Last updated 26 February 2020

The National Disability Insurance Agency (NDIA), as a Commonwealth agency, is bound to apply the law and must be satisfied the legislative criteria are met before granting a person access to the National Disability Insurance Scheme (NDIS) or approving funding for a requested support. It is for this reason that the NDIA requires independent evidence from experts upon which it may base its assessment about a person’s eligibility to access the scheme and/or their reasonable and necessary supports.

However, the gathering of recent, relevant and sufficiently detailed evidence can be burdensome for people with a disability seeking access to funded supports. A person may have difficulty securing necessary evidence because of their disability and/or because of the cost involved.

Where a person is unable to afford medical assessments and reports, the person may ask the NDIA to provide financial assistance to help them cover the costs (s 6 National Disability Insurance Scheme Act 2013 (Cth)).

Evidence must address the relevant criteria and, in cases where it does not, the NDIA may ask for further information from the person. The NDIA have published guidelines about the circumstances in which it is appropriate to ask a person to undergo additional assessment and/or provide further information to support its assessment of access requests (s 10.2 Access to the NDIS Operational Guideline) and reasonable and necessary supports (s 8.3 Access to NDIS – the disability requirements).

See Liddle and National Disability Insurance Agency [2018] AATA 5071 (7 June 2018) in which the tribunal refused a request of the NDIA to direct a person to undergo an assessment by an occupational therapist in circumstances where that person had already undergone an assessment. This decision will be helpful in cases where an applicant (and/or their advocate) considers that sufficient evidence has already been provided to the NDIA.

Further information about the type of evidence that may support an access request is available on the NDIS website. The NDIA has developed an Evidence of Psychosocial Disability form to assist people with psychosocial disability in the access process.