The job of the Administrative Appeals Tribunal (AAT) is to smooth out points of complexity and disagreement in the NDIS. But sometimes you get the impression they probably weren’t expecting the level of mind-bogglingly complexity and vehement disagreement that they have been forced to encounter. PM* v the NDIA is one of those cases. The ruling covers a remarkable amount of ground, with decisions you will probably agree with and others you will not; decisions which are groundbreaking and others that are pretty mundane. Both sides would have probably left the hearing feeling like both winners and losers. But for everyone else involved in the NDIS, trying to get their head around what the reasonable and necessary criteria mean for day-to-day implementation, this case is a winner.

There was so much must-read information in this case, that there was no way one article could do it justice. So stay tuned for Part 2 in two weeks!

The Background

PM is a 25 year old man who lives with severe schizencephaly, epilepsy, a severe visual impairment, a profound intellectual disability, spastic quadriplegia, severe asthma, severe gastric reflux, osteoporosis, scoliosis, chronic deteriorating pulmonary condition, sleep apnoea and sun sensitivity. His goals with the NDIS are to spend quality time with his family, ensure his equipment is up to date and safe, optimise his health, learn to trust his carers and participate in stimulating social activities.

He and his family appealed his first Plan because they felt it did not meet his support needs. In typical NDIS style, his first Plan expired before the issues could be resolved. However, given his second Plan is effectively the same and getting him to start a new appeal would obviously be ridiculous, the NDIA graciously agreed to reflect the Tribunal’s decision in his current Plan. The two parties reached agreement on a whole bunch of supports before the hearing, but many items remained in dispute.

Health V. The NDIS

It feels a bit like Groundhog Day every time we delve into the controversial and mind-bogglingly world of the interface between Health and NDIS. It is like just when you feel like you have started to get a grip on the topic, something new comes along and you realise: