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National Disability Insurance Scheme

If you have a disability, and depending on your situation, the National Disability Insurance Scheme (NDIS) may be able to pay for the care and support you need.

The NDIS is managed by the National Disability Insurance Agency (NDIA).

To get help from the NDIS:

  • You must have a disability that's likely to be permanent.
  • You must meet the requirements to become a participant.
  • You live in an area where the scheme is available.
  • You're seeking supports that are most appropriately funded through the NDIS, and are not more appropriately provided or funded through other service systems such as health or education.

For more information visit the National Disability Insurance Scheme website.

National Disability Insurance Scheme

The National Disability Insurance Scheme is a new way of providing support for people with disability, their families and carers. In July 2016 the scheme started in Queensland to help people with disability get the support they need to live an ordinary life and achieve their goals.

NDIS availability

The NDIS is currently being rolled out across Queensland. To find out if the NDIS is available where you live, go to NDIS in Brisbane and surrounds or NDIS in regional Queensland.

Find out more about when the NDIS will be available in your area

Applying for support in Queensland

You can apply for support from the NDIA:

  • in person at your nearest office or
  • by calling the NDIA help line on 1800 800 110.

You can use the NDIS Access checklist  to help work out if you can access the NDIS. 

If you're unsure about contacting the NDIA yourself, a local area coordinator may be able to help.

Accessing the NDIS

You can access the NDIS, if:

  • you're under 65 years of age
  • the NDIS is available in your area
  • you have a disability
  • you are an Australian citizen or meet the applicable VISA requirements
  • you satisfy the residency requirements.

To get care and support, you need to meet the NDIS's access requirements.

Disability requirements

To meet the disability requirements, you need to have an impairment or condition that:

  • is likely to be permanent (lifelong)
  • substantially reduces your ability to do everyday things by yourself, and
  • impacts on your ability to participate effectively in the community without support.

Early intervention requirements

The NDIS has early intervention provisions if supports are needed now to reduce the need for supports in the future. To meet the early intervention requirements you need to:

  • have an impairment or condition (applies to adults and children) that is likely to be permanent (lifelong) and receiving supports now may reduce how much help you will need in the future, or
  • be a child under 6 with a developmental delay that means you usually need more help with care, communication, learning or motor skills than another child of the same age.

The NDIA won't fund supports if they can be more appropriately funded through other service systems such as health or education.

What support is available?

The NDIA manages the NDIS, and their role is to assess your application and work out what help you need with your disability.

This includes:

  • helping you access community services and activities
  • giving you equipment such as a wheelchair or communications device
  • helping you prepare an individualised support plan for your daily needs
  • treating your disability early, so you may need less support later in your life.

Find out more about what help is available.

Your rights

If the NDIA says you're eligible to participate in the NDIS, and to get care and support to help with your disability, then you have the right to:

  • get reasonable and necessary supports to meet your goals
  • have choice and control over the delivery of your supports
  • have a support person help you deal with staff at the NDIA.

Internal reviews of decisions and plan reviews

If you are unhappy with a decision made by the NDIA about:

  • your application to become a participant or
  • the amount of funding and the supports that have been approved, or
  • the nominee that has been appointed for you, then you can apply for an internal review of the decision.

You must apply to the NDIA for an internal review within 3 months of receiving the NDIA decision.

If your circumstances change, and you want your plan to be reviewed before the due date for review you can ask the NDIA for a plan review. To be able to apply for a plan review you must be able to show that there has been a change in circumstances. You can apply for a review of your plan at any time.

If you're unhappy with a NDIA decision

If you're unhappy with a NDIA decision you can ask for the decision to be reviewed (however, not all decisions made by the NDIA are reviewable).

Here are some examples of decisions that can be reviewed:

  • not letting you join the NDIS (become a participant)
  • not funding, or limiting reasonable and necessary supports in your plan
  • refusing to review your plan after a change of circumstances
  • limiting funding because of compensation you have received
  • appointing a nominee for you.

Asking for a NDIA decision to be reviewed

Asking for an NDIA decision to be reviewed is a 2-stage process:

  • Stage 1: Participant asks the NDIA for an internal review.
  • Stage 2: if unhappy with the internal review decision the participant applies to the AAT for an external review.

Time limits apply for internal and external reviews.

Asking for an internal review of an NDIA decision

If you're unhappy with a decision made by the NDIA (and it's reviewable), then you have 3 months to ask for an internal review of the decision.

You can ask for an internal review by:

When asking for an internal review, you need to:

  • clearly state that you're asking for an internal review of the decision
  • explain why you think the NDIA's decision is wrong
  • provide evidence to support your review (such as a letter from your doctor or support worker).

Your request will be the first step in an internal review of the NDIA's decision. After this, the NDIA will conduct the review and you will get a letter or email advising of their internal review decision.

Legal Aid Queensland doesn't give advice about applying for an internal review. Contact a disability advocate in your area for help. Time limits apply.

Legal Aid Queensland may give advice about applying for an external review to the AAT. Contact us  as soon as possible after receiving the internal review decision from the NDIA. Time limits apply.

Asking for a plan review where there has been a change of circumstances

If, during the life of your plan, there is a change in your circumstances you can ask for your plan to be reviewed.

Changes in circumstances can include (but are not limited to):

  • changes in your condition meaning you need more or different care and supports
  • changes in your condition meaning you need more or different assistive technology or
  • you have a new therapeutic assessment which recommends you need more or different care, support or assistance technologies.

It's important to understand that requesting a review of your plan is different from requesting an internal review of a NDIA decision. You can only request a review of your plan if there has been a change in your circumstances.

When asking for a review of your plan you should:

  • Clearly state why you're asking for your plan to be reviewed.
  • Explain what circumstances have changed, and why your plan needs to be changed.
  • Explain why the review is needed before the date due for the regular review of the plan.
  • Provide evidence supporting your request for a review of your plan (such as a letter from your doctor or a support worker).

Your request will be the first step in the review process. After this, the NDIA will decide whether or not to conduct the review. If the NDIA decides not to conduct a review of your support plan, then it will automatically be internally reviewed by the NDIA. A decision by the NDIA to not conduct a review of your support plan is considered a 'reviewable decision'. If you're unhappy with the NDIA's decision not to conduct a review of your plan you can apply to the Administrative Appeals Tribunal (AAT) for an external review. Time limits apply for external reviews.

Legal Aid Queensland can give advice about applying for an external review to the AAT. Contact us  as soon as possible after receiving the plan review decision from the NDIA.

Asking for an external review of an NDIA decision

If you're unhappy with the NDIA's internal review decision, you can apply to the AAT for an external review. This must be lodged within 28 days of the date you received the NDIA's internal review decision. If you apply outside of these time limits your matter may not be heard unless there are good reasons for the delay.

You can apply for an external review:

  • online to the AAT
  • by completing the AAT application form
  • writing to the AAT-send to: GPO Box 9955, Brisbane QLD 4001.

If you're writing and posting your application to the AAT, you must make sure your application arrives at the AAT before the 28 day limit is up.

Disability Advocates

The Department of Social Services (through the National Disability Advocacy Program (NDAP) has given funding for Disability Advocacy Agencies to help people with a disability go through the planning and internal review processes with the NDIA. NDAP agencies are also funded to support people with disability who seek an external review of NDIA decisions through the AAT.

People with disability, carers and their families can use the NDAP Provided Finder to search for advocacy agencies funded by the Australian Government.

How we can help

Legal Aid Queensland (and other Australian Legal Aid Commissions) have been given funding from the Department of Social Services to provide advice and legal representation for people with a disability and their families about external reviews of NDIA decisions to the AAT.

To get legal advice, you should contact us as soon as possible after receiving the internal review decision from the NDIA. We may also be able to provide legal representation, depending on your situation. Contact us for more information.

More information

Find out more about:

Making a complaint

If you're unhappy with the services or conduct of the NDIA you have the right to make a complaint. This is separate from, and in addition to, your right to request an internal or external review of an NDIA decision.

You can lodge your complaint:

If you're unhappy with the NDIA's response to your complaint, you can contact the Commonwealth Ombudsman. You can lodge a complaint by:

You can also contact your local or Federal Member of Parliament.

Acknowledgement—prepared using content attributed to Victoria Legal Aid (www.legalaid.vic.gov.au)

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