King v National Disability Insurance Agency [2017] AATA 643 saw Ms King apply to the Tribunal for review of a decision that certain supports she applied for were not considered reasonable and necessary supports under s 34 of the Act. She had sought the inclusion of an additional 20 hours of physiotherapy and a gym membership as supports in her statement of participant supports. The NDIA modified its position at hearing, such that the Agency agreed to pay most of the gym membership fee and most of the physiotherapy claimed.

In relation to the gym membership, at [15] the Tribunal said that the NDIA had recognised this support as being reasonable and necessary: “Considering the recent decision of McGarrigle v National Disability Insurance Agency [2017] FCA 308[6], the Tribunal considers the cost of this support should be funded by the NDIA in full…”.

In relation to the physiotherapy:

  • The Tribunal was satisfied that the treatment represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative supports: [26d]
  • The funding or provision of the physiotherapy treatment as recommended took account what it is reasonable to expect of families, carers, informal networks and the community to provide. It was not a support that others can safely provide: [26f].
  • The physiotherapy treatment was most appropriately funded or provided through the NDIS, and was not more appropriately funded or provided through other general systems of service delivery or support services offered by a person, agency or body, or systems of service delivery or support services offered: [26h].

 

 

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