the scheme are referred to as 'participants'.[3] A fundamental aspect of the scheme is to provide individual plans to participants, which fund certain specified supports.
3. Section 33 of the Act identifies the matters that must be included in a participant's plan. Subsection 33(2) requires that a plan include a statement of participant supports prepared with the participant and approved by the CEO. Paragraphs 33(2)(a) to (e) of the Act specifies these statement of participant supports must include general, reasonable and necessary supports, in addition to the date by which the Agency must reassess the plan, as well as information regarding management of other plan aspects.
4. Section 33(5) of the Act directs that when deciding whether to approve a statement of participant supports the CEO (and this Tribunal upon review) must have regard to the participant's statement of goals and aspirations, relevant assessments, the principle that a participant should manage their plan to the extent that they wish, the operation and effectiveness of previous plans and compliance with spending in addition to being satisfied the supports are reasonable and necessary and the NDIS rules are applied.[4]
5. On 3 October 2024, the National Disability Insurance Scheme Amendment (Getting the NDIS back on Track No. 1) Act 2024 (Amending Act) came into force. Numerous provisions in the Act were amended including, relevant to this application, significant amendments to section 34 regarding reasonable and necessary supports. The amendment introduced paragraph 34(1)(aa) which provides that the support must be necessary to address the participant's needs arising from the impairment/s to which they met the disability requirements under section 24 of the Act.
6. Section 34(1) of the Act now provides that when considering what 'reasonable and necessary' supports are provide funding, the decision maker must be satisfied that each limb outlined in paragraphs 34(1)(aa) to (f) is established:

(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. > > Note: For the purposes of paragraph (aa): > > (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).

7. These legislative amendments must be applied by the Tribunal when a statement of participant supports is approved or varied on or after 3 October 2024, even if an applicant's plan came into effect before the commencement of the amendments.[5]
8. Subsections 34(2) and 35(1) of the Act provide for the making of rules with respect to the inclusion of reasonable and necessary supports within a statement of participant supports. The relevant rules in this application are the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Support Rules).
9. Relevant to this application rule 5.1(b) of the Support Rules states that a support will not be provided or funded under the NDIS if it is not related to the participant's disability.

1. The Applicant initially sought the provision of 96 hours per annum of exercise physiology to be included in her statement of participant supports (requested support).
2. In its Statement of Facts, Issues and Contentions dated 8 July 2025 the Respondent asserted that the provision of the requested support did not address the needs of the Applicant arising from an impairment in relation to which she met the disability requirements, and that it does not promote social participation, it is not value for money, nor is it effective and beneficial for the Applicant. As such paragraphs 34(1)(aa), (a), (b), (c) and (d) of the Act are not established.
3. At the commencement of the hearing the Applicant reported that she was seeking only 50 hours per annum of exercise physiology to be included in her NDIS plan but would only agree to this arrangement if the requested support was provided in a 3 year plan.
4. In reply the Respondent advised that it had recently offered to fund 96 hours per annum of exercise physiology and an additional 2 hours per annum for report writing post receipt of the independent exercise physiology report. It amended various aspects of the Statement of Facts, Issues and Contentions dated 8 July 2025 consistent with this offer.
5. The Applicant confirmed that she had received the Respondent's offer to fund 96 hours of exercise physiology but nevertheless intended to proceed with her application. She confirmed that she understood that she could end up worse off with a decision of the Tribunal; that is, the starting point was not to provide her with 96 hours of exercise physiology. The Applicant indicated that she understood that instead the Tribunal may determine that exercise physiology is not a reasonable and necessary support at all. The Applicant was advised by the Tribunal that an option available to her was to accept the Respondent's current exercise physiology offer and withdraw the application. She indicated that she understood but nevertheless wished to proceed with the application.

1. The Applicant provided a written statement dated 8 June 2025 outlining her relevant medical history, including her diagnosis with schizophrenia and depression at the age of 25.[6] She also described a history of trauma. She spoke to her social isolation and that the provision of support workers assists her to access the community. She described the requested support as her most "important paid support" which she undertakes once a week. She went on to state:

...Due to my mental illness, I find it difficult to plan my day and it is hard to find the motivation to start the day. At times I feel so unwell from my symptoms of schizophrenia that I don't want to leave the house. Exercise Physiology gives me structure. It gives me something to look forward to every week. > > I have seen a significant change in my mental health due to exercise physiology. I have more motivation and have started planning my days since starting exercise. It gives me clarity when it comes to my thoughts caused by schizophrenia and allows me to move forward in life. > > I have also seen physical improvements. My posture has improved and my muscle mass has increased. My body looks and feels stronger. I have developed mental and physical resilience. > > ... > > Concluding, my understanding of the NDIS is to support participants to gain complete independence and lead fulfilling lives. > > I strongly believe the support I am asking for is reasonable and fair.

2. At the hearing the Applicant stressed that exercise physiology is a reasonable and necessary support given her mental health. She explained that it is very difficult for her to get out of bed as she has bad days where she's significantly depressed, making it difficult for her to engage in exercise. However, when she has a structured activity such as exercise physiology she can force herself to attend exercise physiology as it has a profound effect on her mental health. She is currently undertaking independent exercise (walking in the community for 30 minutes) three times a week. She is also attempting to increase her incidental exercise, giving examples of walking to the coffee shop in the morning or parking her car further away from the entrance of local shops. She reports that this exercise has many benefits including building her mental resilience. Sometimes she does not want to go walking but she will force herself to get out the door because she knows she will feel better later.
3. The Applicant reported that she has not attended a gym in about 20 years. She stressed that exercise physiology makes her stronger and increases her mental and physical resilience. She currently attends 2 x 30 minute exercise physiology sessions per week. Over time she plans to build up to attending group exercise physiology sessions.
4. In closing submissions the Applicant stressed that the focus should be on her as a human being, not just an NDIS participant and that exercise physiology is very important to her mental health and wellbeing.
5. Ms Madeline Davidson, occupational therapist, conducted a psychosocial functional capacity assessment.[7] She opined in a report dated 17 March 2022 that:[8]

... > > [The Applicant]'s disability is psychosocial, not physical. Therefore, [the Applicant] does not experience difficulties in her mobility, transfers, upper or lower limb function, range of movement or skin integrity. Nil skin integrity issues or physical pain reported. > > ...

6. Ms Davidson recommended exercise physiology to improve the Applicant's health and wellbeing and to reduce weight gain from medications.[9]
7. A further mental health functional capacity report was completed by Ms Jayde Avery, occupational therapist, on 30 November 2022.[10] It was recommended that the Applicant be provided with a gym membership and a personal trainer to support her weight loss goal and improve her mental health.[11]
8. The summons material in evidence indicates that the Applicant attended exercise physiology sessions at Hunter Rehabilitation and Health, generally weekly, from 28 April 2023 to 27 October 2023 and usually twice a week from 30 October 2023 to 19 August 2024. The Applicant also attended weekly exercise physiology at Rebound Health during the period 15 January to 4 June 2025.[12]
9. In evidence is a report from Hunter Rehabilitation and Health dated 1 December 2023, authored by Ms Caitlin Cloete, accredited exercise physiologist.[13] Reference is made to the Applicant demonstrating interest to improve her physical and mental wellbeing through regular exercise and that is an effective treatment for her mental health conditions.[14] Ms Cloete outlined the Applicant's goals from completing exercise physiology as follows:[15]
   • Learn strategies to cope with her psychological disability.
   • Develop the skills necessary to participate in exercise independently.
   • Gain the confidence to navigate social situations comfortably.
   • Receive support surrounding dietary guidance and fitness goals
   • Improve her physical fitness, health and wellbeing.
10. Ms Cloete advocated for exercise physiology stating that exercise has been shown to reduce mental health disorder symptoms, build self-esteem and provide social interaction.[16]
11. Registered psychologist, Ms Claire Ingrid, undertook a psychological assessment and provided a report dated 7 February 2024.[17] It was apparent that the Applicant experiences paranoid ideation, hypervigilance and is socially isolated. It was recommended that she undergo a psychiatric assessment and be provided with support co-ordination and support to access the community.[18]
12. Ms Josephine Duncan-Nagy, accredited exercise physiologist at Rebound Health authored a report dated 12 March 2025.[19] The Applicant has been attending the practice since September 2024 and Ms Duncan-Nagy has been providing support to her since January 2025. Ms Duncan-Nagy states that the Applicant's mental health condition significantly impacts on her capacity to improve her mental health and fitness, noting that the Applicant has experienced medication-induced weight gain. She opined that the requested support directly helps the Applicant to improve her physical capacity for activities of daily living, as well as engage with exercise that improves her mental health and her quality of life:[20]

...Physical activity is a modifiable risk factor for serious chronic illness that can have a significant positive impact on the quality of life and life expectancy of people with Schizophrenia. Individuals with schizophrenia are more sedentary than the general population due to their condition, which causes fatigue, low motivation, lack of confidence and anxiety - all which mean support from an Exercise Physiology is necessary to encourage physical activity and clinically beneficial exercise in this population. > > Although there is no cure for Schizophrenia, exercise is a powerful tool in managing the condition from a mental and physical standpoint. > > ● Aerobic exercise has been shown to improve working memory, social cognition and attention - with greater effects when exercise was supported by an exercise professional and at a higher dose > > ● Another systematic review of 389 participants showed that aerobic and strength training two days a week produced improvement in schizophrenic symptoms including overall mental health, muscle strength and cardiovascular health. > > ● Another meta-review showed that moderate to vigorous intensity exercise (recommended at a dose of 90-150 minutes per week) reduced negative and positive symptoms in people with Schizophrenia, improved global cognition, working memory and attention with better results when exercise was supervised by an exercise professional. > > (Footnotes omitted).

13. Ms Duncan-Nagy reported that the Applicant had attended 25 exercise physiology sessions of a one hour duration at the practice since September 2024, focusing on improving the Applicant's mental health, reducing her social isolation, stress management, establishing an exercise routine and improving her physical fitness.[21] It is apparent that the sessions also include a psychoeducational element.[22] It was stressed that there is significant evidence of the positive effect aerobic exercise has on both the cognitive and mental health of people with schizophrenia.[23] An increase in the funding of exercise physiology was advocated for, noting that it would be unsafe for carers assisting the Applicant to undertake exercise at home or in a park due to "unsafe environmental factors" or for the Applicant to undertake these exercises independently.[24] She cautioned against not providing the requested support as it can significantly impact on physical health, mental wellbeing and social interactions, as well as exacerbate lifestyle diseases:[25]

In relation to mental wellbeing, the role of Exercise Physiology in managing symptoms of schizophrenia is crucial. It has been documented that physical exercise helps alleviate negative symptoms such as depression and anxiety and can improve cognitive functioning, which is often impaired in schizophrenia (Kimhy, Vakhrusheva, Bartels, Armstrong, & Ballon, 2019). Lack of such interventions may result in escalating negative symptoms, poor cognition, and reduced capability to manage daily tasks.

