Access to the NDIS

12. What happens when an access decision is made

12.1 Prospective participants who meet the access criteria (becoming a participant)

A person becomes a NDIS participant on the day the NDIA decides that the person meets the access criteria (section 28(1)).

Once a decision is made under the NDIS Act that a person is a participant of the NDIS that person usually remains a participant for life. However, in some circumstances a person may cease being a participant.

12.2 What happens once a person has become a participant?

Once a person has become a participant, their supports, if any, will be determined in accordance with the NDIS Act and the National Disability Insurance Scheme (Supports for Participants) Rules 2013.

Where necessary, decisions under the NDIS Act (for example, about supports) will be made with a nominee or a child's representative (rule 2.8 of the Becoming a Participant Rules).

If a person becomes a participant in the NDIS, the NDIA must facilitate the preparation of the participant's plan in the timeframe specified in the NDIS rules, or if there is no such timeframe specified within the rules, as soon as reasonably practicable (section 32).

For more information about the planning process for participants, please refer to the Planning Operational Guideline.

12.3 Prospective participants who do not meet the access criteria

Prospective participants who do not meet the access criteria do not become participants in the NDIA. However, these persons may be able to access general supports as non-participants.

The NDIA is particularly conscious that prospective participants who are currently accessing Commonwealth, state or territory disability services but who do not meet the access criteria may need assistance to access supports from Commonwealth, state and territory schemes to ensure continuity for their supports.

12.4 Requirement to notify a prospective participant of the access decision

The NDIA must notify a prospective participant in writing of the decision that they meet the access criteria, and include in the notice the date on which the person became a participant (section 28(2)).

A decision that a prospective participant does not meet the access criteria can be reviewed and is known as a reviewable decision (section 99(a)).

The NDIA must notify the prospective participant in writing of the decision that they do not meet the access criteria, including a statement to the effect that the person may request that the NDIA review the decision (section 100(1)).

Where possible, the NDIA will also attempt to contact the prospective participant by telephone to advise them of the decision which has been made (section 7(2)).

12.5 Protected participant status

The personal information concerning a prospective participant seeking access to the NDIS is available to NDIA staff on a needs-to-know basis (see Operational Guideline - Information Handling).

However, the identity of some participants can be further protected by assigning a 'protected status' to the participant's record. This additional level of protection ensures that a participant's personal information can only be accessed by specific NDIA staff.

Where appropriate, the NDIA will inform a participant of this additional level of security available to them. For example, a protected status may be appropriate for:

  • public figures and their family;
  • people subject to a legal order, for example, where child protection or family violence orders are in place; or
  • NDIA staff or NDIA board members and their family.