Queensland Advocacy Incorporated’s National Disability Insurance Scheme (NDIS) Appeals Advocate Service supported Kelly* and her family through an internal review and external Administrative Appeals Tribunal review.
Kelly is a middle-aged woman with a diagnosis of acquired brain injury, intellectual impairment, paraplegia, epilepsy and bipolar disorder which has significant impacts on her day-to-day life.
Under Disability Services Queensland, Kelly was receiving funding for 24/7 care which she was self-directing with assistance from her mother and Aunty.
Kelly had a wonderful support system around her, by directly employing her staff and working with people who shared the same vision for her life.
When Kelly started to access the NDIS, her funds were significantly reduced, resulting in funding for only five hours of support per day.
Queensland Advocacy Incorporated’s NDIS Appeals Advocate lodged an internal review on behalf of Kelly under the ‘Principle of no disadvantage’; a principle designed to ensure that when a person transitions to the NDIS, they were no ‘worse off’.
The internal reviewer confirmed the Agency’s earlier position and made no changes to Kelly’s plan. Kelly’s family were at breaking point; they had lost six of their nine support workers; family members were completing care shifts and Kelly’s mental health had deteriorated. The NDIS appeals advocate wrote to the CEO of the NDIS to express their very real concerns for Kelly and her family’s wellbeing. Their only option was to lodge an external merits review at the Administrative Appeals Tribunal as the Agency refused to intervene.
The NDIS appeals advocate attended the first case conference on behalf of Kelly and her family and advocated for an expeditious external review, due to the fragile nature of Kelly’s situation. She advocated for directions and clear time frames to be put in place. The Tribunal Case Registrar also understood the urgency of the situation and assisted by pre-booking a directions hearing, should the Agency fail to comply with the directed timeframes. The advocate coordinated obtaining evidence for the external review, liaising with therapists and creating clear funding request breakdowns for the Agency, whilst also supporting the family.
After the first case conference and supplying of evidence and detailed funding request, Kelly was offered her funding request in full, with a seven-day turnaround approving the new plan.
Kelly now has 24/7 support, additional support coordination to rebuild her team and explore housing options, funding to access therapies and assessments, as well as assistive technology. Her family has also been educated on the processes and evidence they will need to obtain before their scheduled review to ensure Kelly’s needs continue to be met.
(*not their real name)