austlii:cth/ARTA/2025/2528
General information, not legal advice.
ARTA
2025-09-19
Senior Member P, Mr J
Original judgment source is linked above.
During this plan period I would like to be supported to improve my functional capacity, mobility, fine and gross motor skills as well as improving my communication.
During this plan period I would like support to continue to live with my family and have the necessary supports in place to keep me safe.
During this plan period I would like to be supported to increase my community participation and engage in activities that I enjoy such as swimming, race running, frame soccer and bike riding.
During this plan period I would like to be supported to help me learn how to regulate my emotions and teach me how to respond more appropriately when I become frustrated and upset.
2 Drake v Minister for Immigration and Ethnic Affairs [1979] FCAFC 39; 24 ALR 577 (Drake) at 589
3 This requested support was not before the internal review delegate when they made their decision; the internal review decision involved a decision not to approve funding for Specialist Disability Accommodation on the Applicant's parents' property as a secondary dwelling.
4 Shi v Migration Agent's Registration Authority [2008] HCA 31; (2008) 235 CLR 286 at [45] - [46]
5 National Disability Insurance Agency v Davis [2022] FCA 1002 (Davis) at [60]; National Disability Insurance Agency v WRMF (2020) 378 ALR 449 at 491 [201]
6 Beezley v Repatriation Commission [2015] FCAFC 165 (2015); 150 ALD 11 at [68]; HPSC and National
Disability Insurance Agency [2021] AATA 727 at [85]
to note that the policy of the Act places significant emphasis on participant choice and control in the selection of their supports, and upon the individualisation of supports.7 The words and phrases that encapsulate these values are to be understood as meaning what they say.8 These principles, at least in so far as they are expressed in s 4, are more than aspirational.9 It is the intention of Parliament that persons making decisions under the NDIS Act give effect to this policy as far as practicable.10
(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
7 see s 3(1)(e), 4(4), 4(8), 17A(1), (2),(3)(b), and 31(b), (g); National Disability Insurance Agency v KKTB, by her litigation representative CVY22 [2022] FCA 181 at [26]
8 National Disability Insurance Agency v WRMF [2020] FCAFC 79 at [142]
meets the disability requirements (see s 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) whether there are comparable supports which would achieve the same outcome at a substantially lower cost;
(b) whether there is evidence that the support will substantially improve the life stage outcomes for, and be of long-term benefit to, the participant;
(c) whether funding or provision of the support is likely to reduce the cost of the funding of supports for the participant in the long term...;
(e) whether the cost of the support is comparable to the cost of supports of the same kind that are provided in the area in which the participant resides;
(f) whether the support will increase the participant's independence and reduce the participant's need for other kinds of supports ...;
Effective and beneficial and current good practice
(a) published and refereed literature and any consensus of expert opinion;
(b) the lived experience of the participant or their carers; or
(c) anything the Agency has learnt through delivery of the NDIS.
(b) for other participants:
(i) the extent of any risks to the wellbeing of the participant arising from the participant's reliance on the support of family members, carers, informal networks and the community; and
(ii) the suitability of family members, carers, informal networks and the community to provide the supports that the participant requires, including such factors as:
- (A) the age and capacity of the participant's family members and carers, including the extent to which family and community supports are available to sustain them in their caring role; and
- (B) the intensity and type of support that is required and whether it is age and gender appropriate for a particular family member or carer to be providing that care; and
- (C) the extent of any risks to the long term wellbeing of any of the family members or carers ...; and
(iii) the extent to which informal supports contribute to or reduce a participant's level of independence and other outcomes;
(c) for all participants - the desirability of supporting and developing the potential contributions of informal supports and networks within their communities.
(a) Is the support that remains in dispute a NDIS Support as defined?
If the answer to this question is "no" then the support can no longer be considered for approval in the Applicant's SOPS because it cannot meet the requirement of s 34(1)(f).
If the answer to (a) is "yes" then the support can be considered for approval in the Applicant's SoPS if it is necessary to address needs that arise from an impairment in relation to which he meets the disability requirement. Therefore:
(b) What are the Applicant's permanent impairments that result in substantially reduced functional capacity to undertake any of the activities of communication, social interaction, learning, mobility, self-care and self-management, and which affect his capacity for social or economic participation?
(c) Does the support in dispute meet the needs of the Applicant arising from an impairment in relation to which he meets these disability requirements?
If the support does not meet the needs of the Applicant arising from an impairment in relation to which he meets the disability requirements then it cannot be considered for inclusion in his SOPS because it does not meet the requirements of paragraph 34(1)(aa).
(d) If the answer to (c) is "yes" then ask whether the support in dispute meets the requirements of paragraphs 34(1)(a), (b), (c), (d) and (e) and Rule 7 of the Miscellaneous Provisions Rules.
Supports that design, change or modify a participant's home to help the participant live as independently as possible and to live safely at home.
(a) Installing equipment or changing a building's structure, fixture or fittings;
(b) Internal and external building modifications to remedy damage arising exclusively from disability-related behaviours or use of NDIS funded assistive technology or equipment;
(c) Regulatory certification requirements for the works
I make that finding.
Does the requested support meet the needs of the Applicant arising from an impairment in relation to which he meets the disability requirements?
11 World Health Organisation (2011), International Classification of Functioning Disability and Health, Geneva; Chapter 1.
Context for consideration of other s 34(1) matters
Option 1 - minor modifications within the existing footprint of the home,
Option 2 - modifications in accordance with a 'sketch' prepared by Ms Young, Occupational Therapist, which is depicted at page 37 of the Joint Expert Report. This involves a 3-room structure internal to the home which provides for an accessible bathroom, bedroom, and a 'carers room' in between.
Option 3 - modifications in accordance with the Type 1 complex home modifications architectural drawings prepared by Lofte Architects for the purposes of the Joint Expert Report. This is based on Ms Young's recommendations and has some association with Option 2. It involves construction of an extension to the home and some internal modification of the existing home to provide an accessible bathroom, bedroom, laundry and suite for a disability support worker, which is designed in accordance with the 'overnight assistance' policy contained in the design standards for Specialist Disability Accommodation.14 There is a corridor external to the bathroom and bedroom from the disability support worker suite and laundry. This option has been costed at $371,000.00 by Ripple Group builders.
Option 4 - modifications in accordance with the Type 2 complex home modifications architectural drawings prepared by Lofte Architects for the purposes of the Joint Expert Report. This involves the construction of a self-contained 'apartment' which is attached to the main house via a connecting corridor. In addition to a bedroom and ensuite, disability support worker suite, and laundry, this option includes a kitchen, living area and storeroom. It is design in accordance with the standards for 'robust' category SDA. This option has been costed at $545,600.00 by Ripple Group builders.
14 National Disability Insurance Agency, NDIS Specialist Disability Accommodation Design Standard, Version 1:1, 25 October 2019
acknowledged and respected.15 It is moreover a general principle guiding actions under the Act that:
5(f) if the person with disability is a child - the best interests of the child are paramount, and full consideration should be given to the need to:
(i) protect the child from harm; and
(ii) promote the child's development; and
(iii) strengthen, preserve and promote positive relationships between the child and the child's parents, family members and other people who are significant in the life of the child.
In my view it is plainly not in the best interests of the Applicant in this case that he be separated from his parents and sibling by being obliged to move to SDA.
16 National Disability Insurance Agency, Pricing Arrangements for Specialist Disability Accommodation 2025-26, 30 June 2025_;_ National Disability Insurance Agency_, NDIS Specialist Disability Accommodation Design Standard, Version 1:1, 25 October 2019._
17 National Disability Insurance Agency, Pricing Arrangements for Specialist Disability Accommodation 2025-26, 30 June 2025
pursuit of this goal. In fact, it was his submission that the CEO accepted that the support would assist the Applicant to pursue all of his NDIS goals in one way or another.
utilisation of the features of the main dwelling, aspects of which are unsafe for him because of his behaviours of concern,
18 Social, Community, Home Care and Disability Services Industry Award 2010
(1) Pursuant to s 105 of the Administrative Review Tribunal Act 2014 (Cth) the decision under review made pursuant to s 48 of the National Disability insurance Scheme Act 2013 (Cth) on 27 May 2025 is set aside and remitted to the CEO for reconsideration by 17 October 2025 in accordance with a direction that the following support is a reasonable and necessary support that is to be included in the Applicant's Statement of Participant Supports:
dated 16 June 2025 and the quotation provided by Ripple Group for this work dated 16 June 2025, such funding to provide for:
(2) Pursuant to s 101(a) of the Administrative Review Tribunal Act 2024 (Cth) the application for review insofar as it concerns the internal review decision dated 4 July 2022 and the decisions to approve a Statement of Participant Supports dated 6 June 2023, 15 December 2023, and 15 December 2024 is dismissed on the basis that it is now lacking in substance.
Date(s) of hearing: 18 - 19 March 2025, 31 March 2025, and 20 June
Solicitors for the Applicant: Mr J Hogan, Victoria Legal Aid
Solicitors for the Respondent: Ms M August, Moray & Agnew
Beezley v Repatriation Commission (2015) 150 ALD 111; [2015] FCAFC 165 Drake v Minister for Immigration and Ethnic Affairs [1979] FCAFC 39; 24 ALR 577 Drake and Minister for Immigration and Ethnic Affairs (No. 2) (1979) 2 ALD 634 HPSC and National Disability Insurance Agency [2021] AATA 727
Mulligan v National Disability Insurance Agency [2015] FCA 544
Re Drake and Minister for Immigration and Ethnic Affairs (No. 2) 2 ALD 634 Shi v Migration Agent's Registration Authority [2008] HCA 31; (2008) 235 CLR 286 National Disability Insurance Agency v Davis [2022] FCA 1002
National Disability Insurance Agency v KKTB, by her litigation representative CVY22 [2022] FCAFC 181
(2008) 235 CLR 286
(2020) 378 ALR 449