austlii:cth/ARTA/2025/1035
General information, not legal advice.
ARTA
2025-07-14
Original judgment source is linked above.
(a) 5 of the requested supports were, in whole, reasonable and necessary supports which should be included in the Applicant's SOPS; > > (b) 1 of the requested supports (VJ panelling), was in part, a reasonable and necessary support which should be included in the Applicant's SOPS;[2] > > (c) 15 of the requested supports were not reasonable and necessary and should therefore, not be included in the Applicant's SOPS.
(a) VJ panelling totalling $48,860. > > (b) Concrete pathway to the right side of the house totalling $4,540. > > (c) Concrete pathway to the left side of the house totalling $21,230. > > (d) Exposed aggregate path to the rear of the house totalling $2,145. > > (e) Driveway with a ramp in the amount of $9,920. > > (f) Grab rails totalling $4,719. > > (g) Slip resistive tiling (unknown amount). > > (h) Air conditioners totalling $22,235. > > (i) Fans totalling $2,543. > > (j) Security screens totalling $19,462. > > (k) Nursery (build / modify additional room) - totalling $32,362. > > (l) Fifth bedroom (build / modify additional room) - totalling $23,222. > > (m) Sixth bedroom (build / modify additional room) - totalling $36,146. > > (n) Family room (build / modify additional room) - totalling $34,720. > > (o) Elevated kitchen bench - $6000. > > (p) Induction cooktop.
(a) the Applicant's Father > > (b) the Builder engaged by the Applicant's parents
(a) E1 - Applicant's NDIS plan dated 10 May 2024 > > (b) E2 - Doc 10912 (Plans) 20250410140552546v11 - [construction firm] construction house plan > > (c) E3 - Image of house plan with red and blue pen markings > > (d) E4 - Preliminary agreement dated 9 November 2022 between Applicant's parents and [construction firm] > > (e) E5 - Indulgence Series Inclusions > > (f) E6 - Doc 10912 (Plans) 202505151312522958v13 - [construction firm] house plan ("flipped version") > > (g) E7 - Indulgence price list > > (h) E8 - Indulgence images > > (i) E9 - Doc 32-Premier 283 (basic house plan) > > (j) E10 - 10912 (Specification) 2024091805055718v17 > > (k) E11 - Variation price list > > (l) E12 - 10912 (Contract) 20240918050603887 > > (m) E13 - Tile selections > > (n) E14 - 10912 (Colour Selections SIGNED) 20250515131652679 > > (o) E15 - Direction dated 14 November 2024 > > (p) E16 - Direction dated 10 December 2024 > > (q) E17 - NZGW and NDIA (20244088) Respondent's suggested evidence > > (r) E18 - Re 20244088 - Email exchange between Respondent lawyers and Applicant's father dated Aug and September 2024 > > (s) E19 - Applicant's closing submission dated 13 June 2025 > > (t) E20 - Respondent's closing submissions dated 13 June 2025.
(a) the Tribunal stands in the shoes of the delegate/internal reviewer and must make the correct or preferable decision based upon the evidence and other material before it;[4] and > > (b) the scope of the Tribunal's jurisdiction is determined by reference to the scope of the internal reviewer's powers under section 100 of the NDIS Act, which is in turn informed by the scope of power under section 33(2) of the NDIS Act.[5]
Supports that are not NDIS supports > > (4) The National Disability Insurance Scheme rules may declare that a support is not an NDIS support for: > > (a) participants or prospective participants generally; or > > (b) a class of participants or prospective participants. > > Note: The National Disability Insurance Scheme rules may declare a support for the purposes of this subsection by identifying a class of supports (see subsection 13(3) of the Legislation Act 2003). > > (5) Before making National Disability Insurance Scheme rules declaring a support for the purposes of subsection (4), the Minister must be satisfied: > > (a) for rules to which paragraph (4)(a) applies - that the support is not appropriately funded or provided through the National Disability Insurance Scheme for participants or prospective participants generally; or > > (b) for rules to which paragraph (4)(b) applies - that the support is not appropriately funded or provided through the National Disability Insurance Scheme for participants, or prospective participants, in the relevant class.
