ZNDV v National Disability Insurance Agency [2014] AATA 921 reports the outcome of an application for review of a decision by the NDIA. It incorporates discussion of early intervention requirements and reasonable & necessary supports on the context of a five year old boy with Asperger’s disorder. The boy was said to experience developmental delay in areas of social interaction: [3].

By the time of hearing there was only one issue in dispute, being the funding of a range of occupational therapy equipment which would allow the boy to have an occupational therapy room in his home: [6]. The cost was to be a little under $10,000: [33].

The AATA noted at [19] that in deciding what are reasonable & necessary supports, the Tribunal must take into account the Act and the Rules including the Rules’ provisions in respect of:

  • value for money (see also [83])
  • effective, beneficial and good practice (see also [94])
  • reasonable family, carer and other support
  • supports appropriately funded through the NDIS

The NDIA had declined to install occupational therapy treatment in the home which was accessible through the community, in therapy visits and also because of consideration of what a parent would usually provide as toys, sporting and hobby equipment: [24].

Oral evidence was considered along with various reports.

The Tribunal was not persuaded that the proposed occupational therapy room would be of long term benefit to the boy, nor substantially improve his life stage outcomes: [89]. The equipment was not value for money, nor reasonable and necessary given that the equipment was accessible in occupational therapy visits: [90], [93].

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