National Disability Insurance Scheme

Who can apply for access to the National Disability Insurance Scheme?

The National Disability Insurance Scheme (NDIS) is for people with a disability. To be part of the NDIS you have to meet the access requirements.

• Age - you must be under 65 years old on the date you apply
• Residency - you must be an Australian citizen, on a permanent visa, or on a Protected Special Category Visa
• Disability - the disability requirements are detailed and this is a summary. Essentially you need to have a disability that is permanent or likely to be permanent. The disability has to substantially reduce your ability to participate in activities, affect your capacity for social or economic participation, and you are likely to need support under the NDIS throughout your lifetime.
• Early intervention requirements - if you don't meet the disability requirements, you may still be able to access the NDIS under the early intervention requirements, if you:
  • have a disability that permanent, or is likely to be permanent, and there is evidence that getting supports now will result in you needing less help in the future and improve or reduce the deterioration of your functional capacity or help your family and carers to keep helping you, or
  • are a child under six years old with a developmental delay and there is evidence that getting supports now will result in you needing less help in the future and improve or reduce the deterioration of your functional capacity or help your family and carers to keep helping you.
    

If you received services funded by Department of Communities and Justice (formerly Family and Community Services) before May 2016, you may be eligible for access to the NDIS even if you don't satisfy these criteria. These services may be things like gardening, home help and caseworkers.

For more information on accessing the NDIS, see:

• Applying to access the NDIS on the NDIS website.
  
• Am I eligible on the NDIS website.
  

How do I apply for the National Disability Insurance Scheme?

You will need to contact the National Disability Insurance Agency (NDIA) and ask for an Access Request Form. If you are already receiving disability supports, you should be contacted by the NDIA.

The Access Request Form asks questions to see if you meet the access requirements. If you already get disability supports, your support provider may be able to provide this information. Otherwise, you may get a doctor or specialist to provide information.

For more information, see Providing evidence of your disability on the NDIS website.

How do I apply for the National Disability Insurance Scheme for my child?

You can apply for access to the National Disability Insurance Scheme (NDIS) for your child if they meet the access requirements. If your child is under six years old, you may use the early intervention requirements. Your child doesn't need to have a formal diagnosis. The NDIA will refer you to an Early Childhood Partner to help you work out your child's needs.

For more information, you can contact the National Disability Insurance Agency on 1800 800 110 or see Offices and contacts in your area on the NDIS website. 

You can still apply for access to the NDIS if your child is aged six or over, but the criteria will be different. A child aged six or over will need a diagnosis of their disability to satisfy the access requirements.

What can I do if I have been refused access to the National Disability Insurance Scheme?

If you have been refused access to the National Disability Insurance Scheme you can ask for a review of that decision. There are two stages of review:

• internal review of a decision done by the National Disability Insurance Agency (NDIA). You must apply within three months of receiving notice of the decision.
  
• review of the internal decision by the Administrative Appeals Tribunal (AAT). If you are not happy with an internal review decision you can apply to the AAT within 28 days of receiving notice of the decision. The AAT can give an extension of time, but you would need to explain why you need an extension.
  

If you would like to ask for a review, you should seek legal advice.

What is a plan?

If you are eligible for the National Disability Insurance Scheme you will be invited to start a plan. The plan includes your statement of goals and aspirations, which includes information about your daily life and what you want to achieve. The National Disability Insurance Agency prepares a plan based on these documents. The plan sets out the funding you will get for disability supports and services. 

Your supports are to assist you to pursue your goals so you should set out all your short-term and long-term goals.

How is a plan changed?

Your plan will have a review date. This is usually every 12 months. It will be reviewed at the end of that period.

You can also ask for your plan to be reviewed at any time. You can use the National Disability Insurance Scheme (NDIS) Change of circumstances form to do this. You can also call NDIS, send an email or use the Participant Portal. 

For more information, see Change in circumstances on the NDIS website.

Who manages the plan?

There are options for how a plan is managed. You can have a:

• self-managed plan - where you find your supports and arrange for them to be paid
  
• plan manager - where you arrange for someone else to manage your plan. If you have a plan manager, you can get additional National Disability Insurance Scheme funding to pay for the plan manager.
  
• plan managed by the National Disability Insurance Agency, known as an agency manager.
  

You can also choose a combination of these options.

For more information, see Managing your plan on the NDIS website.

What decisions can I get reviewed?

If you are unhappy with a decision about the National Disability Insurance Scheme (NDIS) you can ask for an internal review of that decision within three months. This is like an appeal. It is not the same as the review that comes at the end of your plan period or a review that you can ask for if you have a change of circumstances.

Many decisions can be reviewed, including decisions about whether you can access the NDIS and decisions about what is in your plan including what funding for supports are provided.

For more information on what decisions can be reviewed, see How to request an internal review of a decision on the NDIS website.

What is the review process?

There are two stages of review:

• internal review of a decision by the National Disability Insurance Agency (NDIA). You must apply within three months of receiving notice of the decision that you want reviewed.
  
• review of the internal decision by the Administrative Appeals Tribunal (AAT). If you are not happy with an internal review decision by the NDIA, you can apply to the AAT within 28 days of receiving notice of the decision. The AAT can give an extension of time, but you would need to explain why you need an extension.
  

