The NDIA is responsible for determining who is eligible to access the NDIS. To allow the NDIA to determine whether you meet the disability or early intervention access requirements, you may need to provide evidence of your disability as part of your access request. This includes information on what your disability is, how long it will last 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 the NDIA make a fast decision, we recommend providing clear information about your disability and how it impacts on your daily functioning.

What is considered good evidence of disability?

Providing good evidence of disability will support the NDIA 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 impacts most on your daily functioning.

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).

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 your evidence together Local Area Coordinators (LAC) 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 requirements; only the NDIA can make this decision.

Children (0-6 years)

If you are a parent, guardian or representative of a child aged up to six years who may benefit from early intervention or disability support under the NDIS, you should contact an Early Childhood Partner in your area.

Early Childhood Partners can support you to gather evidence to make an NDIS access request.

What evidence do I need from my treating professional?

This will depend on your primary disability. If you have not undergone 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; or
  • Part F 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, a staff member from the NDIA 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.

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 meet NDIS Access Request criteria?

When an Access Request decision is complete, 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 your new information. Alternatively, you can ask for a formal review of the original Access Request decision.

Can another NDIS Access Request be made at a later date?

NDIS Access Request decisions are made 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 a person's day-to-day function.

If your previous Access Request was made more than three months ago, you can contact the NDIA to make a new request.

This page current as of
16 January 2019