austlii:cth/ARTA/2025/2648
General information, not legal advice.
ARTA
2025-12-11
Senior Member P
Original judgment source is linked above.
(a) A Joint Tender Bundle filed on 31 October 2025, > > (b) A supplementary Tender Bundle filed on behalf of the CEO on 7 November 2025, > > (c) The CEO's Statement of Facts, Issues and Contentions filed on 10 November 2025, and > > (d) The Applicant's Statement of Facts, Issues and Contentions filed on 11 November 2025.
Does the Applicant meet the disability requirements?
24 Disability requirements
(1) A person meets the disability requirements if:
(a) the person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory, or physical impairments or the person has one or more impairments to which a psychosocial disability is attributable; and
(b) the impairment or impairments are, or are likely to be, permanent; and
(c) the impairment or impairments result in substantially reduced functional capacity to undertake one or more of the following activities:
(i) communication;
(ii) social interaction;
(iii) learning;
(iv) mobility;
(v) self-care;
(vi) self-management; and
(d) the impairment or impairments affect the person's capacity for social and economic participation; and
(e) the person is likely to require supports under the National Disability Insurance Scheme for the person's lifetime.
(2) For the purposes of subsection (1), an impairment or impairments that vary in intensity may be permanent, and the person is likely to require supports under the National Disability Insurance Scheme for the person's lifetime, despite the variation.
(3) For the purposes of subsection (1), an impairment or impairments that are episodic or fluctuating may be taken to be permanent, and the person may be taken to be likely to require supports under the National Disability Insurance Scheme for the person's lifetime, despite the episodic or fluctuating nature of the impairments.
When is an impairment permanent or likely to be permanent for the disability requirements? > > 5.4 An impairment is, or is likely to be, permanent ... only if there are no known available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy the impairment. > > 5.5 An impairment may be permanent notwithstanding that the severity of its impact on the functional capacity of the person may fluctuate or there are prospects that the severity of the impact of the impairment on the person's functional capacity, including their psychosocial functioning, may improve. > > 5.6 An impairment may require medical treatment and review before a determination can be made about whether the impairment is permanent or likely to be permanent. The impairment is, or is likely to be, permanent only if the impairment does not require further medical treatment or review in order for its permanency or likely permanency to be demonstrated (even though the impairment may continue to be treated and reviewed after this has been demonstrated). > > 5.7 If an impairment is of a degenerative nature, the impairment is, or is likely to be, permanent if medical or other treatment would not, or would be unlikely to, improve the condition.
When does an impairment result in substantially reduced functional capacity to undertake relevant activities > > 5.8 An impairment results in substantially reduced functional capacity of a person to undertake one or more of the relevant activities - communication, social interaction, learning, mobility, self-care or self-management ... - if its result is that:
(a) the person is unable to participate effectively or completely in the activity, or to perform tasks or actions required to undertake or participate effectively or completely in the activity, without assistive technology, equipment (other than commonly used items such as glasses) or home modifications; or
(b) the person usually requires assistance (including physical assistance, guidance, supervision or prompting) from other people to participate in the activity or to perform tasks or actions required to undertake or participate in the activity; or
(c) the person is unable to participate in the activity or to perform tasks or actions required to undertake or participate in the activity, even with assistive technology, equipment, home modifications or assistance from another person.
Paragraph 24(1)(a): Does the Applicant have a disability attributable to impairment?
Paragraph 24(1)(b): Are the Applicant's impairments permanent?
Paragraph 24(1)(c): Do the Applicant's impairments result in substantially reduced functional capacity in a specified life activity area._
The distinction between functional capacity and functional performance
The questions the Tribunal must pose and answer for the purposes of the paragraph 24(1)(c) analysis
- tasks and actions associated with making and keeping friends,
- tasks and actions associated with interacting with other people in the community (who are not friends),
- tasks and actions associated with behavioural and emotional regulation in a social context.
