The National Disability Insurance Scheme (NDIS) supports Australians with a disability. Rolled out in 2019, the scheme was created after a productivity commission revealed the country’s disability system was ‘underfunded, unfair, fragmented and inefficient‘.
Accordingly, the Australian Government acknowledged these concerns and reformed the entire setup. The result is flexible, individual funding packages that support approved NDIS Participants. However, not all Australians with a disability are eligible for this scheme.
The NDIS Commission has a stringent Application process that potential NDIS Participants must complete. This process helps ensure services reach those who need them most. It also maintains integrity within this life-changing scheme.
What is covered by the NDIS?
The NDIS provides funding for many types of support to assist people with disability to pursue their aspirations and live more independently. Funding is classified into three broad categories:
Core Supports – for day-to-day living and disability needs:
- Assistance with daily personal care (e.g., showering, dressing)
- Transport to work or a community activity
- Assistance with social and recreational engagement
- Consumables (e.g., continence products)
Capital Supports – for major purchases:
- Assistive technologies and products (e.g., wheelchairs, communication devices)
- Home modifications (e.g., ramps, handrails)
- Vehicle modifications
Capacity Building Supports – to develop independence and skills:
- Therapeutic Supports (e.g., occupational therapy, psychology)
- Employment supports
- Development of daily living skills
- Support coordination to assist with managing NDIS supports.
Early Childhood Early Intervention (ECEI) Pathway
If a child is under 9 years with a developmental disability or delay, the NDIS has a specialist pathway known as ECEI (Early Childhood Early Intervention). This intervention allows for supports to be provided prior to an initial formal diagnosis.
What it involves:
- Access to early intervention services, such as speech pathology and occupational therapy
- Assistance from local ECEI partners
- Advice and referral to mainstream services like preschools or community health
If ongoing support is required, the child can then move into a full NDIS Plan. The goal is to provide the correct assistance early, in the most important years of development.
Timeframes: What to Expect at Each Step
While timeframes can differ, here’s a general guide to how long each stage of the NDIS process may take:
- Access Request: Participant Applicants will be informed of a decision within a maximum of 21 days after the NDIA receives an Access Request Form and supporting documents.
- Planning Meeting: In the event that a request is successful, Applicants will be invited to a Planning Meeting, often within a few weeks. This may be face to face, by phone, or over the internet.
- Plan Approval: After the Planning Meeting, an Applicant Participant’s Plan is normally approved in 1–3 weeks.
- Plan Implementation: Participants can begin using their Plan as soon as it is approved by the NDIA. A Local Area Coordinator (LAC) or Support Coordinator can assist Participants to organise supports funded under their Plan.
Remember, delays can occur, particularly if additional evidence is required—so it’s always best to chase up with the NDIA if you don’t hear back!
Participant Eligibility for the NDIS
The NDIS provides supports to children and adults who meet NDIS eligibility criteria, known as NDIS Participants. The following requirements clarify the eligibility requirements for people with disability to receive NDIS funding.
Age
Under the age of 65 at the time of your initial NDIS Participant Application.
Residency Status
Living in Australia as an Australian citizen or permanent resident. Or, you can live in the country and have a:
- permanent visa, or
- protected special category visa.
Disability Requirements
Living with a disability caused by permanent impairment that impacts physical or mental health. This includes intellectual, cognitive, neurological, sensory, or psychosocial disability.
Essentially, NDIS Participants regularly need disability support to complete daily life activities, and an Application for NDIS funding allows for these support needs to be funded.
Preparing for Your NDIS Application
Preparing for an NDIS Application requires organisation. That’s because there are many factors to consider, which is why collecting information for your Application can take time.
Double check Application details before you’re complete. This helps avoid Application delays or complications with the online Application form process.
Documentation
Gathering documents and evidence to support your claim is critical for preparation as everything you provide needs to satisfy a set of eligibility questions and parameters. With this in mind, ensure your supporting documentation shows evidence of disability and how it impacts your everyday activities. Ensure all documents are up-to-date and accurate.
Types of documents you need to provide include:
- personal identification documents
- evidence of residence
- income
- medical records
- diagnosis reports
- assessments by health practitioners.
- If you already have a carer, showing carer evidence is also useful.
Support
Seeking guidance from relevant professionals or support networks is recommended when applying to the NDIS for the first time. This may include talking to your doctor, healthcare provider or disability support services. You can also connect with an NDIS Planner to help you understand the Application process.
The NDIS Access Request Form
Submitting the NDIS Access Request Form is the first step to accessing NDIS-funded support. The Form will be assessed by the National Disability Insurance Agency (NDIA), who oversees the implementation of the NDIS.
Step 1- Contact NDIA
To begin, an individual or their representative must contact the NDIA. You can do this via phone or using their email address. The NDIA will describe access requirements, the Application process and necessary documentation. Think of this as your own personal Application Guide.
Step 2- Complete Access Request Form
The next step is to complete the NDIS Access Request Form. Find it on the NDIA website or ask for it at your local NDIS office. This form includes information about the Applicant’s personal details, disability, and support needs. It also highlights an Applicant’s goals and aspirations. You must provide evidence to support the Application.
Step 3- Submit Application
Once completed, submit the Access Request Form and supporting evidence to the NDIA. You can do this via mail (Australia Post), email or manual collection at a local NDIS office.
Step 4- Receive outcome
The NDIA reviews everything to decide if you are eligible. If successful, you will receive a letter or confirmation email with the next steps. This involves the NDIA working with you (or a legal guardian) to develop a Plan for support. If unsuccessful, you can request a review of the decision.
Tips for a Successful NDIS Application
Here are tips that will help you create a successful NDIS Application:
Use professional services
Get professional help if you find the Application process overwhelming. If you’re deaf or find it hard to hear or speak with people on a phone, use the National Relay Service for support: https://www.accesshub.gov.au/about-the-nrs
Local Area Coordinators, NDIS providers, support coordinators and social workers can guide you through the process. They can assist with the Application, gathering documents and navigating the process. They’ll also be able to help you understand all of your support options.
Be patient
The NDIS Application process can take time. Be patient, persistent and stay optimistic.
While time frames vary, it can take several months for Application reviews. It can take even more time if extra information is requested, which may happen if you haven’t met all criteria on the eligibility checklist.
When everything has been reviewed, you will receive a letter or email confirming whether you have been successful. Keep in mind that the NDIS provides long-term support, so it’s worth taking the time to get the Application right.
Be prepared to appeal
Despite your best efforts, your Application may be rejected. Or, the level of support offered may be insufficient. If this happens, you can appeal the decision via the review process.
Be prepared to provide extra documentation and evidence to support your case. Most importantly- don’t give up on seeking the care and support you need for your disability!
General tips
- Make contact with people who can support your claim, such as a social worker. Ask them for what you need. The more details you have, the better.
- Provide a clear list of benefits of NDIS funding to help the NDIA understand your needs.
- Have thorough documents, evidence and records
- Successful NDIS Applications contain detailed and accurate information about the Participants’ disability needs.
- Make sure to document all your symptoms, limitations, and requirements.
- Have medical reports and assessments from medical professionals, and proof of identity documents, on-hand.
- Clearly outline support & health needs
- Be particular when outlining your support needs in the Application.
- Include things like therapy, equipment, personal care, and transport requirements.
- Also include any other support services that help you manage your disability.
- Don’t be shy in listing the emotional impact and functional impact your disability has on you.
- The more you can demonstrate your disability’s impacts, the better your chance of receiving adequate supports from the NDIS.
Was your NDIS Application denied?
Applications for people wanting NDIS funding can be approved or denied.
Unsuccessful Applicants can get frustrated, especially if they feel genuinely entitled to NDIS support. It is good to remember that other supports are available for those who aren’t eligible for the NDIS; and you have the right to request a review of the decision to deny your Application.