14. Ms Duncan-Nagy concluded by recommending 52 sessions of exercise physiology per annum and an additional one hour per 12 month plan period for report writing.[26]
15. Kyle Petry, exercise physiologist authored an independent medical report dated 29 October 2025.[27] The Applicant initially reported that her intrusive thoughts are currently well controlled with her current medication. However, later in the assessment she informed that she had been having suicidal thoughts of late but feels that her state of mind has not negatively regressed in the last 12 months. The Applicant reported experiencing delayed cognitive processing (bradyphrenia) which contributes to fatigue and delayed responses that also impacts her ability to engage in conversations and problem solve, particularly in the mornings when her symptoms are more pronounced. She also experiences reduced motivation which affects her ability to initiate daily activities, particularly getting out of bed and completing her morning tasks.
16. Mr Petry reported that the Applicant did not present with any physical limitations that would directly impact her activities of daily living and she maintains a safe and independent level of mobility for household and community ambulation. Overall, he recommended the need for an individualised exercise program to target improvements in her lean muscle mass, cardiovascular fitness and reduction in central adiposity. He concluded that exercise physiology is a reasonable and necessary support as it will provide "structure, motivation, and professional supervision required to manage fatigue, enhance adherence, and ensure safety"[28], noting that her "primary limitations relate to reduced motivation, low self-belief, and self-limiting behaviours rather than physical impairment. These factors contribute to a sedentary lifestyle, fatigue, and reduced confidence in performing daily activities and participating in community life" and the physical side effects of long-term psychotic medication is weight gain and fatigue and so created a barrier to regular physical activity.[29]
17. Mr Petry reported that the Applicant has not trialled an independent home exercise program. In any event, his view is that such exercise would expose the Applicant to a risk of injury or falls.[30] He expressed that there is a lack of clinical oversight and behaviour modification in generic fitness programs and group classes are not suitable to the Applicant's needs and so exercise physiology remains the most cost effective option.[31] He recommended that the Applicant receive twice weekly sessions of exercise physiology, totalling 96 hours across a 12 month period and an additional 4 hours for stakeholder communication and report writing.
18. At hearing Mr Petry testified that the Applicant had no physical functional deficits. However, amotivation did impact on her capacity to exercise independently and therefore he recommended exercise physiology. He was not aware that the Applicant had commenced independent exercise in the community. He was of the view that the incidental exercise that the Applicant undertook would have a minimal beneficial impact on her health and wellbeing.
19. Ms Laura Holmes, exercise physiologist, Active Movement Studio gave oral testimony. She reported that she has been working with the Applicant for only four weeks. She confirmed that there are no physical limitations that the Applicant experiences. She has not given any thought to transferring the Applicant to a group class given that she has been focusing on understanding her needs and capacity during their short working relationship. She would recommend group activity, but one where an individualised program is still available. She continues to advocate for 1:1 individual sessions for the Applicant in the long-term given her low motivation and the ability of an exercise physiologist to adapt exercises to meet her immediate needs at each session. She understands that the Applicant walks daily for about a 45-minute duration. She spoke to the benefits to a person's mental health when participating in physical exercise, including changes to hormonal levels, reduction in anxiety and stress levels as well as improvements to cognition and self-esteem.
20. Ms Cloete also gave oral evidence. She confirmed that she treated the Applicant in 2023 and 2024; initially the Applicant attended a one hour session per week and then it was changed to two 30 minute sessions per week. She stated that the sessions were focused on the Applicant's mental health, even though there were physical goals which they were working toward. The Applicant reported improvements in her mental health when attending exercise physiology. She confirmed that the Applicant had no physical limitations, describing her as "physically fit". Her goals in the sessions were focused on toning, weight loss and building bone density. She recalled that a longer-term goal was for the Applicant to exercise independently. The focus was not to participate in group activities such as those run by a gym, rather the focus was on the Applicant walking in nature. She recalls that the Applicant was "quite good" at walking independently once a week, especially in the summer months and also undertook incidental exercise with her support worker. She sees no impediment to the Applicant exercising at home but stressed that the main benefit to the Applicant attending the exercise physiology clinic was the provision of social interaction.

The needs that arise from impairments in relation to meeting the disability requirements.

1. The Agency submits the Applicant met access to the NDIS for impairments arising from treatment resistant schizophrenia and was found to have substantially reduced functional capacity in the domains of social interaction and self-management.[32] The Applicant raised not objection to the Agency's submissions on this point. I find accordingly.
2. The note to paragraph 34(1)(aa) introduces a temporal element; I must be satisfied that the disability requirements are met at the time of approval of the statement of participant supports. Therefore, I must make the assessment at the time of this decision.
3. The question that requires resolution is whether the requested support is necessary to address the Applicant's needs arising from her impairment in relation to her psychosocial disability. I must consider whether there is a sufficient nexus between these needs and the requested support.
4. The Macquarie Online Dictionary defines the adjective necessary as follows:[33]

adjective 1. that cannot be dispensed with: a necessary law. > > 2. happening or existing by necessity. > > 3. acting or proceeding from compulsion or necessity; not free; involuntary: a necessary agent. > > 4. Logic > > a. (of propositions) denoting that the denial of that proposition involves a self-contradiction (opposed to contingent). > > b. (of inferences or arguments) denoting that it is impossible for the premises of an inference or argument to be true and its conclusion false.

