Last updated 1 June 2025

Once a person becomes a participant in the National Disability Insurance Scheme (NDIS), the person will be invited to discuss their support needs with the National Disability Insurance Agency (NDIA) and their first NDIS plan will be issued.

Each plan includes a statement of supports, setting out each support that the NDIA has agreed to fund.

The NDIA can only approve funding for a support if  the support:

Any newly accepted participant in the NDIS should prepare for their first planning discussion by considering the supports they want the NDIA to fund, and how they may demonstrate to the NDIA that the supports meet the above requirements. More information to help people prepare for their first planning meeting is available on the NDIS website.

The reasonable and necessary support criteria

The reasonable and necessary support criteria are listed in s 34 of the National Disability Insurance Act 2013 (Cth) (NDIS Act). To be funded, a support must:

  • be necessary to address needs arising from an impairment that meets the disability requirements or the early intervention requirements (s 34(1)(aa))
  • assist the person to pursue their goals, objectives and aspirations (s 34(1)(a))
  • assist the person to undertake activities that facilitate the person’s social and economic participation (s 34(1)(b))
  • represent value for money (s 34(1)(c))
  • be, or likely be, effective and beneficial for the participant, having regard to current good practice (s 34(1)(d))
  • take into account what is reasonable to expect families, carers, informal networks and the community to provide (s 34(1)(e))
  • be an NDIS support for the participant (s 34(1)(f)).

The Supports for Participants Rules and the National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 (Cth) (Transitional Supports Rules) are applicable in the interpretation of these criteria:

  • The Supports for Participants Rules set out what the NDIA must consider when assessing whether a support meets some of the reasonable and necessary criteria (e.g. in assessing what is value for money and what is effective and beneficial). The Supports for Participants Rules also  include general criteria for supports in rr 5.1 to 5.3, which provide that a support will not be funded if it is likely to cause harm to a participant or if the support duplicates other supports that are already funded.
  • The Transitional Supports Rules relate to the s 34(1)(f) criterion (the support must be a NDIS support) and also specify some supports that are excluded by means of the general criteria in rr 5.1 to 5.3 of the Supports for Participants Rules.

Most commonly, people have trouble satisfying the NDIA that their requested support is needed because of an ‘accepted’ impairment, that it represents value for money, that it is beyond what is reasonable to expect of their family/carers and/or community to provide, that the support is related to their disability and/or that the support is most appropriately funded by the NDIA. More detail regarding these reasonable and necessary support criteria and the applicable rules is set out below.

Support needs arising from an impairment

Supports will only be funded if they are necessary to address needs arising from an impairment that the NDIA has accepted meets the disability and/or early intervention requirements.

For participants with multiple categories of impairment, some of which have not been accepted by the NDIA, this requirement can be challenging where it is difficult to distinguish which needs arise from which impairment.

However, showing there is a connection between the support and an impairment that the NDIA has accepted as meeting either the disability and/or early intervention requirements, will generally be sufficient.  This is because:

  • the phrase ‘arising from’ is to be given a broad meaning—see Telstra Corporation Limited v Bowden [2012] FCA 576 and
  • so long as an impairment which meets the disability and/or early intervention requirements contributes to a participant’s need for the support, it does not matter if the participant requires the support to address needs arising from other impairments.

See Eastham and Chief Executive Officer of the National Disability Insurance Agency [2025] ARTA 198, in which the tribunal approved funding for a mobility scooter for a participant where that scooter was required to address a combination of needs arising from vision and hearing impairments (both of which met the disability requirements) and physical impairments associated with, for example,  osteoarthritis of the lower back and hip (which did not meet the disability and/or early intervention requirements). The tribunal referred to the note within the NDIS Act for the purposes of s 34(1)(aa), and also considered environmental factors, in concluding funding for a scooter met this criterion (at [98]):

‘… the Tribunal considers that it is able to take into account the “environment factors” such as the distance between Mr Eastham’s home and the closest bus stop being 1.1 km. The Tribunal is satisfied that this is a distance which Mr Eastham would experience substantial difficultly if he were to regularly traverse that distance on foot due to his physical and sensory impairments, and he is otherwise unable to traverse that distance by car due to his vision-related impairments which prevent him from obtaining a drivers’ licence.’

Value for money

A support will represent value for money if, among other things, there are no comparable supports that would achieve the same outcome at a substantially lower cost (r 3.1 Supports for Participants Rules).

See PPFQ and National Disability Insurance Agency [2019] AATA 1092 (31 May 2019), in which the tribunal accepted evidence to approve funding for more expensive, but equally more beneficial hearing aids for the participant, rather than the lesser expensive standard-issue hearing aids the NDIA suggested were sufficient.

See also Mazy and National Disability Insurance Agency [2018] AATA 3099 (9 August 2018), in which the tribunal determined that nursing assistance for the administration of insulin to a participant with diabetes did represent value for money in circumstances where the participant was not able to self-administer insulin or use an insulin pump. The tribunal noted that ‘… it should not fall to the participant to fully explore alternative supports which may be less expensive … If the Agency claims that there are alternative supports which are preferable to those sought by the Applicant, it is incumbent on the Agency to assist the Tribunal by providing evidence to support its argument …’  [59].

What is reasonable to expect of families, carers and other supports

Families with people with a disability do a lot to support their loved ones. But what is reasonable to expect of them, and what is beyond reasonable? Rule 3.4 of the Supports for Participants Rules provides what factors the NDIA must consider in answering this question, including whether a child’s needs are substantially greater because of the child’s disability, the extent of any risks to the wellbeing of the participant arising from their reliance on their family/carers/others (informal supports), and the intensity and type of support required and whether it is age and gender appropriate for the family member or carer to be providing that support.

