Providing evidence of your disability

What is considered good evidence of disability? | Who can provide evidence of your disability? | What evidence is needed from your treating professional? | How is an access decision made? | What happens if you do not meet NDIS access criteria? | Can another NDIS access request be made at a later date?

The National Disability Insurance Agency (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; and
  • describes future treatment options and expected outcomes of those treatments.

Primary disability referes 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.

A treating health professional may be a:

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

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 'Disability evidence from your treating health professional' page 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) are available to assist 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 NDIS Early Childhood Partner in your area.

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

What evidence is needed from your treating professional?

This will depend on your primary disability. If you have not undergone one of the assessments listed on the 'Disability evidence from your treating health professional' page from your treating health professional 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.

Note: 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 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 states who is eligible to receive support from the Scheme.

At this stage, you may be asked to provide additional evidence to help us complete the decision. If additional evidence is required it might delay the access decision.

You can find out more about how we consider your evidence of disability in our Operational Guidelines: Access to the NDIS.

What happens if you do not meet NDIS access criteria?

When the access decision is complete you will be advised in writing of the decision.

If you do not meet NDIS access criteria you may be able to access mainstream and community supports. Information and referral to these supports can be supported by an LAC or Early Childhood partner in your region.

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 seek a formal review of the original access decision.

Can another NDIS access request be made at a later date?

NDIS access 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 make a new request by contacting the NDIA.

Where can I get help?

Find a Local Area Coordinator or Early Childhood Partner (for children aged 0-6) in your area.