Providing evidence of your disability

The NDIA is responsible for determining who is eligible to access the NDIS.

To allow us to determine whether you meet the disability or early intervention access requirements, you may need to provide evidence of your disability or developmental delay for children younger than 6.

This includes information on what your disability is, whether it is permanent and how it impacts your life. 

If the evidence of disability you initially provide doesn't help the NDIA to make a decision about your eligibility for the NDIS, you will be asked to provide more information, which can delay your access to the Scheme.

To help us decide if you are eligible, we recommend providing clear information about your disability and how it impacts your daily life.

What is considered good evidence of disability?

Providing good evidence of disability will help us to make a decision about your eligibility for the NDIS. Good evidence is:

• recent
• 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
• describes future treatment options and expected outcomes of those treatments.

Primary disability refers to the impairment that has the greatest impacts most on your daily life.

Who can provide evidence of your disability?

You can work with your treating health professionals to provide your evidence of disability.

Examples of common treating health professionals include:

• General Practitioner (GP)
• Paediatrician
• Orthopaedic surgeon
• Occupational Therapist
• Speech Pathologist (Therapist)
• Neurologist
• Psychologist
• Psychiatrist
• Physiotherapist

The treating health professional who provides the evidence of your disability should:

• be the most appropriate person to provide evidence of your primary disability; and
• have treated you for a significant period of time (e.g. at least six months).

You can use the information provided on the Types of disability evidence to help you in deciding the most appropriate treating health professional for your primary disability.

If you need help to get the right evidence together Local Area Coordinators (LAC) or early childhood partners can help you.

It's important to remember that the person helping you to gather your disability evidence will not be able to tell you if you meet the NDIS eligibility requirements. Only the NDIA can make this decision.

Children younger than 9

If you are a parent, guardian or representative of a child younger than 9 and you have concerns about your child’s development or disability, you should first speak with your doctor, child health nurse, early childhood educator or other health professional.

After speaking with your child’s health or education professional our early childhood partners can help connect you and your child to the right supports.

Early childhood partners can support you to gather evidence of your child’s disability or developmental delay (for children younger than 6) to make an NDIS access request.

You can contact an early childhood partner in your area.

If you live in an area that doesn’t have an early childhood partner you should first speak with your doctor, child health nurse, early childhood educator or other health professional.

Your child’s health or education professional can provide evidence of your child’s disability or developmental delay to support an NDIS access request.

If you do not have access to a partner, you can also download and complete the NDIS Access Request Form and email it to [email protected] with supporting information.  

What evidence do I need from my treating professional?

This will depend on your primary disability. If you have not had one of the assessments listed on the Types of disability evidence page, your treating health professional will need to provide evidence that:

• You have, or are likely to have, a permanent disability, including information about:
  • the type of disability;
  • the date your disability was diagnosed (if available);
  • how long the disability will last; and
  • available treatments (i.e. medications, therapies or surgeries).
• Your disability impacts your everyday life in the following areas, including a description of how each area is impacted:
  • mobility/motor skills
  • communication
  • social interaction
  • learning
  • self-care
  • self-management.

For some disabilities, information about how your disability impacts you may not be needed. These disabilities are listed in the List A - conditions which are likely to meet the disability requirements .

Your treating health professional can provide evidence by:

• completing the NDIS Supporting Evidence Form
• completing the NDIS Evidence of Psychosocial Disability Form (PDF 482KB) (preferred for primary psychosocial disability)
• section 2 of the Access Request Form, or
• providing existing reports, assessments or letters that show the impact of your disability.

If additional consultation time with your treating health professional is required to prepare evidence of your disability, this may be claimed by the treating health professional via Medicare.

In exceptional circumstances, where you do not have any existing assessments, an NDIA staff member may complete a general standardised functional assessment (such as WHODAS or PEDI-CAT) with you or your authorised representative.

How is an Access Request decision made?

When the NDIA receives your completed Access Request, it will be reviewed against the NDIS Act (2013).

The NDIS Act is the law which guides the NDIS and it states who is eligible to get NDIS support.

At this stage, you may be asked to provide additional evidence to help us complete the decision.

If we need additional evidence it may delay your Access Request decision.

Find out how long this takes in our Participant Service Guarantee.  

For more information on how we consider evidence of disability, visit our Operational Guidelines: Access to the NDIS section.

What happens if you do not, or no longer meet NDIS Access Request criteria?

When an Access Request decision is made, you will be advised of the decision in writing.

The NDIA may identify your supports are best delivered by other service systems.

Find information about supports if you are not eligible for the NDIS.

Your LAC or early childhood partner can support you with information and referrals to available services.

If your previous Access Request was made within the last three months, and additional evidence is available, we can reassess your eligibility based on this new information.

Alternatively, you can ask for an internal review of a decision.

Can I apply for the NDIS again?

We decide if you are eligible for the NDIS based on the current impact of your disability. The impact of your disability on your life may change over time. Changes in a person's disability may result from progression of a degenerative disability (such as Multiple Sclerosis), a recently acquired traumatic injury or accident (such as acquired brain injury) or an unexpected deterioration in your day-to-day function.

If you applied to the NDIS more than three months ago, you can contact us to make a new request.

I am an NDIS participant but have been asked to provide supporting evidence of my disability again. Why?

You must continue to meet the residence and disability or early intervention criteria to continue using NDIS funded supports and services.

During a plan change, we may ask questions around your eligibility. It is a normal part of your NDIS journey for us to check if you are still eligible. It is also a requirement of the NDIS Act.

If you met the disability requirements when you came into the NDIS, you will not need to prove your eligibility each time we change your plan. We will only reassess your eligibility if we receive information that your disability support needs or situation have changed.

If you receive support because you met early intervention requirements, this means your needs are more likely to change.

If we need more information from you, we will let you know what we need and the next steps.