On this page:
- How to request an internal review of a decision
- What happens next?
- What if you are still dissatisfied after the internal review of the decision?
- What if I have concerns about the decision-making process?
- Further guidance on NDIS planning decisions.
- How were the levels decided?
- The expectation of levels of funded supports
If you think a decision made by the National Disability Insurance Agency (NDIA) has made about you is wrong, you can submit request an application for internal review of a decision. Any person directly affected by a decision of the NDIA can request such an internal review.
There is a list of ‘reviewable decisions’ in the NDIS legislation. If the NDIA makes a decision about you that is on this list, you can request an internal review of that 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.
When you are told about an NDIA decision, you will be told how to request an internal review. 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. They may want to talk to you directly as part of this process.
How to request an internal review of a decision
You can make a request for internal review of a decision by:
- submitting a written request to:
Chief Executive Officer
National Disability Insurance Agency
GPO Box 700
Canberra ACT 2601
- talking to someone at an NDIA office
- calling 1800 800 110
- sending an email to: firstname.lastname@example.org.
When you ask for a review, explain why you think the decision is incorrect.
Visit the Review your access decision page to download the application form. You don’t have to use this form but it can help you describe why you want an internal review of the decision.
What happens next?
A NDIA staff member, responsible for the internal review, will make a decision to confirm, vary or set aside and substitute the earlier decision. This decision will be made as soon as reasonably practicable.
What if you are still dissatisfied after the internal review of the decision?
If you are still not happy after the internal review of the decision, you can apply for a Administrative Appeals Tribunal (AAT) review. The AAT is an external independent tribunal.
You cannot ask the AAT to review a NDIA decision until the NDIA has internally reviewed it.
For information about applying for an AAT review, visit the AAT website (external) (External website) or call 1800 228 333.
What if I have concerns about the decision-making process?
If you are not satisfied with the way the NDIA carried out its decision-making, or how the NDIA dealt with you during the review process, you can make a complaint.
Further guidance on NDIS planning decisions.
The National Disability Insurance Agency (NDIA) is adding better guidance for planners and participants in some of its operational guidelines. This will help to increase the efficiency of our planning process and improve decision making consistency.
The extra guidance will help direct NDIA decisions on some funded supports, those identified as being important to a participant's goal achievement.
Now the operational guidelines give more direction about the expected funded support levels in the following areas:
- personal care supports
- recreational supports
- supports for sustaining informal support
- supports for early childhood; and
- household tasks.
NDIA decision makers will still look at a participant’s individual circumstances when deciding on the right levels of support. The decision makers will also decide when funding should differ from the expected levels, which are set out in the Operational Guidelines.
How were the levels decided?
The NDIA reviewed other Scheme arrangements, including disability support systems for providing assistance for people with high needs. It also consulted with relevant organisations and representatives.
The information about expected levels of supports must consider the experience of people with disability, their families and carers. The NDIA met with peak associations and individuals to help create the expected levels.
As part of applying the expected levels in decision making at trial sites, the NDIA listened to and learnt from participants' experiences. The NDIA will continue to review the expected levels of support, using feedback and consultation to remove barriers which may get in the way of participants being able to reach outcomes in their plans.
The NDIA is focused on building an effective and sustainable NDIS. This will include trialling new ways of doing things and learning what works and what doesn’t. As part of its continuous learning approach, the NDIA will use what works and continue to learn to improve the Scheme.
The expectation of levels of funded supports
NDIA staff make decisions based on the National Disability Insurance Scheme Act 2013 (NDIS Act) (External website) and the rules made under the NDIS Act. The Operational Guidelines also provide practical guidance for decision makers.
Adding further guidance to some of the Operational Guidelines about supports in the plan will help:
- give participants, their families and carers access to information about what to expect in the NDIS funded support levels;
- guide NDIA staff to make consistent decisions when identifying reasonable and necessary supports; and
- assist in ensuring the NDIS' financial sustainability.
The NDIA is clear the expected levels of some funded supports are not caps but rather expected levels of funding a participant might have in their plan.
In some circumstances, a participant’s plan might need higher levels of supports, where they are in line with their goals and outcomes. The Operational Guidelines include information about what can be considered above the expected levels of funding in individual circumstances.