Review Process
The review process challenges NDIA decisions regarding eligibility for support. Here are the steps to take if you receive a ‘NDIS Application Denied’ notification:
Understand the reasons for denial
The first step is to understand why your Application was denied. The NDIA will provide you with a letter explaining the decision and the reasons behind it. Take time carefully to read and comprehend the letter.
Share new evidence
If you have received new evidence about your disability or how a developmental delay affects your daily life, you can use this evidence to challenge the NDIA’s outcome. Consider completing a new access request form and sharing additional documents.
Request an internal review
If you disagree with the decision, you have the right to request an internal review. This means that your Application will be re-assessed by a different NDIA representative. You must request this review within three months of receiving the decision letter.
Prepare for the review
Have a clear understanding of the NDIS eligibility criteria and how your situation meets it. Gather extra information or evidence that may support your Application, such as:
- medical reports
- letters from health professionals
- statements from family and friends.
Attend the review meeting
The internal review process involves a meeting with a new NDIA representative. This can occur in person, over the phone, or via video conference.
The representative will ask questions to clarify your situation. You’ll have the opportunity to present new information or evidence to justify your review of the NDIA’s decision.
Await the outcome
After the review, the NDIA will provide you with a decision in writing.
- If your Application is approved, you will receive a Plan outlining the support you can access.
- A federal administrative review body can assist if your Application is still denied.
- Note: The Administrative Appeals Tribunal (AAT) used to offer ongoing monitoring in this situation. This is no longer the case.
Understanding the NDIS Planning Meeting
The NDIS Plan outlines the funding and support needed to improve the Participant’s quality of life. The NDIS Planning Meeting is a crucial part of the funding process for Participants, ensuring the supports and services required under the NDIS are funded by the Plan.
Planning Meeting
This face-to-face meeting involves a discussion between the Participant and their representatives (as applicable), and an NDIS representative.
The Planning Meeting’s discussions focus on the Participant’s:
- disability-related needs
- functional capacity
- challenges, including difficulty with activities on a daily basis
- goals
- Current support arrangements
- gaps or limitations in existing services.
The NDIS representative will explain all available options under the Plan. This relates to individualised funding packages, support coordination, and other services. Following this discussion, a personalised NDIS Plan is created.
Participant Planning Tips
Preparing for your NDIS Planning Meeting is a key step toward creating a personalised NDIS Plan that truly reflects your goals and support needs. Start by thinking about what you want to achieve in your daily life, at work or school, and in your community.
Some tips include:
- Think about your goals: Write down what you want to achieve in your daily life, at work or school, and in the community.
- List your support needs: Note the types of support that could help you reach your goals and improve your day-to-day life.
- Gather identity documents: Bring documents that confirm your identity, including one with your photo, signature, and date of birth.
- Collect medical and diagnostic information: Obtain recent reports or assessments from doctors or allied health professionals that confirm your disability and explain your support needs.
- Bring a support person or advocate: Invite someone you trust who can help you communicate and stay confident during the meeting.
- Be clear and specific: When discussing your support needs, be honest and detailed about the challenges you face and the help you require.
- Ask questions: Don’t hesitate to ask for explanations if something is unclear or if you need more information.
- Advocate for your needs: Speak up about what’s important to you, and be prepared to negotiate for the supports that matter.
- Plan for regular reviews: Understand how often your NDIS Plan will be reviewed, and know that you can request a review if your needs change.
Receiving Your NDIS Plan
After you’ve finished your NDIS Planning Meeting and your Application is given the green light, you’ll receive your personalised NDIS Plan. This document is designed specifically around your individual goals, daily challenges, and the kinds of supports you need to live the life you want.
You’ll be contacted by the NDIA—either by email or post—with confirmation that your Plan has been approved. This message will include the full details of your Plan, explaining the supports you’re eligible to access and the funding that has been allocated to help you reach your goals.
