Q and A - 7 May
When the NDIA receives your completed access request and required evidence, it is assessed against the NDIS Act (2013)
The NDIS Act is the law delegates use to make access decisions. The legislation guides access decision making and lists the criterion, which must be considered to assess Scheme eligibility.
The delegate considers your access request and the evidence you provide against the criterion. You may be asked to provide additional evidence to help the delegate finalise the decision.
You can find out more about the criterion Delegates use to make access decisions in our Operational Guidelines, under Access to the NDIS.
Providing high quality evidence of disability will support the NDIA to make an access decision. It involves providing evidence, which is:
- Completed by a treating health professional who is relevant to your primary disability
- Confirms your primary disability
- Confirms the impacts of your disability on the different areas of your life
- Describes previous treatments and outcomes, and
- Describes future treatment options and expected outcomes of those treatments.
Your primary disability is the one, which has the most impact on your everyday life.
You can find out more about providing evidence of disability.
With your consent, the NDIA can get evidence of your age and residence from Centrelink records.
It is not possible, at this stage, for NDIA to get evidence of your disability (i.e. copies of reports, assessments or medical information) from Centrelink or Medicare on your behalf.
If you need assistance to gather the right evidence to support your access request, you can work with a Local Area Coordinator; staff from your local NDIA office, or ask Access staff for more information.
There are many ways you can provide evidence of disability to support your NDIS access request. It includes asking a treating health professional to complete a supporting evidence form or by providing a copy of existing reports.
When using existing reports as evidence of disability these should be recent; completed by a treating health professional relevant to your disability, and confirm your disability and the impacts it has on your everyday life.
You can find out more about providing evidence of disability.
As part of the NDIS access process you will need to provide evidence to demonstrate you have a permanent disability (or developmental delay). This evidence will be assessed against the NDIS definition of permanence (or likely permanence), which includes disabilities where impacts vary over time but the condition is considered permanent (i.e. Schizophrenia). The NDIS definition of permanence is different from the one used to obtain the Disability Support Pension (DSP), therefore it is possible to receive a DSP and not meet NDIS access criteria.
To demonstrate permanence you will need to provide evidence:
- There are no-known, available and appropriate evidence based treatments likely to remedy (i.e. cure or substantially relieve) your impairment
- No further medical treatment, or review, is required to establish the permanence of your impairment.
If a person has multiple impairments, the NDIA consider the permanence of each one separately.
You can find out more about when a disability is considered permanent in our Operational Guidelines (sections 8.1 and 8.2): Access to the NDIS.
NDIS access guidelines assist people with a disability, families, carers and treating health professionals, to understand access decision making and evidence requirements. These guidelines included List A and List B, which group specific disability types, based on their expected evidence requirements.
- List A includes permanent disabilities likely to meet NDIS disability criteria (Section 24 of the NDIS Act (2013)). Generally, a person with a disability, included on List A, must provide evidence from an appropriate treating health professional to confirm their disability.
- List B includes permanent disabilities, which may meet NDIS disability criteria, depending on the level of impact the disability has on the person's everyday life. Generally, a person with a disability, included on List B, would provide evidence from an appropriate treating health professional to confirm their disability and evidence of the significant impacts of their disability on their everyday life.
However, a Delegate may request additional evidence, beyond List A or B recommendations, based on certain individual circumstances.
If your disability is not included on List A or B; you are under 65 years of age; live in an area where the NDIS has rolled out; have evidence of permanent disability (or you are a child 0-6 years with a developmental delay) and how it impacts your everyday life, you may apply to the NDIS.
I was diagnosed with Multiple Sclerosis (MS) five years ago. I currently work full-time and manage independently at home and in the community. Should I apply for the NDIS now just in case my situation changes?
Every access request is assessed on the evidence provided about current disability related impacts on everyday life at the time of the access request.
If you have a permanent disability, like MS, but are not currently experiencing significant impacts on your everyday life, you are unlikely to meet NDIS access requirements. Consider making an access request in the future if your situation changes.
If you have a child (0-6 years) with a developmental delay, or permanent disability, and are exploring support options, your first step is to contact your local Early Childhood Early Intervention (ECEI) Gateway. This gateway provides children (0-6 years) and their families with a nationally consistent, evidence based, best practice approach to Early Childhood Intervention.
Your ECEI Partner has extensive expertise in early childhood intervention and working with young children and families. They will support you to gather information and create linkages with local community services such as playgroups, day care centres and health programs.
ECEI Partners work closely with you to develop strategies to use at home to support your child's development as part of the best practice approach to early intervention. They may also provide short-term early intervention services to facilitate your child's development towards their milestones. A child who requires a single therapeutic intervention (i.e. speech therapy) would be unlikely to meet NDIS access criteria as mainstream health services would be expected to provide this support according to Council of Australian Government (COAG) principles.
ECEI Partner's also support families of children who need long-term, multidisciplinary, early intervention support. They link with local community services, gather evidence and make NDIS access requests. If there is evidence the child meets NDIS access criteria (disability or early intervention), the ECEI Partner will also assist with developing a NDIS plan.
No. Unless you are a legally appointed representative, you cannot apply to the NDIS on your brother's behalf. A person with a disability must provide consent to make an access request. It may be in writing, verbal or provided using alternative communication methods. Each person should be supported, to the best of their ability, to be involved in making their own access request.
However, you may assist your brother to make his access request with his consent. If a person with a disability chooses, they may nominate a trusted, independent person (i.e. not a disability service provider representative) to assist them with their access request. It may be a friend, family member or advocate chosen by the person. In these cases, the NDIA requires evidence the person with a disability has provided consent for this person to assist them with the access process.
In some circumstances, a person with a disability may have a legally appointed representative (i.e. legal guardian, public trustee, power of attorney, parental responsibility of a child, appointed by the CEO under s74 of the NDIS Act), who may complete the access request on their behalf. The NDIA will need evidence of the legal representative's authority to act on behalf of the person.
After we get an access request and it is determined to be valid, the NDIS must make a decision, or request further evidence, within specific timeframes. During the transition years, the timeframe was generally 42 days after the NDIA got a valid access request. These timeframes increase if we need additional evidence to complete the access decision.
In exceptional situations, an access decision may be prioritised based on specific criteria and progressed within 21 days. These situations may include where a person's accommodation or care arrangements have broken down or they are at imminent risk of harm.
You can find out more about timeframes in the Operational Guidelines, under timeframes for deciding access decisions
There are a few things you can do to help your access request be processed quicker. They are:
- Visit the NDIS website to find out when the NDIS is available in your area and how you can prepare.
- Visit the NDIS website to find out what evidence is likely to be required for, and the most relevant treating professionals for, your disability type.
- Provide any requested evidence within the relevant timeframes.
- Complete a Verbal Access Request and provide all required evidence to the NDIA.
When you receive a letter, saying the NDIA will contact you about your access request, start to get your evidence ready.
You will need to provide evidence of your age and residence (The NDIA can get it from Centrelink with your consent and CRN). You may need to provide evidence of your disability and the way it affects your everyday life.
If you have a legal guardian, you will need to provide evidence of the appointment of this representative.
If you complete an Access Request Form, make sure all relevant sections are completed; the form is signed by the person with a disability (or their authorised representative), and you have provided all the required evidence (age, residence, disability) to support your request.
If you would like the NDIA to use your Centrelink information to verify your age and residence, make sure you provide your consent and Centrelink Reference Number (CRN).
An access decision will be processed quicker the delegate receives a valid access request with all the required evidence. If the access request is incomplete, not valid and/or does not include the evidence needed to make a decision, we will need to request additional evidence from you. The time involved in following up incomplete, invalid access requests and requesting additional evidence will delay the process.
There is no difference in the information collected by a Verbal Access Request or Access Request Form. They are simply two different ways to make an NDIS Access Request, either over the phone (VAR) or by completing a paper form (ARF), which is returned via mail/email.
The same evidence requirements apply to all access requests (VAR or ARF), and it must be provided to the NDIA within 28 days of the access request being made. The NDIA cannot process your access request until it receives all required evidence.
NDIA decisions are reviewable, including access decisions. If a delegate decides you do not meet NDIS access criteria based on the evidence provided, make time to speak to them to understand the reason for the decision. You will also receive a letter, explaining the reasons for the access decision and your review rights.
Based on the reasons provided for the access not met decision, decide whether:
- You make a new access request because you have new evidence about your disability and its impacts
- You request an internal review of the access decision because you do not have any new evidence for consideration.
A request for an internal review of a decision must be made within three months of receiving written notice of the decision from the NDIA. A staff member, not involved in the initial access decision, will complete the review.
Find out more about requesting a review of decision.