How do we decide if you’re eligible?

Once we have your application, we review all the information we have in your application.

This will help us decide if you’re eligible for the NDIS. As part of the process, we will also need to check your identity.

You are eligible for the NDIS if you meet:

If you’re 7 or older, the first thing we decide is whether you meet the disability requirements. If you don’t, we will then decide whether you meet the early intervention requirements.

For children younger than 7, it’s the other way around.

First, we’ll decide whether they meet the early intervention requirements. If they don’t, then we will decide whether they meet the disability requirements. 

It’s likely children younger than 6 with developmental delay will not meet the disability requirements. So they may only be eligible under the early intervention requirements.

If you don’t meet either the disability requirements or the early intervention requirements, you won’t be eligible for the NDIS. But an early childhood partner or local area coordinator can help you connect with other government and community supports.

When will we decide if you’re eligible?

Once we have your application, we have 21 days to decide one of the following: 

We can make a decision quicker in urgent circumstances. Let us know if your situation is urgent, for example, if you’re about to leave a hospital or custodial setting.

Learn more about our timeframes for urgent decisions.

How do we consider your evidence of disability?

When we’re deciding if you’re eligible, we may look at things like:

  • how old your evidence is
  • who provided your evidence.

If we get more than one type of evidence from you, we might consider some evidence over others.

We call this weighing evidence. 

What if we need more information to decide if you’re eligible?

When we decide if you’re eligible, we look at:

  • the information in your NDIS application
  • any other information we have.

We need enough information in your application to show us you’re eligible for the NDIS by meeting the disability requirements or the early intervention requirements.

Sometimes we might need to ask you for more information. For example, we may not have enough information about your functional capacity.

We’ll ask you for more information if we need it to make sure we have the full picture.

We might ask you for more information if:

  • your application doesn’t have all the information we need
  • we need to answer a particular question.

We only ask for more information if we need it to decide if you’re eligible. If we need more information, we’ll let you know:

  • what you need to do
  • what information we need
  • when you need to give us the information.

If we ask for more information, you’ll have at least 90 days to give it to us. We can’t decide if you’re eligible until we have this. You can ask for more time if you need it. We can give you more time if we think it’s reasonable for your situation. 

If we can’t contact you within 90 days, or you don’t give us the information within the timeframe, we’ll withdraw your application. This means we’ll stop processing your application.

If you don’t get the information to us in time, you can apply again.

What happens after we get your information?

Once you give us the information we need, we then have 14 days to decide if: 

  • you’re eligible for the NDIS
  • you’re not eligible for the NDIS
  • we need more information – for example, if the information you gave us isn’t what we need.

What happens if we don’t decide on time?

If we don’t meet our decision-making timeframes, we have to treat this as if we decided you’re not eligible. 

If this happens, we’ll automatically review this decision that you’re not eligible. We’ll send you a letter to explain this. You don’t need to do anything.

We’ll then make sure your application is reviewed by a staff member who wasn’t involved in the original application. We’ll contact you to let you know the outcome.

Learn more about reviewing our decisions.
 

This page current as of
27 October 2023
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