FOI 24/25-1470 DOCUMENT 1
Section 24(1)(a)
The content of this document is OFFICIAL
Section 24(1)(a)
| Section 24(1)(a) | |
|---|---|
| Presentation Slides | Technical Training -… |
| Transcript | s24(1)a presentati… |
| Case Studies | Case study 1 ARF… |
| Case study 1 psychologi… | |
| Case study 2 SEF | |
| Case study 3 SEF | |
| Feedback Survey | Please email redacted: s47E(d) - certain operationsndis.gov.au if you have any feedback |
| Key Points | • Apart from conditions on List A and B, there are no blanket rules to what does and doesn’t meet Section 24(1)(a) — when making the decision ensure it is all evidence based and not based on past knowledge of that condition, previous cases or lived experience. • Regardless of the name of the diagnosis, if the evidence shows the person has a disability that is attributable to one of the listed impairments then it will meet 24(1)(a) — this is because you do not need to have a diagnosis to meet access, we assess on the impairment, not the diagnosis • NB: A diagnosis does make it easier to meet the criteria, as we can determine if there is any treatment available for Section 24(1)(b), but we cannot ask someone to provide a diagnosis • There are some cases that we think should meet 24(1)(a) based on the name of the diagnosis, but the health professional has ticked “no” to everything and there are no red flags to show that require follow up. On the other hand, there are times where the health professional will tick “no” to everything but due to red flags we need to follow up (i.e. Schizophrenia, not compliant with medication, regular hospitalisation but the health professional has ticked “no” to all the domains) |
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FOI 24/25-1470
| Questions from Meeting | • List B impairments always meet 24(1)(a) and (b), even if the evidence doesn’t show the person is impacted (i.e. if it wasn’t on List B we would rule out on Section 24(1)(a). This is as per Is your impairment likely to be permanent? of Our Guidelines which states “If you give us evidence you have been diagnosed with a condition on List B, we’ll likely decide your disability is from an impairment that’s likely to be permanent”. |
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How can someone without a diagnosis meet 24(1)(a)?
It is important to remember that we are not assessing the diagnosis, we are assessing whether the person has a disability that can be attributable to an impairment. This can be difficult with our previous knowledge and the language used. This is where you need to assess the evidence to determine if the person has a disability and if this disability can be attributed to an impairment.
For example - an application stating someone has autistic traits and is recommending that the person undertake an Autism Assessment:
- The person will likely have a disability (as per the definition in Our Guidelines) - this means they will have some sort of reduction or loss of an ability
- However, it can be difficult to attribute this to an impairment (as per the definition in the OGs) if there has not yet been any testing completed to attribute the disability to an impairment. Depending on what the evidence shows we may be inferring that it’s attributable to a neurological impairment. There are circumstances where it will be quite clear that it can be attributed to an impairment which is why someone can meet 24(1)(a) without a diagnosis
Separating Condition, Impairment and Disability:
When looking at 24(1)(a), remember that the definition used for disability and impairment may be different to what we are used to using and also what health professionals use. For instance, society views “Autism” as being a disability, and that is correct, however when we are applying “Autism” to our legislative criteria we need to break it down as per the below:
- Condition: Autism
- Impairment: Why the person can’t do tasks activities - neurological
- Disability: What the person can’t do/has a reduction in completing - i.e. communication barriers
If a condition is on the DSM, why is it not considered a psychiatric impairment?
A diagnosis does not always mean a person has an impairment, or a disability that can be attributed to an impairment listed in 24(1)(a). It will depend on how this condition impacts the person as to whether it meets 24(1)(a). The DSM is a handbook used to diagnose mental disorders - it sets out the diagnostic criteria and provides informatifon to help clinicians communicate this to their patients. Having a mental disorder does not always mean the person’s disability can be attributable to an impairment as a disorder does not always result in a “loss of, or significant change to, your body’s function, structure or how you think and learn“ - this is where we need to apply the evidence to the legislative criteria to determine if they meet that criteria.
Specific to Case Study 1, why are we not accepting that the disability can be attributed to an impairment when the psychologist has stated it is?
The psychologist has repeated the NDIA legislative criteria back to us in their EOD with their interpretation of the NDIA criteria. If we utilise the information they provided (i.e. the assessments they completed) then it does not actually show that the disability can be attributed to an impairment. We are not questioning the results from the psychologist, we are accepting the test results. Instead, we are not satisfied with how they have interpreted the NDIA legislation and this is supported by their assessment reports. Remember that we are the experts in our legislation, not the health professionals.
Specific to Case Study 2, why are we requesting a follow up and would we still do this if a past CTO order was not mentioned?
It is important to maintain a participant-first approach when considering the access criteria and the applicant’s circumstances. As there are no blanket rules when considering psychosocial impairments we would expect an Assessor to take into consideration the nature of the condition, and the potential vulnerability of a prospective participant applying with psychosocial disabilities. This would likely be made evident within the EOD provided but a clarifying call may not be appropriate for more high prevalence disorders permitting there are not aggravating factors noted throughout available evidence.
A clarifying call would be encouraged when considering the nature of the condition and the potential vulnerability of the applicant. While evidence provided for case study 2 notes CTO, a clarifying call would still be recommended if the CTO was not noted to ensure we maintain participant-focused.
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