Suresh wants to improve his personal fitness to help manage the effects of his disability.
Would we fund this?
No, we would not fund a gym membership. It is a day-to-day living cost not related to Suresh’s disability support needs.
Why don’t we fund this?
We don’t fund supports that are day-to-day living costs for people whether or not they have a disability. If one of your goals is to get fit by going to a gym or playing sport, we may fund a support or assistive technology to help you to do these activities, but not the gym membership itself.
Under the Act, supports need to help you take part in activities that will help you with your social and economic life. The supports must show value for money in relation to both benefits of the support and the cost of similar supports. We must also consider what families and other informal supports would usually provide.
To work out whether a support to help your health and wellbeing goal is reasonable and necessary, we look at the information you give us against the NDIS Funding Criteria. You would need to give us evidence, such as assessments from a registered therapist, to show you need the support for your disability needs.
What related supports might we fund?
We may fund things such as:
- transport to and from the gym, if your family or the community can’t provide it and you aren’t able to use public transport independently
- funding for a care worker to help you to use the gym equipment
We can also fund “recreation supports” but only if they relate to your disability. You are still responsible for registration fees, uniforms or any other costs that everyone pays when playing sport, whether or not they have a disability.
Sue’s genetic condition causes intellectual disability, behavioural and learning issues. She wants to improve her personal fitness. She has been unable to join a gym as most gyms can’t accept a member who needs someone supporting her at all times while she exercises.
Sue applies for funding for gym membership and for a support worker to help her at the gym.
To work out whether the funding for gym membership and for a support worker is reasonable and necessary for Sue, the planner looks at the information provided against the NDIS Funding Criteria. When deciding if the supports are reasonable and necessary, the planner thinks about such things as whether:
- the supports are needed solely and directly because of Sue’s disability needs
- funding for Sue’s gym membership and support worker is value for money in relation to both benefits of the support and the cost of similar supports
- an exercise program is likely to help Sue improve her fitness and become more independent in physical activity.
- Sue is able to take part in other exercise programs, for example walking groups
- the gym membership is a day-to-day living costs not directly related to Sue’s disability support needs
In Sue’s case the planner decides:
- there is enough evidence from an exercise physiologist that taking part in her gym program is likely to have long term benefits for Sue, which may include reducing her need for support in future
- the need for a support worker to help Sue to improve her personal fitness at the gym is needed solely and directly because of Sue’s disability needs
- using a support worker to help Sue access and use the gym represents value for money in relation to both the benefits of the support and the cost of alternate available supports
- the cost of the gym membership is a day-to-day living costs not solely and directly needed due to Sue’s disability support needs. It is a cost that anyone would have to pay for regardless of their disability needs.
It Sue’s case the planner decides:
- funding for gym membership is not reasonable and necessary, and funding was not approved
- if Sue chooses to self-fund her gym membership, we will fund a support worker to help her pursue her personal fitness goal and use the gym equipment.
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