AAT Case Management Guide
Supportable Impairments
OFFICIAL For Internal Use Only
| Field | Content | Reference Documents |
|---|---|---|
| Title | Supportable Impairments | - |
| Purpose | This document is part of a suite of guidance documents for case managers to use in formulating their approach to managing individual cases before the Administrative Appeals Tribunal (AAT). | - |
Scope
- A participant’s disability or impairment can permanently and substantially reduce their functional capacity or their ability to undertake activities. For the purposes of this document, an impairment can be:
- intellectual;
- cognitive;
- neurological;
- sensory;
- physical; or
- one or more of the above, to which a psychosocial disability is attributable.
Escalation to Hearing Oversight Committee (HOC)
If a matter is within the parameters of this document, the AAT Case Management Branch Manager may approve proceeding to hearing. Where there is substantial risk or the matter is outside the parameters of this document, the matter should be referred to HOC.
Current National Disability Insurance Agency (NDIA) policy on the subject
The AAT process is often seen as stressful and adversarial by the participants and our focus should be on resolving issues as practicably and quickly as possible. The role of the NDIA is to assist the AAT and the participant in reaching the best possible resolution for the participant by agreement. Participants are generally ineligible to receive NDIS funding if:
- their impairment is temporary; or
Reference Documents:
- Section 24 of the National Disability Insurance Scheme Act 2013
- Operational Guideline – Applying for the NDIS: Do you meet the disability requirements?
- Does your impairment substantially reduce your functional capacity?
- Do you have an extreme functional impairment or very high support needs?
- NDIA Dispute Resolution Policy
- Appendix B to the Legal Services Directions 2017
- Section 24 of the National Disability Insurance Scheme Act 2013
AAT Case Management Guide
Supportable Impairments
OFFICIAL For Internal Use Only
| - their impairment is treatable, whether treatment is ongoing or whether there are unexplored treatment options available to the participant. The NDIA is also unable to fund supports which would more appropriately be funded by other mainstream service delivery systems. | List B: Conditions that | |
| are likely to result in a permanent impairment | ||
| - Whether the NDIA is able to offer support funding in relation to a particular impairment will typically hinge on whether or not: |
- the impairment is, or is likely to be, permanent; and
- whether the support needed is most appropriately funded by the NDIA.| Operational Guideline – Applying for the NDIS Section 25 of the National Disability Insurance Scheme Act 2013| | | - The primary concern of the NDIA is the participant’s wellbeing. The NDIA will rely on the available evidence and best practice when considering whether a participant is entitled to receive funding from the NDIA for a particular impairment. The NDIA will refer to evidence from health and allied health providers, expert evidence, opinion evidence and witness statements. The NDIA will also closely consider a participant’s daily support needs as a result of their impairment when considering the appropriate level of funding to provide, wherever possible.| Providing evidence of your disability Persons Giving Expert and Opinion Evidence Guideline | Administrative Appeals Tribunal| | | - Some participants may have an impairment which will improve over time, meaning that the participant will require progressively less disability support over time. In those circumstances, participants may be eligible to receive early intervention support funding.| Do you need early intervention? Sections 24, 25 and 27 of the National|
AAT Case Management Guide
Supportable Impairments
OFFICIAL For Internal Use Only
In those circumstances, the NDIA will consider:
- whether the impairment is likely to be permanent;
- whether early intervention supports are likely to reduce the need for future supports; and
- whether the early intervention needed is most appropriately funded by the NDIA.
Disability Insurance Scheme Act 2013 Rule 6.9 of the National Disability Insurance Scheme (Becoming a Participant) Rules 2016
The question is not whether the impact of a participant’s impairment is significant in general terms, or whether a support is actually funded by another mainstream service delivery system. Instead, the test is whether or not the legislative requirements are met; which is to say, whether a participant’s impairment is permanent and substantially reduces their functional capacity, and whether or not support funding in relation to that impairment is most appropriately provided by the NDIA, and not another mainstream service delivery system.
The AAT affirmed a decision of the NDIA on the basis that it was not satisfied these legislative requirements were met, on the available evidence.
Previous matters that may advise the NDIA position Document admin Assistant Director, Policy, Continuous Improvement 10 September 2024 Approved Director, Continuous Improvement 10 September 2024