(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 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).
Stage 1 Ascertain if the requested support is an "NDIS" Support as defined. This inquiry is focused on the support, not the participant.
Step 1: Determine if the requested support is of a character that falls within the scope of a category of support specified in column 1 of the Table to Schedule 2 of the Transitional Rules by reference to the description of supports that fall within the scope of that category contained in column 2 of the Table.
If the answer to that question is "yes", then stage 1 is complete. The requested support is not a NDIS Support and cannot be approved for inclusion in a SoPS because of s 34(1)(f) (subject to a replacement support determination being made, as to which see following).
If the answer to that question is "no", then proceed to step 2 of stage 1:
Step 2: Determine if the requested support is of a character capable of falling within the scope of a category of support specified in column 1 of the Table to Schedule 1 of the Transitional Rules by reference to the description of supports that can fall within the scope of that category contained in column 2 of that Table.
If the answer to that question is "no", then the requested support will not be a NDIS Support and cannot be approved for including in a SoPS because of s 34(1)(f).
If the answer to that question is "yes", then the requested support will be a NDIS Support that is capable of being approved for inclusion in a SoPS by operation of s 34(1)(f), and stage 2 of the enquiry is reached.
Stage 2: Ascertain if the requested support satisfies each of the other criteria specified in s 34(1)(aa) to (e) and the associated Supports Rules. There is some overlap of the stage 1 and 2 enquiries. However, in my opinion stage 2 is primarily a participant focused enquiry. That is, it seeks to establish the benefit of the support to the participant. To the extent that stage 2 also requires examination of the efficacy of the support per se it adds nothing to the outcome of the stage 1 enquiry in my opinion.
The following: > > ... > > (b) purchase of land, or house and land packages; > > (c) standard home security and maintenance costs, fencing, gates and building repairs; > > ... > > (e) standard home repairs, home improvements, standard renovations and maintenance. > > (i) standard household (including garden) items, appliances, tools and products; > > (j) standard furniture, fixtures or fittings.
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. This includes the following:
(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 works.
(a) In a letter dated 19 March 2025, the Applicant's Occupational Therapist (OT) reported VJ panelling had been privately funded in the Applicant's current home "because of the damage [the Applicant's] wheelchair and walker was doing to the walls".[10] > > (b) The Applicant's parents also asserted the Applicant's equipment had previously put holes into their walls stating: > > Funding for VJ Paneling- We have this in our current home after [the Applicant's] equipment put holes into our walls previously. We are hoping that the VJ paneling will also be put into all requested rooms such as Nursery, Family, Bed 6, Support Worker, Dining as well as all corridors as these are places where either we spend a lot of our time as a family or [the Applicant] accesses as she roams around and explores as she often does being a highly inquisitive child. [The Applicant] is needing her wheelchair and walkers more as she gets older and we want to make sure that home is set up for her future equipment needs. > > Whilst NDIS has already partially funded a small area they deem [the Applicant] will utilise as her current age our request is encompasing her growth and accessing all areas of the house which if not now, she will undoubtedly in the next few years and to try re-sheet the walls in VJ at a later date would not be cost effective. > > (Errors in orig.)[11]
(a) The Applicant's 25-year older brother, when he was a child, used "to dig out big holes in the gyprock with spoons and stuff and, like, kick holes in the walls". > > (b) The Father "got sick of repairing them". > > (c) At the time, a builder suggested VJ panelling. It was "only $2.00 a square meter more". So, when they renovated his father-in-law's house (where they currently live) they put VJ panelling through the entire property. > > (d) The VJ panelling was already in place before the Applicant was born. > > (e) The Applicant mainly uses her walker inside the home or leans on furniture. The wheelchair is predominantly used outside the home.[12]
(a) left side of the house totalling $21,230. > > (b) right side of the house totalling $4,540. > > (c) rear / backyard pathway totalling $2,145.
40. To the extent that the request for the construction of the perimeter pathways relates to the Applicant's eczema condition, the Tribunal cannot be satisfied that the support is necessary to address a need arising from an impairment for which the Applicant meets the access criteria (s 34(1)(aa)). To the extent that the perimeter pathways represent a home improvement or standard renovations, they are not NDIS supports (s 34(1)(f)). > > 41. One external pathway is generally an NDIS supports to the extent that the pathway facilitates ingress and egress to a participant's home in a way that takes account of the participant's disability. Section 5 of the HM Builder Guidance Policy explains: > > If it's supported by clinical evidence, we can fund an external continuous accessible path of travel to enable the participant to safely enter and exit their home. The NDIS funding criteria allow for a pedestrian path of travel from the front boundary or the car parking area, to one accessible entrance of the dwelling. > > 42. The Applicant will have access to accessible entry and exit from her home via the stepless front porch and the driveway.[20]
Grab rails totalling $4,719 (and rear exit ramp)
52. The Respondent does not understand the particulars of the Applicant's request for grab rails on the material before the Tribunal. The building contract refers to internal grab rails not being included in the scope of works for the building contract. There is a line item in the contractor's bill of quantities document identifying that an amount of $4,719 represents an '[a]llowance to supply and install stainless steel modular rail to pathway and ramp'. The Respondent understands that this is not a reference to internal grab rails but, rather, an external railing installed in proximity to the driveway. > > 53.There are references in the CHM AT to rails in different parts of the home. For example, there are references to support railings for the requested perimeter pathway supports which are in contention (see, above). However, there is no clear evidence justifying the installation of rails in proximity to the driveway (nor that this is requested as a support, despite the description in the bill of quantities). > > 54.If this support relates to a request for rails that are to be internal to the home or in proximity to the disputed perimeter pathways, there is insufficient evidence to satisfy the Tribunal as to the cost of those proposed rails. The Tribunal could not be satisfied that this requested support represents value for money (NDIS Act, s 34(1)(c)). Further, if the Tribunal were not satisfied that the perimeter pathways were reasonable and necessary supports (for the reasons above) occasion to instal rails would only arise if the Applicant funded one or more concrete paths of the type proposed. The Respondent repeats its contentions about the requested perimeter pathways. > > 55.To the extent that the rails are only proposed to be situated in proximity to the driveway, there does not appear to be a reference to this in the CHM AT or the reports of the Applicant's occupational therapists. The Tribunal could not be satisfied that there is sufficient evidence on which it could determine that this support is reasonable and necessary for s34(1).
It is highly recommended that all entry's (sic) and exits to the home be ramped. It is not anticipated that [the Applicant] will be able to safely and easily manage steps and stairs. Even on 'good days' [the Applicant] is safer walking up/down a ramp than a step. [The Applicant] will not be able to manage steps on the days where she needs her wheelchair more.[25]
Allowance to supply and install stainless steel modular rail > > to pathway and ramp - $4,719.00 > > Supply and install exposed aggregate pathway - $5,190.90 > > Additional allowance for ramping of pathway - $500.50.[26]
Supply and install stainless steel modular rail to LHS ramp, porch ramp and LHS corner (includes 3 rails).[27] (Tribunal's emphasis)
To accommodate a suitable workspace for [the Applicant] to participate in kitchen meal prep activities which she enjoys; adjustability will make it suitable for standing or seated and as she grows to need higher bench top with large seated or standing mobility equipment.
Construction of four new rooms and 'other housing costs'
73. ...The primary contention is that the construction supports, to the extent that they are ordinary incidents of acquiring a desirable house for the Applicant and her family to live in, are not NDIS supports. In addition to the Transitional Rules declaring generally that 'housing' is not an NDIS support (see, paragraph 57 above), the Transitional Rules declare for s10(4) of the NDIS Act that the following are not NDIS supports: > > (a) the purchase of land or house and land packages are not NDIS supports; and > > (b)standard home repairs, home improvements, standard renovations and maintenance.[31]
The NDIS will not be responsible for: > > (a) the provision of accommodation for people in need of housing assistance, including routine tenancy support and ensuring that appropriate and accessible housing is provided for people with disability; or > > (b) ensuring that new publicly-funded housing stock, where the site allows, incorporates Liveable Housing Design features; or > > (c) homelessness-specific services including homelessness prevention and outreach, or access to temporary or long term housing for participants who are homeless or at risk of homelessness; or > > (d) the improvement of community infrastructure, ie accessibility of the built and natural environment, where this is managed through other planning and regulatory systems and through building modifications and reasonable adjustment where required.