Choosing How Your NDIS Funding Is Managed
One of the most important decisions a Participant makes when their NDIS Plan is approved is how their funding will be managed. This choice determines how you engage with Providers, track your budget, and access support services. There are three main options available, each offering different levels of flexibility and control.
Self-Managed
When a Participant chooses to self-manage their funding, they are responsible for overseeing all aspects of their NDIS budget. This includes selecting and paying Support Providers, handling invoices, and keeping financial records.
Self-Managed Participants have the flexibility to engage both Registered Providers and Unregistered Providers for most services, offering the broadest range of choice.
Plan-Managed
A Plan-Managed Participant works with a dedicated Plan Manager who handles the financial and administrative side of the Plan. The Plan Manager pays Providers directly, keeps track of spending, and helps ensure that services align with the Participant’s goals.
Like Self-Management, Plan Management allows Participants to use both Registered Providers and Unregistered Providers.
NDIA-Managed
Participants who select NDIA Management have their funding managed directly by the National Disability Insurance Agency. The NDIA pays Providers on the Participant’s behalf, and funding under this arrangement can only be used with Registered Providers.
This option may suit Participants who prefer minimal financial administration and want the confidence of working only with NDIS-approved services.
Making Your Decision
Participants can choose the funding management option that best suits them. It is, however, important to know each option has advantages and disadvantages. That’s why Participants must carefully consider their options before making a decision.
Where possible, it’s encouraged to become a Plan-managed or self-managed NDIS Participant. This is because they can access a range of services from many providers – registered and unregistered.
How to Use Your NDIS Plan Once It’s Approved
Getting your NDIS Plan is only the first step! Here’s how to begin using it:
- Read Your Plan: Know your funding categories and objectives. Your LAC or Support Coordinator (if funded) can discuss it with you.
- Set Up the myplace Portal: This internet portal allows you to view your Plan, make payments, and monitor spending.
- Find Providers: You can select NDIS-registered or unregistered providers, depending on how your Plan is managed. Registered Providers are the gold-standard, having undertaken rigorous auditing and being subject to ongoing compliance obligations.
- Make Bookings and Begin Supports: Call service providers to book therapies, support workers, and purchase assistive products needed to support your disability.
- Keep Records: If you’re self-managed or Plan-managed, ensure you retain invoices and receipts for services accessed.
You’re in charge of how the supports and services you receive, and when you spend your Plan funding.
NDIS Plan Reviews and Renewals
NDIS Plans aren’t set-and-forget—they’re reviewed from time to time to make sure they continue to suit your needs.
- Scheduled Reviews: Plans typically run for 12–24 months. A Plan reassessment will be arranged with you before your Plan expires.
- Change in Circumstances? If your circumstances change significantly (e.g., new health requirements, changing address), you can ask for an early review at any time.
- Check-in Calls: The NDIS can also make mid-Plan check-ins to check on how your Plan is progressing and whether changes are required.
- Prepare for Reviews: Take notes on what’s working, service gaps, and new goals you’d like to have included. Regular reviews are your opportunity to ensure your funding continues to reflect your life.
Conclusion
The National Disability Insurance Scheme (NDIS) is a voluntary program designed to provide funding for individuals living with a permanent or significant disability. People who are approved to receive this support are referred to as Participants.
To become an NDIS Participant, the first step is submitting an NDIS Access Request Form. If an Application is not approved, there is a formal process available for review and appeal. Following Approval, Participant Applicants will attend a Planning Meeting to help shape their personalised NDIS Plan.
Once the NDIS Plan is approved, NDIS Participants can access a wide range of services from Registered Providers or Unregistered Providers, including support from qualified disability support workers.
Providers are expected to deliver consistent, person-centred support and must have clear risk management strategies in place. This not only builds trust with the Participants they support, but also helps uphold the long-term credibility and sustainability of the NDIS.
If you’re looking for guidance on applying to the NDIS or want to better understand your options, visit the official National Disability Insurance Scheme website for more detailed information and resources.
