National Disability Insurance Scheme

About the NDIS

The NDIS is an Australian government initiative designed to provide support and funding to individuals with significant and permanent disabilities. The NDIS aims to help people with disabilities achieve greater independence, improve their quality of life, and participate more fully in their communities.

The scheme offers funding for a wide range of supports and services, including personal care, therapy, and assistive technology. It also connects participants with community services and activities, such as sporting clubs, support groups, and educational programs.

Eligibility

To be part of the NDIS you have to meet the following access requirements. You must:

• be under 65 years old .
• be an Australian citizen, have a permanent visa or on a Protected Special Category Visa.

You may be elgible under the disability requirements if you have a disability caused by a permanent impairment. The impairment may be intellectual, cognitive, neurological, sensory, physical, or psychosocial. The disability must impact your ability to do daily life activities and affect your social life, work and study. You must be likely to need NDIS  throughout your lifetime. 

If you don't meet the disability requirements, you may still be able to access the NDIS under early intervention requirements, if you:

• have a disability that permanent or is likely to be permanent, or
• are a child under six years old with a developmental delay and there is evidence that getting NDIS supports now would mean you’ll need less help in the future and improve your functional capacity.

You may be eligible under both the disability and early intervention requirements.

The support you need must be an ‘NDIS support’. NDIS supports are services, items and equipment that can be funded by the NDIS.

For more information on accessing the NDIS, see Applying to access the NDIS and Am I eligible on the NDIS website. 

Applying for the NDIS

To apply for the NDIS, 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.

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

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.

To assess whether you meet the early intervention or disability requirements, or both, you may need to provide evidence of how your disability or developmental delay for children under 6 years old, impacts your daily life.

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

If you need assistance with your application or gathering the required documents, NDIS partners can help. When you apply, NDIS may connect you to an NDIS partner from a community-based organisation.

After you apply NDIS will make a decision and notify you within 21 days.  If you’re eligible, you’ll become a participant and NDIS will start creating your plan.

On 3 October 2024 changes to the NDIS legislation came into effect. For all NDIS applications received on or after this date, the current version of the legislation will be used to make an access decision. If your NDIS application was received before 3 October 2024, they will use the previous version of the legislation to make an access decision.

For more information, see the guidelines for  Applying to the NDIS on the NDIS website.

Applying for NDIS for your child

You can apply for access to the 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.

If you have a child younger than 9, an early childhood partner can provide supports to children before they apply, and let families know if the NDIS is right for their child. 

NDIS plans

 If you are eligible for the NDIS you will be invited to start a plan. The plan includes your statement of goals and aspirations, which has information about your daily life and what you want to achieve. The NDIA prepares a plan based on these documents. Your plan sets out the funding you’ll get for NDIS supports. 

Your supports are to help you reach your goals, so you should include all your short-term and long-term goals.

NDIS Supports

Your NDIS plan explains the type of funding that pays for the supports you need. Your plan will include NDIS supports for the impairments that meet the disability and/or early intervention requirements.

From 3 October 2024 changes to the NDIS legislation regarding supports and plans affect new and existing participants:

• You can only use your NDIS funding for items listed as approved NDIS supports.
• In some circumstances, NDIS may agree that you can spend your funding on supports that are not NDIS supports. You may be able to request a substitution from the replacement support list.  
• There is also a ‘transition period’ for the first year of the new NDIS supports lists to ensure participants aren't penalised for minor mistakes. 

For a list of the supports that NDIS funding can and cannot cover, including replacement support lists, see What does NDIS fund? on the NDIS website.

From the 1 January 2025 all new participants will receive an impairment notice when they access the NDIS. This notice will list the impairments that meet the disability and/or early intervention requirements, Current participants will receive a notice of impairments prior to their transition to new framework plans. 

Changes to plans 

Your plan will have a reassessment date, usually every 12 months.  Some participants may request a longer plan ( up to three years), if their support needs are unlikely to change.  

At the end of that period, NDIS will schedule a check-in to see how you are going with your goals and whether you have the right NDIS supports or any changes are needed.

For more information see Preparing for your plan reassessment on the NDIS website.

You can also change your plan by asking for:

• a plan reassessment  at any time, or
• a plan variation without a full reassessment, if it’s a minor change.

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

To do this you can download and complete the Change of details or change of situation form from the NDIS website, call NDIS, send an email or use the Participant Portal. 

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

Managing the plan

The NDIS will ask you who you want to manage your funding. You have different options for how your NDIS plan is managed. You can have a:

• Self-managed plan: you find your supports and arrange for them to be paid.
• Plan manager:  you choose someone else to manage your plan. If you use a plan manager, you can get additional NDIS funding to pay for the plan manager.
• NDIA-managed plan: NDIA manages the funding and pays your providers. This is known as an agency managed funding.

You can also choose a combination of these options.

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

You can use the funding in your plan to buy NDIS supports if they are related to your disability and are in line with your plan, whether your plan is self-managed, done by a registered plan manager, or the agency. Spending in line with your plan means only spending your funding on the supports included in your plan. To spend in line with your plan, you need to:

• spend the funding as described in your plan, including for any stated supports, which are supports that NDIS says you can buy more specifically
• make sure your funding will last for the whole length of your plan
• spend within the funding periods and funding component amounts,if listed in your plan.

From 3 October 2024, new NDIS laws may affect self-managed participants. When deciding your plan management type NDIS will consider if you or your nominee have been convicted of an offence punishable by two years or more or involving fraud or dishonesty. If you self-manage or use a registered plan manager, the NDIA may change your plan management if they believe you or your manager won’t spend your NDIS funds in line with your plan.

For more information, see  What are your options for managing your funding? on the NDIS website.

Appealing an NDIS decision

If you are unhappy with a decision about the NDIS, you can ask for a review of that decision. 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.

There are two stages of review:

• internal review of a decision by the NDIA
• review of the internal decision by the Administrative Review Tribunal (ART), if you are not happy with an internal review decision by the NDIA.

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

Internal review by the National Disability Insurance Agency

If you are unhappy with a decision by the  NDIA you can apply for an internal review.

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.

An internal review is conducted by an officer within the NDIA, but not the same person who made the original decision.

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.

Review by the Administrative Review Tribunal

If you have had an internal review of a decision by the NDIA and you are still unhappy, you can apply for a review by Administrative Review Tribunal (ART).

The ART can review decisions like whether someone has access to NDIS, what supports are in a plan or whether to review a plan. 

You can apply by:

• lodging an application for review online using the ART Online Services 
• filling out an Application for Review of Decision (Individual). You can get a copy from the Forms page on the ART website. You can also ask the ART to send you one
• calling the ART on 1800 228 333
• emailing reviews@art.gov.au 
• sending a letter to the ART 
• visiting the ART at Level 6, 83 Clarence Street, Sydney. 

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

For more information, see National Disability Insurance Scheme on the ARTwebsite. 

After you make an application for a review, you will receive a letter from ART explaining the next steps. The NDIA will receive a copy of your application. 

For more information, see After applying on the ART 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. 

Problems with NDIS-funded goods and services 

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.

Disputes about a disability services 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 how you would like them to fix the problem.
• 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. 

Repairs, returns, and refunds 

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

• not of 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 service provider or seller. You can do this in writing or by phone. Explain your problem and suggest a possible solution. 

If you can't fix the problem yourself, NSW Fair Trading may be able to help you with your complaint and help you try to negotiate 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 on making a consumer claim to NCAT, see Consumer claims on the NCAT website.