Introducing the National Disability Insurance Scheme
The National Disability Insurance Scheme provides individualised support for people with permanent and significant disability, as well as their families and carers.
The primary purpose of the NDIS is to change the lives of people with disability, their families and carers for the better, enabling them to fully participate in the social and economic life of the nation and to live ordinary lives. (NDIS Corporate Plan 2013-16)
The NDIS website has a wealth of information and we highly recommend you become familiar with the content in depth. In particular, the information around eligibility, access and planning are important.
If your child is aged 0-6 years, they will access the NDIS via the Early Childhood Approach.
You can apply by either
The most important thing you need to know is that you DO NOT NEED A FORMAL DIAGNOSIS to start accessing some help.
If you call the NDIS , they will give you the number of an Early Intervention Partner in your local area. These are community organisations that are paid by the Government to help you and they can be searched by postcode here. These organisations often have a range of services from therapies to workshops and other activities that you can access after being approved for early intervention.
These organisations will appoint an early childhood coordinator to manage your application and help you access funding and services. While they work for the early childhood partner they’re like the middleman between you, the NDIS and ECEI Partner. They’re your advocate and will step you through the process, help you fill out and submit your paperwork. They generally have some experience with child developmental delays and their role is to help you get what you need. They’ll ask about medical histories, family relationships and basic questions about what kind of functions or activities your child can do.They’ll ask you to send through any reports you have on your child whether they be medical or psychological. They’ll want as much information as you can give them and they might also ask your permission to speak to your gp or therapist.
The process to access funding
NDIS access checklist
Access Request Form
Once The Plan Is In Place
Accessing the NDIS
To become an NDIS participant you must:
Preparing for your NDIS planning meeting
Attending an NDIS planning meeting can be daunting. Preparation is the key. Completing a pre-planning workbook can help to prepare you for the planning conversation.
Association for Children with a disability have a NDIS planning workbook specifically for use by parents.
Goals and Aspirations
You will be asked to identify Goals and Aspirations as part of your NDIS planning conversation. Use the SMART acronym to ensure your goals are:
Tips for your planning meeting
It’s important to know: If you don’t agree with the funding you or your child is allocated by the NDIS, you do not have to accept it. You can request a review of the decision.
However, reviews can be time consuming and emotionally draining. The better prepared you are during the planning process, the more likely you are to secure the reasonable and necessary supports that you need without the need for review.
What kinds of supports can be funded under the NDIS?
Before the NDIS planner or Local Area Coordinator makes a decision on what supports might be funded in a participant’s NDIS plan, they will take into account a participant’s network of informal supports (family and friends), mainstream supports (health, mental health, education) and community supports.
The NDIS will fund reasonable and necessary supports to help participants to reach their identified Goals and Aspirations.
‘Reasonable and Necessary’ are three very important words in the NDIS. It’s not as simple as whether a support might be ‘needed’, it has to meet Reasonable and Necessary criteria outlined in the NDIS Act 2013.
Pursue Goals and Aspirations
Increase social and economic participation
Develop capacity to take part in the community
Take into account informal supports given by family, carers, networks and the community
Be related to your disability
Not include day to day living costs
Represent value for money
Be likely to be effective and beneficial
The types of supports that the NDIS can fund fall into three broad support purposes: Core, Capacity and Capital. These could include:
The NDIS will not fund a support if it:
Options for managing the funded supports in your plan
There are 4 ways to manage the funding in your plan:
NDIA agency Management
Self Management gives you maximum control over, and responsibility for, your NDIS funds. It allows you to use your preferred service providers, including both registered and non-registered providers of support. You can make decisions in line with your plan goals, including paying above the NDIS price guide limits or bargaining for a better deal from providers.
Plan Management gives you increased control over how your plan is used. The financial intermediary helps you to pay your NDIS support providers by processing claims and paying invoices on your behalf. Using a plan manager allows you to use registered and non-registered providers of supports, however you need to stick to the price limits determined by the NDIS price guide.
NDIA Agency Management gives access only to registered providers of NDIS supports. Registered providers claim for services provided directly from the NDIA provider portal. You can access the MyPlace participant portal to see what claims providers are making against your NDIS funds and monitor expenditure. Registered providers are only able to charge in accordance with the NDIS Price Guide.
A combination of any of the methods of management might suit you. For example, NDIA agency management of Improved Daily Living will allow your Allied Health professionals (speech, OT, Psych) to claim directly for therapy services, while self-managing Core supports could give you the choice and control to directly engage a team of support workers to help around the home and in the community and stretch your budget further.
What to do if you are unhappy with an NDIA decision
If you think a decision made by the National Disability Insurance Agency (NDIA) is wrong, you can submit an application for a review of a reviewable decision.
Many decisions made by the NDIA are reviewable, including things like being accepted as a participant, the provision of reasonable and necessary supports, and becoming a registered provider of supports.
A request for internal review of a decision must be made within three months of receiving notice of the decision from the NDIA. The staff member who works on the internal review will not have been involved in the earlier decision.
You can use the disability advocacy finder to search for NDIS Appeals providers and disability advocacy agencies across Australia.
What if you are still unhappy after an internal review by NDIA
If you are still not happy after an internal review of the decision, you can apply for a review by the Administrative Appeals Tribunal (AAT). You cannot ask the AAT to review a decision by the NDIA until the decision has been internally reviewed by the NDIA.
For information about applying for a review by the AAT, see AAT: National Disability Insurance Scheme applicants or call 1800 228 333