austlii:cth/ARTA/2025/1541
General information, not legal advice.
ARTA
2025-08-25
Original judgment source is linked above.
Schaefer and National Disability Insurance Agency (NDIS) [2025] ARTA 1541 (25 August 2025)
Respondent: National Disability Insurance Agency
Decision: The Tribunal affirms the decision under review pursuant to section 105(a) of the Administrative Review Tribunal Act 2024.
National Disability Insurance Scheme - reviewable decision of Chief Executive Officer - Statement of Participant Supports - reasonable and necessary supports- Getting the NDIS Back on Track Transitional Support rules - NDIS support -- plan management - transport - behavioural support - movement of funding between categories - reasonable and necessary - Note 1 to section 34 - payment of invoices - reviewable decisions - decision affirmed
National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth)
National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 rr 4, 5, 6, Schedule 1 & 2
National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (Miscellaneous Provisions) Transitional Rules 2024
Drake and Minister for Immigration and Ethnic Affairs (No. 2) 1979 2 ALD 634
McGarrigle v National Disability Insurance Agency [2017] FCA 308
National Disability Insurance Agency v WRMF [2020] FCAFC 79
Revised Explanatory Memorandum - National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024, Item 46
NDIS Operational Guidelines - Principles we follow to create your plan, dated 27 April 2025
NDIS Operational Guidelines - Reasonable and Necessary Supports, dated 28 March 2025.
NDIS Operational Guidelines - Including specific types of supports in plans dated 2 December 2024
NDIS Operational Guidelines - Supports funded by the NDIS dated 26 March 2025.
NDIA Information Sheet - Support co-ordination Support coordination | NDIS
NDIA Information Sheet - Psychosocial recovery coach PB Psychosocial Recovery Coach Information PDF.pdf
(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 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 wither 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).
However, early in the hearing the Agency conceded that it was satisfied transport, funded at level 1 funding, would be reasonable and necessary with respect to Ms Schaefer's impairments. This was particularly so because of her impairment related difficulty in utilising public transport.
This 'functional capacity assessment' was completed four years ago and must be considered out of date. This report is noted to be based only on interview with Ms Schaefer and written from her perspective.[41] It is noted to have taken 1 hour in Ms Schaefer's home and two further sessions by telephone. It does not appear that a formal assessment of Ms Schaefer's observed capabilities was undertaken. Even apart from the age of this assessment I have concerns about its usefulness given the assessor's approach.
On the basis of an Abbreviated Life Skills Profile assessment Mr Ebden determined Ms Schaefer was socially withdrawn, had poor self-care, displayed moderately poor compliance with health services, had some anti-social traits and was overall operating with a high level of difficulty.
These difficulties were also reflected in a WHODAS assessment.
A Care and Needs Scale assessment suggested Ms Schaefer required assistance and cueing with basic ADL's and social participation and required support for or monitoring of severe behavioural/cognitive disabilities. He formed the view Ms Schaefer could not be left alone at night.
Screening for cognitive disorders via a Saint Louis University Mental Status Examination resulted in a score of 12 out of 30, considered to indicate significant cognitive impairment.
Recommendations included physiotherapy, occupational therapy, exercise physiology, neuropsychology, psychology, equine therapy, podiatry, dietician, urology, psychiatry, psychosocial recovery coach and dental intervention, support workers up to 20 hours a day and various AT such as SD cards, electric bike, Cannon Camera, Rapid Spin Video technical support, and security alarm.
Ms Hill assessed Ms Schaefer at home including an interview, administration of WHODAS and Care and Needs Scale and subsequent phone contacts, including on more than ten occasions when Ms Schaefer requested amendments to the report. Again, this is an aged assessment which appears to have been based on Ms Schaefer's self-report.
Ms Hill recommended 14 hours of support per day, 7 days a week, support co-ordination, physio and regular exercise.
Ms Schaefer was noted to have requested transport to tribal lands and a security guard to keep her safe there, computer equipment, a folding e-bike, and equine therapy. It was not clear that Ms Hill recommended these or how these address needs that are attributable to Ms Schaefer's impairments.
Mr Bright notes that Ms Schaefer has complex PTSD exacerbated by spinal and cervical injury as a consequence of a number of assaults in 2007 and 2016. She has an acquired brain injury arising from an MVA in Canada. When under stress Ms Schaefer is noted to be prone to mental confusion, panic attacks and dissociative PTSD response symptoms. She has cognitive deficits in concentration, attention and problem solving which limit her capacity to deal with daily requirements. Mr Bright was of the view her condition was 'treatment resistant'. There is no evidence before the Tribunal as to interventions or treatments that have been provided, nor any input from a psychiatrist.
Written to support a study deferment, Dr Ahmed advised that Ms Schaefer reports significant distress from reportedly being a direct witness to the murder of her partner, on the background of a prior diagnosis of PTSD.
Dr Ahmed identified a history of treatment resistant PTSD presenting in the form of low mood, anxiety and flashbacks and an acquired brain injury arising from a motor vehicle accident years ago. This leaves her with cognitive deficits. No information about past treatment was provided.
Ms Coop wrote to clarify that over the time she had been involved in Ms Schaefer's care she had seen multiple examples which she believed indicated Ms Schaefer's ability to make decisions about personal, health, and financial matters was so compromised she would fail the general test for capacity under Queensland's guardianship legislation.
As an example, Ms Coop noted she had observed Ms Schaefer stipulating terms of service delivery for providers that were impossible to meet, effectively hamstringing the assistance offered. When services did not meet Ms Schaefer's expectations, Ms Schaefer responded in a verbally abusive fashion or by withholding payment. This had caused services to withdraw.
Following Ms Coop making a guardianship application in relation to Ms Schaefer, her services were terminated by Ms Schaefer with assertions of unconscionable/unethical and vindictive conduct[47].
I note that Ms Coop was in the middle of completing a functional capacity assessment when her services were terminated. The Tribunal has not been provided with a copy of this and it is unclear if it was completed.
Dr Gourley writes that Ms Schaefer has a complex psychiatric history, including PTSD, generalised anxiety and panic attacks and acquired brain injury. Dr Gourley notes Ms Schaefer requires psychiatric assessment, occupational therapy assessment, psychological intervention and video hardware to assist with communication.
The writer discussed accompanying Ms Schaefer to Mareeba Community Legal Service to seek assistance with respect to the application by Ms Coop for a guardianship order for Ms Schaefer. Ms Schaefer was noted to be able to calmly express her concerns, advise of the actions she had already taken to address the application (including obtaining medical reports about capacity) and being able to draft an enduring power of attorney document. She was noted to remain calm even when an advocacy service specifically declined to offer services to Ms Schaefer.
Marissya indicated she was available to provide occupational therapy services for Ms Schaefer once her plan is plan-managed.
Dr Radcliffe noted Ms Schaefer had been suffering from significant anxiety, panic episodes, dizzy spells, confusional states and flashback trauma of her previous assaults related to NDIS service reduction. He writes in support of changing management of her NDIS plan from Agency managed due to the limited number of providers.
Dr Vasei had had two consultations with Ms Schaefer, one face to face and one by phone. He noted the following diagnoses: major depression, general anxiety, PTSD, panic disorder, physical assault, brain injury, MVA. Dr Vasei supported change of plan management from Agency managed to plan managed.
Ms Fuller noted there were few Agency registered services in the Mareeba region and that Ms Schaefer was unable to use some of her past providers because of that limitation. Ms Fuller recommended a plan managed plan would provide more flexibility.
This letter noted clear signs of heavy bruxism which they noted was traditionally associated with stress and psychological trauma.
Ms Bonanno had been acting as Ms Schaefer's complex support co-ordinator since 23 October 2024. Ms Bonanno noted that Ms Schaefer required services that would be able to take into consideration her complex behaviours, her disability needs and her cultural identification needs.
Of the multiple agencies Ms Bonanno had contacted, 6 declined to work with Ms Schaefer because of past behaviours, 7 could not work with her complex needs, and 14 had no capacity. Six services would work with her but were not registered and so were unable to while her plan remained Agency managed.
Ms Bonanno noted that the ongoing issues meeting Ms Schaefer's disability needs and her cultural needs continued to prevent progress towards her NDIS goals. Ms Bonanno stated Ms Schaefer continued to require intense ongoing support.
Despite Ms Schaefer wishing to rely on this letter in her Tribunal proceedings Ms Bonanno was terminated by Ms Schaefer (by email to the NDIS dated 8 February 2025) after having been accused of 'negligent misconduct, arrogance and bullying'. [55]
Ms Owens wrote in support of Ms Schaefer's request for plan management of her plan. She noted that Ms Schaefer had lost her access to supportive workers by transferring to agency management.
