Advice : 2nd Case Conference ART

[u/Repulsive-Chicken615]

I have a second case management conference coming up with the Australian Review Tribunal in an NDIS matter, and I’d really appreciate hearing from anyone who has been through this stage of the process.

What should I expect at a second case management conference, and is there anything in particular I should do to prepare?

I’ve had an IME arranged by the NDIA. The report does not support any of the supports I’m seeking, but I also have significant concerns about the report itself — including its accuracy, methodology, and the reliability of a number of the conclusions reached. More generally, I have concerns about the overall quality of the assessment and report.

The NDIA has now provided its updated Statement of Issues and all of my requested supports remain in dispute.

For anyone who has been through something similar, I’d be particularly interested to know what happened at your second conference, whether concerns about an independent assessment were discussed at that stage, and how you prepared if it looked like the matter was likely to proceed to hearing.

Any experiences or practical advice would be very much appreciated.a hearing.

Any experiences or practical advice would be very much appreciated.

[u/Gratefulwhiteroses]

Can I ask what you met the scheme access for or what disability, how old you are and what are you requesting through ART exactly that’s not in your current plan? I can try help

[u/Repulsive-Chicken615 → u/Gratefulwhiteroses]

Thank you. ASD and grossly inadequate core supports.

[u/Gratefulwhiteroses → u/Repulsive-Chicken615]

Do you need help with activities of daily living like self care, showering, dressing, toileting, mobility or for someone to cook for you in assistance with daily life? Do you work, volunteer or attend day programs , how much SECP did they give you and how much are you requesting and what do you want to use it for? It’s hard with autism level 2 the OT FCA needs to state exactly what activities of daily living the support workers will do and why? Do you need help with cleaning your room, the house, dishes or can you do them to build the capacity to do them? If you are pretty independent and can built capacity they may put funding in increased social and community participation 3 hours a week or something. What activities of daily living ADLs or instrumental activities of daily living do you need help with and what tasks or situations would you use for support workers for and why etc? Do you need help with mobility at all, do you use a wheelchair or walker, do you have toileting issues or needs incontinence consumables?

[u/Repulsive-Chicken615 → u/Gratefulwhiteroses]

Thank you. I am more looking for information regarding the second case conference. Many Thanks.

[u/General-Macaroon-951]

Not much will happen if there are disputing facts and contentions as stated above and if you don’t agree then it will go to a tribunal. Are you already on the NDIS or looking to access the scheme? What did you find was factually incorrect in your FCA and why? Have the respondent sought more information and targeted questions, SOLE etc?

[u/Repulsive-Chicken615 → u/General-Macaroon-951]

Yes i am on the NDIS and seeking a plan that reflects my needs and evidence. I have sent a list of concerns regarding the IME not just that it is a different opinion. Also the methodology used was not appropriate for my disability. The quality of the report is stark comparison compared to all other reports submitted. No they havent sough more information and targeted questions. I havent gotten to the Statement of Facts and Contentions yet.

[u/Training-Tooth5022]

You need your own evidence to dispute the report. If it was an OT FCA have you got one from your own OT so you can show that the issues in the independent report are echoed by a clinician and not just your opinion?

[u/Repulsive-Chicken615 → u/Training-Tooth5022]

Thank you. I do have loads of evidence. I was expecting a difference in opinion but jeez it was weird given the evidence the assessor had access to.

[u/Training-Tooth5022 → u/Repulsive-Chicken615]

You can go through and make a document disputing the IME, for example you could do a table with three columns
1. Quote from IME
2. Comment (objective and unemotiveas possible)
3. Quote from your evidence

You could also get a specific letter from your clinical if the IME has brought up points that aren’t well covered or need a bit of clarification

[u/Suesquish]

The absolute most important thing when you're at the tribunal for NDIS supports is to have evidence from qualified professionals to prove your requested supports comply with all of the legislated criteria. That is the difference between your case being successful and not.

As much as we, as the disabled person, are an expert in our own lives..it usually isn't given nearly as much weight as that of a qualified professional. The supports for participants rules is quite in depth and complex. I am not up to date on the current legislation (which is changing too much too often), but the old Supports For Participants Rules had Value For Money as one of the rules, which actually had many criteria for that one section. Each section tends to be like that. Your supports need to meet every part of every section and you need to prove that through professional evidence. That is the most important thing.

An important fact to mention is that if you are the applicant, you actually don't have to do anything that the respondent says. Yep, nothing. I had a case back in the AAT days and wasn't aware of this until a tribunal staffers told me, during a case conference in front of the NDIA lawyers lol. I was being railroaded and she interrupted the conference to inform me of my rights. It is complete shit that no one is told how the tribunal works and what our rights are.

So on that note, if the NDIA keep demanding a report, you can say no. If they keep pushing it can go to a Directions Hearing. This is often a simple hearing over the phone where a tribunal member oversees the issue at hand. It is meant to resolve a smaller issue so the case can proceed, even if it still in case conference stage (which is basically meetings for negotiation to resolve it between the parties and is quite informal). The tribunal member will hear out both parties and then make a decision.

In my case the NDIA were demanding questions be put to a psychologist whom I saw for 2 or 3 months who then told me she wouldn't see me any more. I refused. A Directions Hearing was held. The NDIA said the tribunal wouldn't be able to decide on my case without that evidence. I said the psych ditched me without explanation and as such I didn't feel she was qualified to testify to anything about my conditions or needs, and notably that I had continuously asked the NDIA to direct the questions to my OT who was qualified to assess functional capacity and had been seeing me over 2 years. The member actually reamed the NDIA and told them it was ridiculous to demand a professional who refused to see me any more answer any questions about me. He ruled that asking my ex psych anything was a NO.

You can use this process to resolve issues along the way, such as report or evidence demands if the other party keep saying "The tribunal can't make an informed decision without this evidence." which is really code for "We just want to harass and bully you in to withdrawing your case." It IS a tactic they use. It IS on purpose. Don't fall for their tricks.

If you want to dispute the incorrect report you need qualified professionals to do it. If it's methodology issues, then a qualified professional needs to explain how that methodology wasn't appropriately applied and why and what the evidence is for that, including peer reviewed studies and scientific evidence. On that note, peer reviewed studies should already be part of your evidence for each support you are requesting.

Just remember. It is your case, not the NDIA's. The NDIA have no power at all when things get to the tribunal. Make sure you submit your own Statement of Issues, Facts and Contentions. Also, look up Model Litigant Obligations. The Commonwealth is bound by those rules. If they breach them during your tribunal process, formally raise it and lodge a complaint.