CEO, National Disability Insurance Agency and KDKJ by her nominee, NKHPV (Guidance and Appeals Panel)
[2026] ARTA 1166
“Vague but unsubstantiated statements where there are no temporal assessments demonstrating progress against benchmarks or objectives are simply insufficient.”
What the record established
Not a pain case. KDKJ is a child with cerebral palsy and complex medical needs. It's here because it's a Guidance and Appeals Panel decision on therapy supports, physiotherapy and hydrotherapy among them, and on how practitioners' reports are weighed.
An earlier Tribunal had funded 24-hour nursing, physiotherapy, occupational therapy and speech therapy twice a week, weekly hydrotherapy, and art and music therapy [7]. The Agency applied for review, and the Panel reconsidered every funded support, not only those in dispute [12], [40].
The treating practitioners said KDKJ had made substantial progress. Their reports didn't show it: the Panel found “a concerning lack of measurable progress, identifiable benchmarks or credible assessment of actual progress being made or benefits achieved” [37]. The hydrotherapy report didn't disclose that the last session had been weeks before it was written, or that 27 sessions had been delivered in just over two years [280], [287].
What carried it
The Panel weighed the evidence by independence and measurement. It preferred two experts who “displayed greater objectivity”, and gave less weight to treating practitioners who stood to be paid from the plan, several of whom seemed “motivated principally to seek to continue the supports for which they are already receiving a pecuniary benefit” [181].
Hydrotherapy was refused on value for money. Each session needed a physiotherapist and an assistant [290], was interrupted for suctioning up to ten times [288], and land-based physiotherapy would achieve “the same, if not a better, outcome at a substantially lower cost” [292].
Physiotherapy survived, reduced from 104 to 72 hours a year, with time funded to train the family in a home program [259], [260], [269]. Attendance alone wasn't enough: “it is insufficient to merely attend therapy” [41].
Art therapy, music therapy and an intensive therapy program weren't funded at all [362].
KDKJat [180]
The Tribunal should expect to be provided reports that are balanced, transparent and capable of being independently verified.
The standard every allied health report in the matter was measured against.
KDKJat [36]
including reference to relevant qualitative assessment, benchmark, or measurement of a purported benefit, outcome or progress
What a practitioner's opinion about a support has to rest on.
KDKJat [41]
it is insufficient to merely attend therapy
Therapy has to carry into daily life, and the record has to show that it does.
Read the decision
CEO, National Disability Insurance Agency and KDKJ by her nominee, NKHPV (Guidance and Appeals Panel) [2026] ARTA 1166
Published in full on AustLII, and citable by that reference.
Read with NNFXT [2026] ARTA 308. The same Deputy President, earlier in 2026, on opinions built from the family's account rather than observation.
These are published Tribunal decisions, not my clients. They're summarised to show what the records in each matter did and didn't establish. Nothing here is a prediction about any other matter, and no outcome is implied. Every decision turns on its own evidence.