Last updated 25 February 2020                                                                                                      click to download a pdf of this chapter

Overview of the National Disability Insurance Scheme Journey
How to Access the National Disability Insurance Scheme
Supports for Participants
The Challenge of Obtaining Necessary Evidence
Scheduled Reviews and Change of Circumstances
How to Appeal a National Disability Insurance Agency Decision
Free Advocacy and Legal Services

The National Disability Insurance Scheme (NDIS) provides funding for supports and services for eligible people living with an intellectual, physical, sensory, cognitive and/or psychosocial disability.

The NDIS is administered by the National Disability Insurance Agency (NDIA), a federal government agency. The NDIA is responsible for assessing applications from people with disability seeking access to supports and services, and subsequently determining the nature of the supports to be provided to successful applicants (participants).

The law that underpins the NDIS is the National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act). There are a number of accompanying Rules, including the National Disability Insurance Scheme (Becoming a Participant) Rules 2016 (Cth) (Becoming a Participant Rules) and the National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth) (Supports for Participants Rules).

The NDIA applies the Act and Rules to determine an applicant’s eligibility to access the NDIS and to determine the funded supports a participant will receive in their individualised NDIS plan.

The NDIA also rely on their Operational Guidelines, however, the guidelines cannot be relied upon when they are inconsistent with the Act and Rules (see Re Drake and Minister for Immigration and Ethnic Affairs (No 2) [1979] AATA 179).

Most legal issues arise when the NDIA refuses to grant a person access to the NDIS or approves an NDIS Plan with which a participant is not satisfied. These decisions are reviewable.

This chapter will outline the decision-making processes of the NDIA, including the considerations it must make and the steps a person can take if they are not satisfied with a decision made by the NDIA that impacts them.