5. It is apparent from the exercise physiology and occupational therapy reports in evidence that the Applicant does not have physical impairments generally. The exercise physiology reports show that her physical capacity is generally within the normal range for her age and gender and that she has no mobility issues or difficulties in completing activities of daily living.
6. I am satisfied that the Applicant has no physical impairments that make it necessary for her to attend exercise physiology. Therefore, she does not meet the requirements set down in either sections 24 or 25 of the Act in respect to any physical impairments.
7. I accept that the Applicant's psychosocial symptoms include bradyphrenia, paranoid ideation, amotivation and fatigue. These symptoms contribute to the Applicant's difficulties in undertaking activities of social engagement and self-management. The allied health evidence before me leads me to conclude that the Applicant's needs arising from her impairments are assistance with amotivation, bradyphrenia, low mood, social interaction and self-management. I also accept that the Applicant's mental health medications have contributed to weight gain.
8. I have no doubt that the Applicant finds attending exercise physiology beneficial, including providing social interaction, improving her physical fitness and that the Applicant has testified that it positively affects her mood, reduces her fatigue and increases her motivation levels and cognition. Her goals identified in conjunction with her exercise physiologists are primarily focused on her physical health, though they also include strategies to cope with her psychosocial disability.
9. Nevertheless, I am not satisfied that exercise physiology is necessary to address the Applicant's needs arising from her psychosocial impairments. Certainly, there is no clear nexus between the needs arising from the Applicant's impairments and exercise physiology. This is not to say exercise physiology is not beneficial to her; I have already found that this is so.
10. It is evident that it is exercise and not exercise physiology that provides these benefits and so the latter is not necessary to address the Applicant's psychosocial impairments. Instead, the provision of exercise physiology is but one way the Applicant engages in the community and undertakes physical exercise. It is certainly not the only way. The Applicant testified that she currently engages in 30 minute walks three days per week; she is not always motivated to do so but does because she knows it will improve her mood. She also takes the opportunity to engage in incidental exercise each day, including walking to get a coffee each morning. She does so because of the positive benefits this exercise brings to her general wellbeing and mental health.
11. I am not persuaded that the requested support is necessary as required and so paragraph 34(1)(aa) of the Act is not satisfied.
12. Section 34(1) of the Act is cumulative, and therefore all the criteria must be met. If one criterion is not met, the section is not satisfied. Therefore, I am not required to proceed to consider whether the remaining criteria set down in paragraphs 34(1)(a) to (f) of the Act are met.
13. I conclude that exercise physiology is not a reasonable and necessary support pursuant to subsection 34(1) of the Act.

1. The practical effect of this decision is that no exercise physiology is to be funded by the NDIS in the Applicant's plan. All other supports and the current plan management arrangements should be replicated in a new statement of participant supports, with a reassessment date of 12 months. Further, the current plan management arrangements should also be replicated.

The Tribunal sets aside the decision under review and remits the matter for reconsideration in accordance with the direction that:

(a) The provision of exercise physiology is not a reasonable and necessary support pursuant to subsection 34(1) of the National Disability Insurance Scheme Act 2013;

(b) all other reasonable and necessary supports in the Applicant's current statement of participant supports shall be replicated in the approval of a new statement of participant supports;

(c) the reassessment date is 12 months after the approval of the Applicant's new statement of participant supports; and

(d) the plan management specifications in the Applicant's current statement of participant supports shall be replicated in the Applicant's new statement of participant supports.

[5] Subitems 129(1) and (2) of Schedule 1 to the Amending Act.

[33] https://app.macquariedictionary.com.au