Eligibility and early intervention FAQ

FAQs GPs and other health professionals ask about eligibility and early intervention.

Before supporting a patient to complete an access request, we recommend using this 6-point checklist to check their suitability for the Scheme:

Generally speaking, patients must meet three requirements:

AGE – be aged under 65 years
RESIDENCE – reside in Australia and be an Australian citizen, or hold a Permanent or Protected Special Category Visa
DISABILITY OR EARLY INTERVENTION – have a physical, intellectual, cognitive, neurological, visual, hearing or psychosocial impairment that meets either the disability or early intervention requirements.

Your patient must have a physical, intellectual, cognitive, neurological, visual, hearing or psychosocial impairment that:

is (or is likely to be) permanent
substantially reduces their ‘functional capacity’ in one or more of the following areas: mobility, communication, social interaction, self-management, learning and self-care
restricts their ability to participate in work/study, engage with peers and/or interact with their wider community (i.e. has a clear social and/or economic impact)
requires lifelong NDIS support.

Full guidance can be found in the Access to the NDIS Operational Guideline.

For the purposes of the NDIS, ‘substantially reduced functional capacity’ means that on most days, a person’s impairment significantly limits their ability to manage/perform ordinary activities of daily living across a range of tasks in one or more of the following areas: mobility, communication, social interaction, self-management, learning and self-care.

These six areas are referred to as functional domains.

Mobility and motor skills	e.g. moving about the home or community, getting in and out of bed or a chair, fine motor skills, gross motor skills.*
Learning	e.g. understanding and remembering information, learning new skills, practicing and using new skills.
Communication	e.g. being understood in spoken, written or sign language, understanding others and expressing needs and wants by gesture and speech (age-appropriate).
Self-care	e.g. showering/bathing, getting dressed, eating or preparing meals, caring for own health
Social interaction	e.g. making and keeping friends, interacting with peers or the wider community and coping with related feelings and emotions.
Self-management	e.g. doing daily jobs, making decisions, problem-solving and managing money

*Only includes issues that cannot be solved by commonly used items such as glasses, walking sticks, non-slip bathmats, grab rails and hand-rails installed at stairs.

If an impairment is permanent but its functional impact fluctuates and/or is still in its early stages but expected to worsen over time (e.g. multiple sclerosis), your patient may not meet the disability requirement outlined above. However, they may meet the Scheme’s early intervention requirements instead. Children with developmental delay are also eligible for early intervention supports.

The purpose of early intervention is to lessen the impact of a person's impairment upon their functional capacity by providing support at the earliest possible stage. Early intervention support is also intended to benefit a person by reducing their future need for supports and by strengthening the sustainability of their informal supports, e.g. building the capacity of their carer.

Refer children under 7 years old with developmental delay or disability to an NDIS early childhood partner for assessment. They will support the family to apply for the NDIS if appropriate.

Refer patients 65 years and over who are looking for disability services and support for the first time to My Aged Care .

Local Area Coordinators (LACs) are local organisations that help deliver the NDIS in the community.

This includes assisting NDIS participants to create, implement and review their support plans.

Pre-access, LACs can provide patients with general information about the NDIS, so they can make an informed choice about whether or not to apply for NDIS funding and supports.

LACs can then guide the patient through the process of making an access request. LACs can also help identify whether the supports the patient requires are best provided by the NDIS or other mainstream providers.

For children under 7 with a developmental delay or disability, refer the family to an Early Childhood Partner instead.

These local organisations co-ordinate short-term support for children under 7. If the child requires long-term support, the Early Childhood Partner will assist the family to make an NDIS access request.

Refer all children under 7 years of age to an Early Childhood Partner in the first instance.

To direct a patient to a LAC or Early Childhood Partner in your local area, please refer to the partner map for your state:

There are a number of other professionals – both within and beyond your practice environment and from both a health and non-health background – who can help you in your efforts to support patients as they navigate access to the NDIS.

Please see our ‘Who can help?’ brochure for more information: