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What weight should be given to evidence-based treatments when determining ‘reasonable and necessary support’? | A case study

Catherine Henry Lawyers
Catherine Henry Lawyers

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Pexels - Eligibility NDIA appeal A case study
Jourfian v National Disability Insurance Agency [2020] AATA 1883 – June 2020

Mr Jourfian was involved in a motor vehicle accident in 2009, in which he was struck by a car while crossing the road, sustaining injuries to the low back, face and head. The relevant issue for the Tribunal is whether there are ‘any known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy’ Mr Jourfian’s back injury and/or his depression.

The Tribunal noted the inconsistent evidence before about whether surgery could reduce Mr Jourfian’s back pain and assist his functionality and held:

In the absence of consistent medical evidence and recent specialist review, I cannot be satisfied that surgery is not a treatment to remedy Mr Jourfian’s back injury. This means I am not satisfied that Mr Jourfian’s back injury is permanent within the meaning of paragraph 24(1)(b) of the NDIS Act.

Also absent was medical evidence concerning potential benefits of early intervention on the impact of Mr Jourfian’s impairments on his functional capacity and reducing his future needs for supports (at [62]). In any event the Tribunal found that Mr Jourfian’s impairments of back injury and depression are health conditions.

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