If a participant is injured in an accident and:
- receives compensation that covers care and supports, and;
- these supports could also be covered by the NDIS.
- NDIS will not duplicate the funding for these supports.
Participants should seek compensation if they have not yet done so and there is a reasonable chance of success. If a participant chooses not to do so, the NDIS may reduce their plan funding. The NDIS is not usually directly involved in compensation claims. It will support all those involved to help them understand how compensation works and how it could affect a NDIS plan. In some cases, the NDIS may be able to seek compensation on a participant’s behalf.
Any kind of accident could cause an injury. Injuries can happen at work or on the roads. Medical accidents or crimes can also cause injury. If someone else is responsible, compensation may be paid.
How could compensation affect a NDIS plan?
Commercial insurers may provide lump sum compensation. This can include amounts for loss of income, pain and suffering, or medical costs. These payments will not affect a NDIS plan. Victims of Crime payments will not affect a NDIS plan.
Compensation may also cover the cost of support needs caused by the injury. This may lead to duplicate funding if a NDIS plan also provides them. These payments could affect a NDIS plan.
Compensation can affect a NDIS plan in three ways.
- NDIS payments made for past supports covered by a compensation lump sum is a debt. It can be recovered by the NDIS. The NDIS will provide full funding for supports while a claim is in progress. This provides a participant with the supports they need while the claim is decided. Usually an insurer will pay amounts due to the NDIS directly when a claim is resolved in the participant’s favour. If the participant has already received the compensation, they will need to repay it to the NDIS themselves. Participants should feel confident to use their plan fully while a claim is in progress. If the claim is unsuccessful, there will be no debt to the NDIS.
- Compensation payments can include amounts for future supports. This is not a debt. Participants will need to use their compensation to pay for these supports. The NDIS will reduce the future funding in a plan to account for this. Reductions will account for the time the compensation should last based on the expected lifetime of the participant. A reduction will no longer apply to a plan if the participant lives longer than this.
- States and territories support people injured in motor vehicle accidents or at work. All states and territories provide these supports. In most cases, this covers everything required. The NDIS will reduce funding in plans to account for the value of these supports.
Compensation Recoveries team
This team provides support to participants and their carers, representatives, guardians and trustees. It can answer any queries or provide information.
If a participant receives compensation or it is a possibility, it will:
- Ask for information about the injury and/or compensation claim
- Ask participants to seek compensation if they haven’t done so, or do that for them
- Seek recovery from a compensation lump sum of NDIS payments already made
- Calculate and apply reductions to NDIS plans
- Periodically review ongoing NDIS plans to adjust reductions.
For more information on compensation recoveries, please contact the Compensation Recoveries team at email@example.com