Home modifications - Elevator vs Stairclimber - Loadsman and NDIA [2021] AATA 1990

Key Points

• In Loadsman and NDIA [2021] AATA 1990 [opens in new window], the Tribunal refused to include funding for installation of a home elevator in a participant's plan, instead providing funding for a stairclimber.
• The case is a useful example of how the Tribunal (and the NDIA) approach the question of home modifications. It is apparent that if there is a suitable cheaper alternative that can be reused, then this will likely be funded instead of permanent home improvements.

Facts

Ms Loadsman is a participant in the NDIA who suffers from motor neurone disease (MND). She lives with her family in a two-storey home. Ms Loadsman sought funding from the NDIA for the installation of an elevator in order to allow her to access the upper storey of her home.

Ms Loadsman gave evidence that she was unable to climb the stairs because her legs did not function properly. She had previously been using an ankle foot orthosis and a walker to navigate her house, but had recently begun using a power wheelchair. 

Ms Loadsman was opposed to a stairclimber (a device that carries a person and their wheelchair up and down stairs), because she would need a person's help in order to use it. She could use an elevator independently, at least until her MND progressed to a point where she would be no longer able to do so. Ms Loadsman also argued that the cost of a stairclimber was less cost-effective than an elevator, when the cost of a support person to operate the device was factored in.

Decision

The Tribunal refused to include an elevator in Ms Loadsman's plan. However, it did vary the NDIA's decision to include the cost of a stairclimber. 

The Tribunal observed that the cost of an elevator was a total of $105,682, while the cost of a stairclimber was only $22,450. Moreover, when Ms Loadsman was no longer able to use a stairclimber, it could be uninstalled and reused elsewhere, meaning that another NDIS participant who needed a stairclimber would eventually benefit. 

The Tribunal referred to the NDIS Act, as well as the NDIS Operational Guideline Including Specific Types of Supports in Plans - Home Modification [opens in new window]. That Guideline indicates that the NDIA generally does not fund the installation of elevators or inclinators. In deciding whether to fund an elevator or inclinator, the NDIA will consider, among other things, whether it represents value for money and whether there are alternatives, such as reorganisation of the home so that the second storey does not ned to be accessed, or alternative accommodation. 

The Tribunal observed at [99] of the decision that both occupational therapists who gave evidence in the matter had concluded that Ms Loadsman could use a lightweight powered wheelchair at home, which the stairclimber could safely lift. Ms Loadsman's plan also had funding for assistive technology that would allow her to use a heavier wheelchair outside of the home. 

At [104] of the decision, the Tribunal concluded that compared to a stairclimber, an elevator did not represent value for money, which is one of the requirements for supports found in s 34(1)(c) of the NDIS Act [opens in new window]. 

At [106] the Tribunal found that it would be reasonable for members of Ms Loadsman's family to operate the stairclimber, given that they had already been providing her with assistance in climbing the stairs.

At [109], the Tribunal had regard to the overall financial sustainability of the NDIS. It observed that three stairclimbers could be purchased for the cost of installing an elevator in Ms Loadsman's home. Given that over 75,000 NDIS participants have neurological impairments, installing elevators as a matter of course would not be financially sustainable.

At [111], the Tribunal rejected Ms Loadsman's arugment that care costs should be factored into the cost of the stairclimber. The Tribunal found that Ms Loadsman's NDIS plan contained funding for carers to provide her with support, which could take the form of operating the stairclimber, and it was also reasonable to expect that Ms Loadsman's family members would continue to provide her with support. 

Analysis

As with all cases in this area, the Tribunal's decision is very fact-specific. The fact that the Tribunal considered that a stairclimber was reasonable and necessary in Ms Loadsman's case does not mean that it would consider a stairclimber to be reasonable and necessary in someone else's case.

However, this case is a useful example of how the Tribunal approaches the question of value for money in the context of home modifications. Clearly, the NDIA will be reluctant to fund expensive capital improvements like elevators that can only be used by one participant, if there are options for cheaper equipment that can potentially be reused.