If you would like to ask for a review, you should seek legal advice.

What is an internal review of a decision?

If you are unhappy with a decision by the National Disability Insurance Agency (NDIA) you can apply for an internal review. An internal review is conducted by an officer within the NDIA, but not the same person who made the original decision.

You need to apply for a review within three months of when you were notified of the original decision. If you got a letter telling you of the original decision, you have three months from when you got the letter to apply for a review.

You can request a review by filling in an Request for a Review of a Decision form.

You can also apply for a review by:

• talking to someone at an NDIA office
  
• calling the NDIA on 1800 800 110
  
• sending an email to enquiries@ndis.gov.au
  
• sending a letter to: Chief Executive Officer National Disability Insurance Agency GPO Box 700 Canberra ACT 2601.
  

Before you apply for internal review, you should get legal advice. 

For more information, see Request a review of a decision on the NDIS website.

What is a review by the Administrative Appeals Tribunal?

If you have had an internal review of a decision by National Disability Insurance Agency and you are still unhappy, you can apply for a review by the Administrative Appeals Tribunal (AAT).

The AAT can review decisions like whether someone has access to the National Disability Insurance Scheme, what supports are in a plan or whether to review a plan.

You can apply by:

• lodgin an application for review online. See apply online, on the AAT website.
  
• filling out an Application for Review of Decision (Individual). You can get a copy from the NDIS review forms page on the AAT website. You can also ask the AAT to send you one
  
• writing a letter to the AAT.
  

If you decide to write a letter you should include information about the decision and why you are appealing. 

For more information, see How to apply on the AAT website.

You must apply within 28 days after you are notified of the decision that you want reviewed. The AAT can extend this time limit if they think it is reasonable. To apply for an extension of time, you will need to fill out an Application for Extension of Time for Making an Application for Review of Decision form. You can get a copy from the NDIS review forms page on the AAT website.

The AAT will appoint a Contact Officer who will contact you to tell you what will happen with your application. There will often be a case conference to discuss your case and see if you can come to an agreement with the NDIA. If there is no agreement, there will be a hearing and the AAT will make a decision. 

For more information on the steps involved at the AAT, see:

• National Disability Insurance Scheme (NDIS), and
• AAT Practice Direction Review of National Disability Insurance Scheme Decisions on the AAT website.

You may be able to get help with your review. There are services funded by the Australian Government to help people applying for a review of a NDIA decision. You may be able to get help from a disability advocate or you may be able to get legal help from Legal Aid NSW. 

For more information on appeal supports, see NDIS Appeals program on the Department of Social Services website.  

Do consumer laws apply for goods and services purchased through the NDIS?

The Australian Consumer Law (ACL) applies to goods and services purchased through the NDIS. These rights are called 'consumer guarantees.'

Businesses must guarantee the goods and services they sell, hire or lease for:

• under $100,000 (or $40,000 if supplied before 1 July 2021)
• over $100,000 (or $40,000 if supplied before 1 July 2021) that are normally for personal or household use.

For more information, see Consumers with disabilities on the NSW Fair Trading website and Your consumer rights: a guide for consumers with a disability on the Australian Competition and Consumer Commission website.

What can I do if I am not happy with a disability service or support?

If you are not happy with a disability service or support, you can:

• make a complaint directly to the disability service. Set out your problem and explain why you would like them to fix the problem.
  
• contact a Community Justice Centre (CJC). CJCs are a free government mediation service. They can help you try to come to an agreement with someone else.
• make a complaint to the NDIS Quality and Safeguards Commission. The Commission deals with complaints about NDIS service providers. For more information, see For Participants – Make a complaint on the NDIS Quality and Safeguards Commission website.
• make a complaint to NSW Fair Trading. If you are unhappy with any service you have purchased in NSW, you can make a complaint to NSW Fair Trading. NSW Fair Trading can help you try to negotiate with the seller. You can make a complaint to NSW Fair Trading about any goods or services you purchase, not just disability services. 

For more information about what you can do, see the FAQ below 'What can I do if I am not happy with goods and services I buy?'.

What can I do if I am not happy with goods and services I buy?

Depending on the circumstances, you can ask for the repair, return, replacement or a refund if you buy a good or service and it is:

• not an acceptable quality, for example, goods are broken or services are not provided well
  
• doesn't match the description
  
• not fit for the purpose it was sold
  
• doesn't fit any special promised conditions.
  

The first step is usually to contact the seller. You may do this in writing or by phone. Explain your problem and suggest a solution. 

If you can't fix the problem yourself, NSW Fair Trading may be able to help you with your complaint. NSW Fair Trading may be able to help you try to negotiate with the seller to come to a solution.

For more information, see Make a complaint on the NSW Fair Trading website.

If your complaint still is not resolved, you may apply to the NSW Civil and Administrative Tribunal (NCAT). NCAT has a special division that decides consumer claims. You can apply online on the NCAT website or download an application form from the website. There is an application fee, but you can apply for reduced concession fees. You have three years to apply to NCAT about a consumer claim to do with goods and services. 

For more information, see the Time Limits section of this topic.

For more information on making a consumer claim to NCAT, see Consumer claims on the NCAT website.