This email advised Ms Schaefer that as a result of treatment received from Ms Schaefer that day Flexichoice would be ceasing services immediately. It was noted the agency had a zero tolerance for abuse and threats.
Notification from Apels that in response to an email from Ms Schaefer, Mareeba Community Centre Inc. terminated all service arrangements between it and Ms Schaefer and barred Ms Schaefer from attending the centre and contacting its staff.
Mr Imani explained he had been working with Ms Schaefer but had had to cease due to the change to Agency management of her plan. He indicated his success in relation to cultural understanding of Ms Schaefer's needs and his willingness to return to work with Ms Schaefer.
Dr Mason wrote in support of Ms Schaefer's request for a change in plan management noting the difficulties of finding supports in their area. In the 'Past History' section of his letter he notes 'histrionic personality disorder, assault, temporomandibular joint dysfunction, choledocholithiasis, fibromyalgia, anxiety/depression, panic disorder and PTSD'
Ms Campbell wrote to give support for the change from agency managed to plan managed and to request additional funding generally.
Ms Schaefer specifically asked the Tribunal to consider this document. Ms Hersey has assessed the presence of the following risks:
Strengths were noted to include cultural identity or spiritual beliefs, trusted informal supports, willingness to engage with services and an ability to communicate preferences and boundaries.
Ms Schaefer requested the Tribunal give consideration to this document. Against each of Ms Schaefer's goals the report notes:
Ms Schaefer feels she has regressed since being placed on Agency management and being unable to connect to her former supports of Ms Rona Bartlett, coach, Anne Atkinson, Raymond Condren, Stella Wason, Tim Yelland and Jonathon Imani. A further barrier was the difficulty of accessing trauma informed services that were culturally safe.
In her oral evidence Ms Hersey advised the Tribunal she formed this view after speaking with both the former recovery coach, Ms Rona Bartlett, and Ms Schaefer.
'reduced emotional regulation or behavioural volatility, poor impulse control or frustration tolerance, and ABI contributing to conflict, self-harm or unsafe decisions.'
S34(1)(aa) - are the supports necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements or early intervention requirements. (the Note to the section provides that the time at which these requirements must be met is the time the decision maker approves the SOPS)
Depression, anxiety and post-traumatic distress syndrome
Level 1: up to $1,784 per year for participants who are not working, studying or attending day programs but are seeking to enhance their community access.
Level 2: up to $2,676 per year for participants who are currently working or studying part-time (up to 15 hours per week), participating in day programs and for other social, recreational or leisure activities.
Level 3: up to $3,456 per year for participants who are currently working, looking for work, studying at least 15 hours per week and are unable to use public transport because of their disability.
Transfer of behaviour support funding to support-co-ordinator/recovery coach funding
The Tribunal affirms the decision under review pursuant to section 105(a) of the Administrative Review Tribunal Act 2024.
Solicitors for the Respondent: Sparke Helmore Lawyers
[1] Agency Statement of Facts, Issues and Contentions (SFIC) at [20]
[6] Item 4 and 6 of section 99 of the NDIS Act
[7] National Disability Insurance Agency v WRMF [2020] FCAFC 79 at [201]; McGarrigle v National Disability Insurance Agency [2017] FCA 308
[10] Section 3(3)(b) and 4(17) of the NDIS Act.
[13] Re Drake and Ministrer for Immigration and Ethnic Affairs (No. 2) (1979) 2 ALD 634
[15] Supplementary Explanatory Memorandum, National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024
[16] Item 138 of Schedule 1 to the Amending Act
[20] Sections 10(2) and (4) of the NDIS Act.
[29] Page 495, 507, 511, 515, 518 of Exhibit 1
[31] Sections 4(11), s34, s3(2)(d) of the NDIS Act; the Plan Principles Guidelines and the Supports Guidelines
[32] Plan Principles Guideline; s34(1)(aa) of the NDIS Act
[33] Section 3(3)(b) and 4(17) of the NDIS Act
[37] National Disability Insurance Agency and WRMF [2020] FCAFC 79 at [201]
[63] Page 114 of Exhibit 1 and page 1 of Exhibit 4
[66] Required by subsection 24(1)(a) and (b)
[70] Item 46 Revised Explanatory Memorandum - National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024