While the NDIA expects families to provide support to their loved ones with a disability, it is clear there are limits. See JQJT and National Disability Insurance Agency [2016] AATA 478 (6 July 2016), in which the tribunal determined that while parents are expected to meet a child’s transport needs, it was not reasonable to expect parents of a child with complex and high-level needs to drive their child to and from respite, because ‘… without the inclusion of transport in his plan, transporting JQJT to community access support increases the burden on them, reduces the benefit of respite during those hours, and poses a risk to their wellbeing …’  (at [40]).

This decision can be contrasted with NLXY and National Disability Insurance Agency [2024] AATA 2275, in which the tribunal did not approve funding for transport for a child participant to and from school because ‘… it would be the general expectation of the Australian community that families bear the responsibility and cost of transporting their children to and from school, being an everyday transport requirement.’ (at [70]).

See also Dudgeon and National Disability Insurance Agency (NDIS) [2024] ARTA 154, which concerned the level of support that is reasonable to expect to be provided by ageing parents to an adult child with disability.

What supports are disability supports and not day-to-day living costs

Rule 5.1(d) of the Supports for Participants Rules provides that a support will not be funded if it relates to a  day-to-day living cost. This is subject to rule 5.2, which provides that day-to-day living costs may be funded if they are incurred solely and directly as a  result of a participant’s disability needs (e.g. an ipad may be required as a communication aid) and/or the costs are ancillary to another support that is funded through a participant’s NDIS plan (e.g. additional insurance premiums that are payable for a modified vehicle).

See Warwick v National Disability Insurance Agency [2024] FCA 616, in which the Federal Court of Australia found the costs associated with moving house for a participant whose Parkinson’s disease had progressed to such an extent that he needed to move to a more accessible home were not day-to-day living costs because selling and buying a house is not an everyday expense (like rent, groceries and utility fees that are incurred on a recurring and regular basis).

The Transitional Supports Rules, which must also be applied, now exclude many items described as day-to-day living costs irrespective of whether they are incurred solely and directly because of a participant’s disability needs and/or are ancillary to another funded support.

See VPYC and Chief Executive Officer of the National Disability Insurance Agency [2025] ARTA 3, in which the tribunal rejected a request for a weighted blanket for a 15-year-old with emotional dysregulation because the blanket was a ‘day-to-day living cost—accommodation and household’ under the Transitional Supports Rules.  However, see also Dudgeon and National Disability Insurance Agency (NDIS) [2024] ARTA 154, in which the tribunal approved funding for home modifications rejecting the contention that certain aspects of the modifications, such as tiling, waterproofing and plastering, could not be funded as they were ‘day-to-day living costs—accommodation and household’ under the Transitional Supports Rules.

What is an NDIS support

The Transitional Supports Rules list what are and are not NDIS supports.  Schedule 1 lists supports that are NDIS Supports. It is subject to sch 2, which lists supports that are not NDIS supports (ss 10(1), 10(4) NDIS Act). The Transitional Supports Rules will be replaced by permanent lists once these are negotiated by Commonwealth, state and territory governments.

In limited circumstances, the NDIA has discretion to approve funding for a non-NDIS support within sch 2 if the non-NDIS support replaces a NDIS support and provides the same or greater benefit to the participant at no extra cost ( s 10(6) NDIS Act and pt 3—replacement support determinations of the Transitional Supports Rules). The NDIA is otherwise required to apply the Transitional Supports Rules strictly.

The following cases demonstrate how the lists within these rules are applied, the difficulties in their interpretation and how supports that may previously have been approved as reasonable and necessary are now excluded:

  • In Johnstone and National Disability Insurance Agency [2025] ARTA 106, the tribunal found the term ‘generally’ means the rules apply to all participants; and not, as the applicant had argued that there is some discretion to not apply the rules. The tribunal noted the application of the rules is not straightforward and approved funding for dietary supplements, categorising these as a modified food under item 9(a) sch 1, but noted the supplements could also have been excluded as ‘day-to-day living costs—food and groceries under item 3(a) sch 2.
  • In WVGM and Chief Executive Officer of the National Disability Insurance Agency [2025] ARTA 47, the tribunal rejected a request for funding for an air-conditioner in a social housing unit, preferring the conclusion that the air-conditioner was a standard household appliance and housing and community infrastructure, both categories of items that are excluded by sch 2 rather than a home modification, which is an NDIS support in sch 1.

Several items are declared not to be NDIS supports in sch 2 because they are ‘standard items’ (items that are not modified or adapted to address a participant’s functional impairments as defined in r 4).

In Hyde and National Disability Insurance Agency (NDIS) [2025] ARTA 365, the tribunal considered what is meant by the term ‘standard’ and rejected the NDIA’s contention that a home automation system was a standard home-security cost. The tribunal noted Ms Hyde could not use the standard security system that was already installed in her home and the requested automation system was ‘,,, a support for Ms Hyde that is adapted, modified and customised to put her in control of her own home safety by allowing her the independence to lock and unlock her own home amongst other voice automation tasks, without the dependency of requiring direct support from another person.’

Schedule 2 of the Transitional Supports Rules also excludes supports that are the responsibility of other service systems, such as health, justice and housing, to fund. These expand on funding responsibility distinctions set out in sch 1 of the Supports for Participants Rules, which are still applicable.  For example, the intersection of responsibility for funding supports in the area of health is set out in rules 7.4–7.7 of the Supports for Participants Rules, and item 12 of sch 2 of the Transitional Supports Rules lists supports that are health-related and excluded as not NDIS supports. Responsibilities for funding supports in other areas, including early childhood development, child protection and family support, education, employment, housing and infrastructure, and justice, are similarly differentiated.

The intersection in funding responsibility has been considered in: