austlii:cth/ARTA/2025/727
General information, not legal advice.
ARTA
2025-06-12
Original judgment source is linked above.
(a) All supports except $3,000.00 of flexible core supports to be Agency-managed; > > (b) A plan term of 24 months; > > (c) Total NDIS funded supports to be increased to at least the total funding in the Applicant's plan dated 15 December 2020 ($115,809); > > (d) Removal of any special reporting requirements imposed on support coordinators who provide services to the Applicant;
Core supports
(e) Assistance with the cost of preparation and delivery of meals increased to the amount in the Applicant's plan dated 15 December 2020 ($30,662.10);
(f) Self-managed funding of $3,000 per year for flexible core supports for use across Consumables, Assistance with Daily Living and Assistance with Social and Community Participation;
(g) Consumables funding to include $2,674 for basic (Level 1) and standard (Level 2) assistive technology;
(h) Increased core support funding for house cleaning and other household activities;
(i) Increased core support funding for regular house and garden maintenance, including lawn mowing;
Capacity Building Supports
(j) One-off, self-managed support for a decluttering and organising specialist to assist with sorting, removing and disposing of unnecessary items in the Applicant's home (in addition to the existing 15 hours per year of occupational therapy);
(k) 10 hours one-off support from an occupational therapist to support the Applicant with sorting and removing unnecessary items from the Applicant's home (in addition to the existing 15 hours per year or occupational therapy);
(l) Podiatry services;
Capital supports
(m) Eligibility for SDA.
(a) Paragraph 34(1)(aa) of the Act has been included, which provides that a decision maker must be satisfied "the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements." > > (b) Paragraph 34(1)(f) of the Act has been varied, and now provides that a decision maker must be satisfied that "the support is an NDIS support for the participant." > > (c) Section 10 of the Act has been included, which defines NDIS support and provides that supports are, or are not, NDIS supports if, among other things, they are declared to be so in the National Disability Insurance Scheme Rules made for the purpose of this section. Relevantly, the NDIS Support Rules can declare that a support is not an NDIS support: s 10(4).
(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.
"The phrase "reasonable and necessary supports" is not defined in the NDIS Act. Section 34 does not exhaust the universe of matters which a decision-maker may consider to decide whether a support is a reasonable and necessary one for a particular participant, given their impairments: see McGarrigle at [91]. See also WRMF at [150]. Section 34 prescribes matters about which the decision-maker must be satisfied before a support can be included in a statement of supports under s 33. Satisfaction as to those matters (where relevant and applicable) may be conditions on the power to approve a support or supports, and enter a support in a statement of supports under s 33. However, the phrase "reasonable and necessary supports" has a qualitative aspect and leaves 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": WRMF at [143], [152]. It is a composite phrase, which should not be definitively constrained, with each limb of the phrase using language well understood by courts: WRMF at [149]-[150], [252]."
(a) Supports that are NDIS supports; > > (b) Replacement supports; > > (c) Supports that are not NDIS supports, unless otherwise provided; and > > (d) Supports that are generally not NDIS supports.
The NDIS Operational Guidelines for Reasonable and Necessary Supports are also relevant to the decision under review. The Operational Guidelines should be applied by the Tribunal to the extent they are consistent with the legislative scheme, unless there is a good reason not to do so.
(a) All supports, except $3000 of flexible core supports, to be Agency managed
(c) Total NDIS supports to be increased to at least the total funding amount in the Applicant's plan of 15 December 2020 ($115,809)
(d) Removal of any special reporting requirements imposed on support co-ordinators
(e) Assistance with the cost of preparation and delivery of meals to be increased to $30,662.10
(a) Groceries including all food, beverage, cleaning, household and health products; and
(b) Fast food services, takeaway food and food delivery platforms (though meal delivery platforms where the food ingredient component can be separately identified from the meal preparation and delivery components are not included in paragraph (b)).[21]
(f) Self-managed funding of $3,000 per year for flexible core supports
(g) Consumables funding to include $2,674 for assistive technology support
(a) Dragon Professional v16 dictation software from Voice Recognition Australia ($995); > > (b) Kurzweil 3000 English screen reader software (Approximately $1,500); > > (c) An accessible mobile phone - Olitech EasyMate2 from Vision Australia ($179).
"(d) internet devices (such as modems and routers), land line phones, mobile phones (including smart phones), mobile phone accessories, tablets and sim cards".[29]
"support him in using a computer in his university studies and in daily life (writing and reading email, filling in forms, paying bills etc) which will help him pursue two of his goals: > > (a) "I would like to complete my studies and per chance find suitable and modified employment within the field of my study" and > > (b) "I would like to be supported so I can maintain my confidence/independence in looking after myself and continue caring for my partner".[30]
(a) products that help a participant to receive, send, produce and/or process information in different forms; and > > (b) products that facilitate a participant communicating by language, signs and symbols, receiving and producing messages, having conversations and using communication devices and techniques."[38]
(a) Supports (including assistive products) for students that primarily relate to their education and training.[39]
(b) (c) (d) (e) (f) (g)
(h) Increased core support funding for house cleaning and other household activities
(i) Regular house and garden maintenance, including lawn mowing and gutter cleaning
(a) There is no clinical recommendation with respect to gutter cleaning and there has been no assessment of how much gutter clearing is required, or to what extent this is subject to common maintenance by a strata body; > > (b) There has also been no proper assessment of how much gardening is required, and the Applicant's Occupational Therapist, Jasse Jang, has not visited the Applicant's residence for this purpose. It is also unclear to what extent any garden area is maintained by a strata body; > > (c) Provision of the support would actively limit the Applicant's social participation and for that reason would not be beneficial for him; and > > (d) The evidence does not demonstrate that support for yard maintenance and gutter clearing is necessary to address a need arising from an impairment in relation to which the Applicant meets the disability requirements as required by s 24 of the Act.[55]
(e) (f) (g) (h) (i)
(j) One-off self-managed support for decluttering and organising specialist
(a) Neither Jasse Jang or any other professional has recommended a decluttering specialist; > > (b) It is unclear why a regular support worker could not assist the Applicant to go through the boxes and dispose of unnecessary items; > > (c) The additional 10 hours of one-off support from an occupational therapist to assist with decluttering (which the Respondent has agreed to) should be sufficient to assist the Applicant with decluttering; and > > (d) In the circumstances, the requested support does not represent value for money for the purpose of s 34(1)(c) of the Act.[63]
(k) Additional 10 hours one-off support from an occupational therapist to assist with decluttering
(a) the diagnosis, early intervention and clinical treatment of health and dental health conditions, including ongoing chronic health conditions;
(b) equipment or assistive products prescribed or issued as a result of clinical care, treatment or management from a medical practitioner and then delivered in the clinical setting, unrelated to the person's disability;
(c) surgical services or procedures related to aids and equipment.
"To clarify, the applicant does not "now" seek to be determined eligible for SDA. However, they have consistently requested SDA supports for when their current informal carer is no longer available."
(a) Specify that $3,000 of the Applicant's core supports budget for consumables is to be self-managed; > > (b) Allow 25 hours per year for occupational therapy (increased from 15 hours) to support the Applicant with decluttering (as agreed to by the Respondent); > > (c) Allow 4 hours per week (increased from 2 hours) of support worker assistance for House Cleaning and Other Household Activities (as also agreed to by the Respondent); > > (d) Specify a review date of 24 months from commencement of the varied plan.
(a) A budget of $3,000.00 per year for consumables within the Applicant's existing core supports budget is to be self-managed;
(b) The amount allowed for occupational therapy is to be increased from 15 to 25 hours per year;
(c) The amount allowed for support worker assistance with House Cleaning and Other Household Activities is to be increased from 2 to 4 hours per week;
(d) The review date is to be in 24 months from when the varied SOPS is implemented; and
(e) All other supports are to be replicated on a pro rata basis.
[1] Respondent's Amended Statement of Facts, Issues and Contentions (SOFIC) dated 6 November 2024 at [31].
[6] Section 103(2), National Disability Insurance Scheme Act 2013 (Cth).
[8] Applicant's Submissions dated 30 September 2024, at [17].
[10] Operational Guidelines, "Creating Your Plan",16 May 2025, p 31.
[11] Operational Guidelines, "Creating Your Plan",16 May 2025, p 31.
[13] Applicant's submission dated 30 September 2024, at [23].
[14] Applicant's final submission, p 6.
[15] Applicant's submission of 30 September 2024, at [46]-[49].
[16] Applicant's final submission, p 7.
[17] Applicant's submission of 30 September 2024, at [28].
[18] Applicant's final submission of 1 May 2025, p 8.
[19] Applicant's final submission of 1 May 2025, p 8.
[20] Respondent's Amended SOFIC, Annexure A.
[21] Item 3, Schedule 2 to the NDIS Supports Transitional Rules.
[22] Respondent's Amended SOFIC at [45].
[23] Respondent's Amended SOFIC, at [48].
[24] Applicant's submissions of 30 September 2024 at [30].
[25] Applicant's submissions of 30 September 2024 at [30]; T Documents, p 97.
[28] Applicant's submissions 30 September 2024, at [33].
[29] Item 4, Schedule 2 of the NDIS Supports Transitional Rules.
[37] Applicant's Final Submission, p 9.
[38] Item 11, Schedule 1 to the NDIS Supports Transitional Rules.
[39] Item 17, Schedule 2 to the NDIS Supports Transitional Rules.
[40] Respondent's Amended SOFIC, [56].
[41] Report of Ms Manlapid dated 28 July 2021, T Docs, T6/45; report of Jasse Jan-Webb dated 11 June 2024, TB 13, pp 46-47.
[42] Respondent's Amended SOFIC at [57].
[55] Respondent's Amended SOFIC, at [68].
[56] Applicant's submissions dated 30 September 2024, at [78].
[57] Applicant's submissions dated 30 September 2024, at [79].
[63] Respondent's Amended SOFIC, at [70]-[75].
[65] Applicant's submission 30 September 2024, Annexure 4.
[66] Item 12, Schedule 2 to the NDIS Supports Transitional Rules.
[70] Annexure A to Applicant's Final Submissions.
[80] Submission 30 September 2024, at p 10.
[84] Respondent's Amended SOFIC, Annexure A.
National Disability Insurance Agency v KKTB, by her litigation representative CVY22 [2022] FCAFC 181