- d710 Basic interpersonal interactions: interacting with people in a contextually and socially appropriate manner, such as by showing consideration and esteem when appropriate, or responding to the feelings of others. Inclusions: showing respect, warmth, appreciation, and tolerance in relationships; responding to criticism and social cues in relationships; and using appropriate physical contact in relationships,
- d720 Complex interpersonal interactions: maintaining and managing interactions with other people, in a contextually and socially appropriate manner, such as by regulating emotions and impulses, controlling verbal and physical aggression, acting independently in social interactions, and acting in accordance with social rules and conventions. Inclusions: forming and terminating relationships, regulating behaviours within interactions, interacting according to social rules; and maintaining social space,
- d730 Relating with strangers: engaging in temporary contacts and links with strangers for specific purposes, such as when asking for directions or making a purchase,
- d740 Formal relationships: creating and maintaining specific relationships in formal settings, such as with employers, professionals or service providers. Inclusions: relating with persons in authority, with subordinates and with equals,
- d750 Informal social relationships: entering into relationships with others, such as casual relationships with people living in the same community or residence, or with co-workers, students, playmates or people with similar backgrounds or professions. Inclusions: informal relationships with friends, neighbours, acquaintances, co-inhabitants and peers,
- in the past the Applicant has had various friendships. However, these have mostly fallen away. He currently has local contact with one friend who he sees regularly, approximately fortnightly. That has been a close supportive friendship in the past. However, the friend has more recently put boundaries on their relationship because of the extent of emotional support the Applicant has sought from him,
- the Applicant believes he has made bad intimate relationship choices in the past. Because of this he is avoidant of intimate contact with others, and of social environments where he perceives himself at risk of making other bad relationship choices,
‑- the Applicant is engaged with his psychologist in relation to the above and will work on these issues over the coming year,
- the Applicant is lonely and feels isolated from others,
- in the past the Applicant has experienced episodes of emotional and behavioural dysregulation on a reactive basis in the context of a violent domestic partnership. Additionally, he reports episodes of dissociation in interactions with police officers and medical staff when under extreme stress. Objectively, these events are historical and context specific. There is no evidence of the Applicant being emotionally and behaviourally dysregulated on any systemic basis,
- in the recent past the Applicant has been an active participant in the local Hare Krishna temple community. However, he has withdrawn from participation because he apprehends that he will be the target of ridicule by an organiser of that community who he contends has verbally abused him twice for being unable to provide physical assistance in the conduct of community events,
- the Applicant is a participant in a therapeutic support group which he attends regularly. He interacts with the group organiser and other participants during those events. He contends that social interaction with group members outside the group sessions and workshops is discouraged, and he does not pursue this,
- he contends that he avoids participating in social events, and attending recreation and entertainment events, to preserve funds to pay for his various medical appointments,
- he drives into the centre of his town every day, or nearly every day. He attends a local community centre established to support his community to recover from severe floods. He socialises with the staff of that centre and with other people who drop-in there over coffee. However, he contends these are relatively superficial interactions. This centre is likely to close in the foreseeable future because the flood-recovery effort is winding up,
- he does all his own shopping at least weekly. As noted above, he attends his town centre and environs every day, or nearly every day. He interacts with staff in shops and has incidental contact with other customers and members of the community. He does not experience any social interaction problems in doing so,
- he has regular appointments with a psychologist, chiropractor, remedial massage therapist, osteopath and general practitioner. He does not experience any social interaction difficulties in doing so,
- he goes to the gym twice a week and has incidental context with gym staff and other gym members/attendees. He does not experience any social interaction difficulties in doing so,
- he maintains close telephone contact with his sister who lives in another country. He both initiates and receives this contact. Although for the reasons I stated in Coffey,[48] family relationships do not come within the scope of the social interaction life activity area, the skills he demonstrates in maintaining this relationship are relevant to the assessment of his functional capacity for social interaction.
- the Applicant presented at the hearing and gave evidence without any evidence of difficulty in social interaction. He interacted with the Tribunal, the CEO's counsel, and his disability advocates in a contextually and socially appropriate manner. His conduct demonstrated respect, warmth, and appreciation.
- tasks associated with personal care, including personal hygiene and grooming,
- d510 Washing oneself: washing and drying one's whole body, or body parts, using water and appropriate cleaning and drying materials or methods, such as bathing, showering, washing hands and feet, face and hair, and drying with a towel,
- d520 Caring for body parts: looking after those parts of the body, such as skin, face, teeth, scalp, nails and genitals, that require more than washing and drying,
- d530 Toileting: planning and carrying out the elimination of human waste (menstruation, urination and defecation), and clean oneself afterwards,
- d540 Dressing: Carrying out the coordinated actions and tasks of putting on and taking off clothes and footwear in sequence and in keeping with climatic and social conditions, such as by putting on, adjusting and removing shirts, skirts, blouses, pants, undergarments, saris, kimono, tights, hats, gloves, coats, boots, sandals and slippers,
- d550 Eating: Carrying out the coordinated tasks of eating food that has been served, bringing it to the mouth and consuming it in culturally acceptable ways, cutting or breaking food into pieces, opening bottles and cans, using eating implements, having meals, feasting or dining,
- d560 Drinking: Taking hold of a drink, bringing it to the mouth, and consuming the drink in culturally acceptable ways, mixing, stirring and pouring liquids for drinking, opening bottles and cans, drinking through a straw or drinking running water such as from a tap or spring; feeding from the breast,
- d570 Looking after one's health: Ensuring physical comfort, health and physical and mental well-being, such as by maintaining a balanced diet, and an appropriate level of physical activity, keeping warm or cool, avoiding harms to health, following safe sex practices, including such as using condoms, getting immunisations and regular physical activities.
- the Applicant experiences defecation and urinary urgency during 'flare-ups' of his neurological impairments. He does not experience faecal or urinary incontinence but prefers to be near a toilet because of these sensations. He can perform all the tasks and actions involved in toileting independently,
- the Applicant can perform all the tasks and actions involved in washing himself independently. During flare-ups of his neurological impairments, he may shower less frequently due to pain and may sit on the floor to do so. However, it is not contended, and there is no evidence of, any lack of personal hygiene,
- the Applicant can wash his face and hands, brush his teeth, shave, brush his hair, and cut his toenails and fingernails independently,
- the Applicant generally maintains good nutrition. During periods of flare-ups of his neurological conditions, he chooses to prepare simpler meals, or prepare meals (such as soups) in bulk, or order meals to be delivered, but it is not contended, and there is no evidence, of malnutrition,
- the Applicant can dress his upper and lower body and put on shoes and socks independently. During flare-ups of his neurological impairments, he elects to wear loose fitting clothing that is easier to put on and take off,
- the Applicant is independent in his health care. He manages his medications and regularly attends on his General Practitioner, psychologist, chiropractor, and remedial massage therapist independently. As noted above, he generally maintains good nutrition. He attends a gym and maintains a regular structured home-based exercise program designed to reduce pain and maintain body function,
- there is no evidence of squalor in the Applicant's home. The photographs of its interior in Ms Cumming's report depict it to be in immaculate condition.
- tasks associated with moving around within the home,
- tasks associated with moving around within the community (how you get out and about),
- tasks associated with getting in and out of bed, and
- tasks associated with getting in and out of a chair.
- d4103 Sitting: Getting into and out of a seated position and changing body position from sitting down to any other position, such as standing up or lying down. Inclusions: getting into a seated position with bent legs or cross-legged; getting into a sitting position with feet supported or unsupported.
- d4104 Standing: Getting into and out of a standing position or changing body position from a standing to any other position, such as lying down or sitting down.
- he can walk with normal gait throughout his home, yard, neighbourhood, and town independently.
- he can transfer from lying to a seated position independently,
- he can transfer to and from a seated to a standing position independently (including a chair, lounge and toilet), but may experience some stiffness and an initial limp after being seated for a prolonged period,
- he is able to stand, but prolonged periods of standing have the potential to aggravate the Applicant's neurological impairments,
- during flare-ups of his neurological impairments, he experiences discomfort and pain in movement, but can maintain his independence by regulating his movements with periods of rest and reduced activity,
- he may experience aggravation of his neurological impairments when walking up his driveway, due to its steep gradient,
- there are three self-reported incidents over the past 10 years of the Applicant losing sensation in his lower extremities resulting in him falling when attempting to transfer from bed to a standing position. The details of these incidents are vague. They do not appear to have resulted in the attendance of medical services or admissions to hospital,
- he maintains a regular home- and gym-based exercise program to maintain and develop musculoskeletal function. This exercise regime has been developed in consultation with his osteopath and physiotherapist,
- he has difficulty maintaining balance using one exit from the back of his house into the backyard because it does not have a step or rail (and does not appear to comply with building standards),
- he can usually carry weights of up to 5kgs. He can bend and stretch to reach all internal cupboards,
- he owns and regularly drives his own car. His drivers license has no impairment related conditions or restrictions. His car has no impairment related modifications, and he does not use any generally available or specialist seating aids. He is usually able to drive for period of up to one-hour without difficulty, but during flare-ups of his neurological impairments he may not be able to drive for periods longer than 10minutes,
- he does not use any mobility aids, such as a walking stick or walker. His home has no impairment related modifications,
- there are few public transport options in the Applicant's neighbourhood. The closest bus stop is over one kilometre away. He does not use this bus service, preferring to drive himself to town and his various appointments.
Conclusion with respect to the paragraph 24(1)(c) requirement
Does the Applicant meet the early intervention requirements?
25 Early intervention requirements > > (1) A person meets the early intervention requirements if: > > (a) the person:
(i) has one or more identified intellectual, cognitive, neurological, sensory or physical impairments that are, or are likely to be, permanent; or
(ii) has one or more identified impairments to which a psychosocial disability is attributable and that are, or are likely to be, permanent; ...
(b) the CEO is satisfied that provision of early intervention supports for the person is likely to benefit the person by reducing the person's future needs for supports in relation to disability; and
(c) the CEO is satisfied that provision of early intervention supports for the person is likely to benefit the person by:
(i) mitigating or alleviating the impact of the person's impairment upon the functional capacity of the person to undertake communication, social interaction, learning, mobility, self-care or self-management; or
(ii) preventing the deterioration of such functional capacity; or
(iii) improving such functional capacity; or
(iv) strengthening the sustainability of informal supports available to the person, including through building the capacity of the person's carer.
Note: In certain circumstances, a person with a degenerative condition could meet the early intervention requirements and therefore become a participant.
1(A) For the purposes of subparagraph (1)(a)(i) or (ii), an impairment or impairments that are episodic or fluctuating may be taken to be permanent despite the episodic or fluctuating nature of the impairments.
...
(3) Despite subsection (1) ..., the person does not meet the early intervention requirements if the CEO is satisfied that early intervention support for the person is not most appropriately funded or provided through the National Disability Insurance Scheme, and is more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or through systems of service delivery or support services offered:
(a) as part of a universal service obligation; or
(b) in accordance with reasonable adjustments required under a law dealing with discrimination on the basis of disability.
Deciding whether provision of early intervention supports is likely to benefit the person > > 6.8 ... the main way in which the CEO can determine whether the provision of early intervention supports is likely to benefit the person ... is to consider evidence going to those matters, as indicated in paragraph 6.9 below.... > > Where evidence is required > > 6.9. In deciding whether provision of early intervention supports is likely to benefit the person ... it is expected that the CEO would consider:
(a) the likely trajectory and impact of the person's impairment over time; and
(b) the potential benefits of early intervention on the impact of the impairment on the person's functional capacity and in reducing their future needs for supports; and
(c) evidence from a range of sources, such as information provided by the person with disability or their family members or carers. The CEO may also in some cases seek expert opinion.
[1] This proceeding commenced before the Administrative Appeals Tribunal (AAT) in accordance with the power conferred by s 25 of the Administrative Appeals Tribunals Tribunal Act 1975 (Cth). The AAT was abolished and replaced by the Administrative Review Tribunal (ART) with effect from 14 October 2024. By operation of Item 24 in Schedule 16 of the Administrative Review Tribunal (Consequential and Transitional Provisions No 1) Act 2024 (Cth) any proceeding which was not determined by 14 October 2024 continues in the ART and is to be determined by the application of the provisions of the ART Act.
[2] Drake v Minister for Immigration and Ethnic Affairs (1979) 2 ALD 60; 24 ALR 577 at 589
[3] Shi v Migration Agent's Registration Authority [2008] HCA 31; (2008) 235 CLR 286 at [45] - [46]
[4] Joint Tender Bundle, Tab T14, page 150.
[5] The requirement for "permanence" of an impairment does not apply for the purpose of the early intervention requirement in the case of a child with a developmental delay: subparagraph 25(1)(a)(iii).
[6] Mulligan v National Disability Insurance Agency [2015] FCA 544; 233 FCR 201 (Mulligan) at [50]
[7] The NDIS was designed to fund direct supports for persons with significant disabilities who are assessed as needing such support; Mulligan at [53] referencing clause 24 of the Explanatory Memorandum to the National Disability Insurance Scheme Bill 2013, and recommendation 3.2 of the Productivity Commission's Inquiry Report, Disability Care and Support, No. 54, 31 July 2011.
[10] National Disability Insurance Agency v Davis [2022] FCA 1002 (Davis) at [82].
[11] Drake and Minister for Immigration and Ethnic Affairs (No.2) (1979) 2 ALD 634 (Drake No. 2) at [644-5].
[13] National Disability Insurance Agency v Davis [2022] FCA 1002 (Davis) at [60]
[14] Beezley v Repatriation Commission [2015] FCAFC 165 (2015); 150 ALD 11 at [68]; HPSC and National Disability Insurance Agency [2021] AATA 727 at [85]; National Disability Insurance Agency v Lampard [2025] FCAFC 139 at [31] - [32].
[15] Hearing Tender Bundle, Tab T14, page 152.
[19] National Disability Insurance Agency, Applying to the NDIS Pre Legislative Changes, 14 October 2024
[21] World Health Organisation, (2011), International Classification of Functioning, Disability and Health, Geneva: International Classification of Functioning, Disability and Health (ICF)
[22] 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.
[24] DQKZ and National Disability Insurance Agency [2024] AATA 2276 at [144] - [149]. I adopt what I have said there for present purposes without repeating it.
[32] As this is not in issue it is sufficient to point to the evidence of Ms C Cummings (independent Occupational Therapist) in relation to these life activity areas, which I accept: Joint Tender Bundle, Tab D7, pages 438 - 446.
[33] Burrows and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 607.
[34] T B Ustun, N Kostanjsek, S Chatterji and J Rehm (eds) Measuring Health and Disability, Manual for WHO Disability Assessment Schedule (WHODAS 2.0), World Health Organisation, 2010.
[36] Ibid at page 38; see also World Health Organisation, International Classification of Functioning, Disability and Health, Geneva, 2001 at page 22.
[40] See also my decision in Foster and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 718 (Foster (on remittal)) at [64] and [91].
[41] Drake (No.2) at pages 643 - 645.
[42] Mulligan and National Disability Insurance Agency [2015] FCA 544; (2015) 233 FCR 201 at [55].
[43] National Disability Insurance Agency v Foster [2023] FCAFC 11; (2023) 295 FCR 521
[44] Foster and National Disability Insurance Agency (NDIS [2025] ARTA 718 (Foster on remittal) at [83]
[47] This summary is taken principally from the Applicant's response to the Agency's targeted questions, Joint Tender Bundle, Tab C25 page 361-362, the Applicant's oral evidence, and the Applicant's self-report and clinical observations made by Ms C Cummings, Independent Occupational Therapist, in her report, Joint Tender Bundle, Tab D7.
[48] Coffey and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 634 at [69] - [70].
[51] National Disability Insurance Agency v Jones [2025] FCA 877 at [24]
Beezley v Repatriation Commission [2015] FCAFC 165
Burrows and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 606
Coffey and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 634
DQKZ and CEO, National Disability Insurance Agency [2024] AATA 2276
Foster and CEO, National Disability Insurance Agency (NDIS) [2025] ARTA 718
HPSC and National Disability Insurance Agency [2021] AATA 727
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 Jones [2025] FCA 877
National Disability Insurance Agency v Foster [2023] FCAFC 11; (2023) 295 FCR 521
National Disability Insurance Agency v Lampard [2025] FCAFC 139
(2008) 235 CLR 286
(2015) 233 FCR 201
(2023) 295 FCR 521