Defining NDIS supports will make it easier for participants and other members of the disability community to identify what is appropriately funded by the NDIS, and what NDIS funding can be used to purchase. > > The general descriptions of the kinds of supports that are NDIS supports in the Instrument and in participant's plans will continue to provide participants with choice and control over how they spend their plan while also returning the NDIS to its original intent, consistent with the recommendations of the NDIS review. > > In the current planning framework (now known as the 'old framework'), the definition of NDIS support clarifies the boundaries of what supports are reasonable and necessary under section 34 of the NDIS Act. This is an essential step to ensure that participants are able to continue receiving the supports they need as a result of their disability for many years to come. > > In the new budget-based planning framework, reasonable and necessary supports will be replaced by reasonable and necessary budgets. This means the definition of NDIS supports has an even more important role in guiding participants to understand the supports that are able to be funded by the NDIS, as most supports will no longer be identified in participant's plans.[32] (Tribunal's emphasis)
Power to make the Instrument > > Section 10 of the NDIS Act allows the Minister to make NDIS rules declaring what supports are, and are not, NDIS supports. These rules are Category A NDIS rules made under section 209 of the NDIS Act. Items 124 and 138 of Schedule 1 to the Amending Act allow the Minister to make a transitional rule for the purposes of section 10. > > The Instrument is not an NDIS rule, but rather a transitional rule that will remain in place only until NDIS rules are made for the purposes of section 10 under section 209. It is necessary to have a transitional rule in place for a period of time to allow time to develop and agree the final NDIS rule. > > ... > > Before making rules declaring what supports are not NDIS supports, the Minister must be satisfied that the support is not appropriately funded or provided through the NDIS.[33]
[24] In the context of s 24(1)(a), and Chapter 3 of the NDIS Act more generally, the term "disability" has a specific meaning, being a functional outcome that is attributable to specified categories of impairment. The concept of impairment is distinct from the concept of 'disability', and from a diagnosed health condition. Care needs to be taken not to conflate these separate concepts or use them interchangeably. Failure to maintain this conceptual distinction may lead to a misapplication of the access provisions. > > [25] The term 'impairment' is not defined in the NDIS Act. However, the Agency's operational guidelines define it to mean "a loss of or damage to your body's function". I note that this conceptualisation of impairment for the purposes of s 24(1) was specifically approved by the Court in Davis.[34] That definition is a simple rendering of the definition of impairment[35] used in the application of the International Classification of Functioning Disability and Health (ICF), which is "a problem of body function or structure such as a significant deviation or loss as compared with typical or expected function or structure".[36]
[55] Using the concept of impairment enables assessment of the severity and permanency of a person's condition, and of the effects of that condition through not only the evidence of an applicant, but also medical and clinical evidence. The legislative scheme contemplates a relatively high degree of precision by decision makers (see, for example, the six activities in s 24(1)(c)) in assessing what a person can or cannot do. The assessment to be undertaken is avowedly functional, and multi-faceted.
Nursery (build / modify additional room) - totalling $32,362.
Fifth bedroom (build / modify additional room) - totalling $23,222.
Sixth bedroom (build / modify additional room) - totalling $36,146.
Family room (build / modify additional room) - totalling $34,720.
Driveway with a ramp in the amount of $9,920.
126. The Tribunal is satisfied that the KloudSac, a foam filled bean bag alternative, is a type of household furniture that is routinely used as a sofa or bed. The fact that not every household has a KloudSac does not mean it is not a standard household item - most houses have a sofa/couch and/or bed for its occupants to rest on. Similarly, whilst it appears the Applicant's schools have provided KloudSacs for use by students with sensory disabilities, this does not mean the KloudSac has been modified or adapted in either a general or specific sense - it is simply a different type of furniture. For the avoidance of doubt, the Tribunal accepts the KloudSac is a type of furniture that students living with ASD may prefer and the Applicant clearly derives some comfort from using it, despite not in accordance with its intended use as a type of furniture.
(a) it is normal or standard practice for air conditioning units to be included in newly built homes and highly unusual for people not to want air conditioning in Queensland; > > (b) air conditioning is included in the home package purchased by the Applicant's parents; and > > (c) the number of air conditioning units is tied to the number of rooms in the house.
[2] The Respondent varied the original decision and decided to fund VJ panelling in parts of the new home as a reasonable and necessary support totalling $19,016 which comprised $6,651 in the Applicant's bedroom, $9,027 in the hallway and $3,338 in the family room. The Applicant sought an additional $29,844 of funding for VJ panelling across the rest of the house, totalling $48,860.
[4] See Shi v Migration Agents Registration Authority [2008] HCA 31; (2008) 235 CLR 286 at [37]- [38], [45]-[46] (Kirby J), [99] (Hayne and Heydon JJ), [143] (Kiefel J). Esber v The Commonwealth [1992] HCA 20; (1992) 174 CLR 430 at 440; Frugtniet v Australian Securities and Investment Commission [2019] HCA 16; (2019) 266 CLR 250 at [51]; QDKH, by his litigation representative BGJF v National Disability Insurance Agency [2021] FCAFC 189.
[5] QDKH, by his litigation representative BGJF v National Disability Insurance Agency [2021] FCAFC 189 at [7].
[6] Subitem 129(2) of Schedule 1 of the Amending Act provides that if a statement of participant supports is approved or varied on or after 3 October 2024, the amendments apply irrespective of whether the Applicant's plan came into effect before, or on or after commencement.
[7] National Disability Insurance Agency v WRMF [2020] FCAFC 79 at [201].
[8] For example, Beezley v Repatriation Commission (2015) FCAFC 165 at [68] (North, Tracey and Mortimer JJ).
[9] Re Drake and Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 634 at [635].
[14] The 'flipped' or council approved plans - see E2.
[17] T10 of JHB, p82. The Tribunal understands this to refer to the pre-flipped plan and represents the 'narrower' pathway.
[35] World Health Organisation (2002), Towards a Common Language for Disability, Functioning and Health, ICF, Geneva, WHO/EIP/GPE/CAS/0.1.3 (WHO (2002) at page 2.
[36] World Health Organisation, (2011), International Classification of Functioning, Disability and Health, Geneva: International Classification of Functioning, Disability and Health (ICF)
[37] At [111]. It should be noted that nothing turned on that distinction in that decision, with the Tribunal proceeding on the basis that the blanket could be a NDIS support but finding it was not reasonable and necessary pursuant to section 34(1)(e).
[39] These modifications were not in dispute - the Respondent previously found modifications to the Applicant's bathroom were a NDIS support and reasonable and necessary.
Beezley v Repatriation Commission [2015] FCAFC 165
Esber v The Commonwealth [1992] HCA 20; (1992) 174 CLR 430
Frugtniet v Australian Securities and Investment Commission [2019] HCA 16; (2019) 266 CLR 250
National Disability Insurance Agency v WRMF [2020] FCAFC 79
Mulligan v National Disability Insurance Agency [2015] FCA 544
QDKH, by his litigation representative BGJF v National Disability Insurance Agency [2021] FCAFC 189
Re Drake and Minister for Immigration and Ethnic Affairs (No 2) [1979] AATA 179; (1979) 2 ALD 634
Shi v Migration Agents Registration Authority [2008] HCA 31; (2008) 235 CLR 286
FSWN and National Disability Insurance Agency (NDIS) [2025] ARTA 114
Burrows and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 607
VPYC and The CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 3
(1992) 174 CLR 430
(2019) 266 CLR 250
(2008) 235 CLR 286