We recognise changing to a new way of doing things can be confusing and difficult to navigate. These FAQs are designed to help answer some questions you may have about the NDIS, how it will affect you and the types of help available to you throughout the process of moving to the NDIS.
What is the National Disability Insurance Scheme (NDIS)?
The National Disability Insurance Scheme (NDIS) is Australia’s first national Scheme for people with disability. It moves away from the previous system of providing block funding to agencies and community organisations, to direct funding for individuals.
The NDIS is a federally managed and funded safety net, providing a nationally-consistent, lifetime commitment to people who have permanent and significant disability with funding for supports and services.
The NDIS is not welfare, it is an insurance-based scheme that invests in participants to improve long-term outcomes.
Why do we need the NDIS?
Previously each state and territory has managed disability support themselves, and the system was underfunded, unfair, fragmented, inefficient and gave people with a disability little choice.
The NDIS is a federally managed and funded safety net, providing a nationally consistent, lifetime commitment to supports for people with a disability in their everyday life.
When does it start?
What is the National Disability Insurance Agency (NDIA)?
The NDIA is an independent Commonwealth government agency responsible for overseeing the implementation of the NDIS.
What supports can I receive under the NDIS?
Support must be ‘reasonable and necessary’ and also:
- Help you reach your goals and aspirations
- Develop your capacity to actively take part in the community
- Foster greater independence
- Increase your social and economic participation
- Represent value for money.
This can include things you’d like to access for learning, work, daily living, accommodation, equipment/assistive technology, health, transport and hobbies.
What’s ‘reasonable and necessary’ and why is it important?
Put simply, anything you request that doesn’t meet reasonable and necessary criteria set by the National Disability Insurance Scheme Act (2013) will not be funded.
Supports must meet all of the following criteria:
- Will assist you to pursue your goals, objectives and aspirations as stated in your plan
- Will facilitate your social and economic participation
- Be value for money
- Be effective and beneficial for you, and in line with current good practice
- Takes account of what is reasonable to expect families, carers, informal networks and the community to provide
- Is most appropriately funded through the NDIS (rather than other systems like Health or Education).
This is in the legislation (NDIS Act) and is a guiding tool for planners. So, remember to use this is a checklist for all your requests and use this language when you are pre-planning!
When thinking about supports you need for your plan you can apply the ordinary life principle e.g. ‘I’m 37, do other 37 year olds have to be showered daily or driven to work or their medical appointments by their Mother?’ If the answer is no, then it is often reasonable to ask for supports to cover these areas as long as they meet the ‘reasonable and necessary’ criteria.
What is the price guide?
The price guide sets a price by the NDIS for supports offered under NDIS. It determines what a service provider can charge for supports, much like a Medicare line item.
Some people find it helpful to look through to better understand the breadth of supports available. However, it isn’t an exhaustive list as it doesn’t cover every single item.
For more information visit the price guide pages on the NDIS website.
How much funding will I get?
How long is a piece of string? No-one can tell you that except the NDIS themselves when you receive your plan.
The NDIS looks at your individual goals and what reasonable and necessary supports you need to achieve these. They will take into account your age, stage of life, primary disability, functional impairment, living situation and your informal supports.
You can, however, take a look at the NDIS quarterly reports for your state and it will give you an idea of average funding packages for different age groups.
Will the NDIS pay for me to go on a holiday?
This is where the reasonable and necessary checklist comes in handy. Is a holiday a related to your disability? No, it’s not. It’s something everyone has to pay for to access – flights, accommodation, meals etc.
However, the NDIS will pay for your supports to access a holiday because that’s an expense over and above what everyone has to pay for. So, they may pay for a support worker (but not their flights, accommodation – just the support itself), or any special equipment you might need to go on a holiday such as the difference between a standard hotel room and an accessible hotel room.
Will the NDIS buy me a smartphone?
Generally, the answer is no, the NDIS won’t buy you a smartphone or a tablet. This is because people who don’t have a disability generally must buy these things themselves.
What the NDIS could fund though, are apps or other access equipment you might need as part of your disability. Things like communication aids are commonly funded.
We have actually seen the NDIS fund smartphones and tablets, but it’s incredibly rare, and generally only done in exceptional circumstances. You’ll need to prove it meets all the reasonable and necessary criteria, not just because you want one!
Do I have to change to NDIS from the disability supports I currently receive?
Yes. It is important to know that the NDIS will replace all other sources of disability funded supports (NOT the DSP or Carer’s allowance) when the NDIS is available in your area. You can, however, remain with your current provider/s if you wish to when you transition to the NDIS.
Existing national and state-based disability support services will continue until all eligible people phase into the NDIS.
Does the NDIS affect the Disability Support Pension?
No, the NDIS is not means tested and has no impact on your DSP.
Will the NDIS cost me anything?
Not directly. The NDIS is a universal insurance scheme paid through tax contributions, like Medicare. The NDIS is designed to work side-by-side with health, education and other universal services.
Am I eligible?
To be eligible for the NDIS you must:
- have a permanent disability that significantly affects your ability to take part in everyday activities or a developmental delay
- be less than 65 years old when you first access the NDIS
- be an Australian citizen, hold a permanent visa or a Protected Special Category visa.
Or to meet the early intervention requirements for children:
- your child is aged under 6 and has a developmental delay, and
- you or your child have a disability that is likely to be permanent or early supports would reduce how much help you or your child need to do things in the future.
To further assess your eligibility the NDIS will ask you:
- Do you usually need support from a person because of a permanent and significant disability?
- Do you use special equipment because of a permanent and significant disability?
- Do you need some supports now to reduce your future needs?
What happens when I turn 65?
If you turn 65 years after you have become an NDIS participant, you will have a choice. You can either continue to receive disability supports in the NDIS or receive supports through the Commonwealth aged care system.
What happens if I am aged 65 years or over (or 50-64 years if you are an Aboriginal and Torres Strait Islander person) when the NDIS rolls out?
The Commonwealth Continuity of Support (CoS) Programme makes sure that older people with disability currently receiving state and territory-managed specialist disability services, who are not eligible for the National Disability Insurance Scheme (NDIS), receive ongoing support.
If you are 65 years and over and do not currently receive supports, or you are diagnosed with a disability after the age of 65 years, you will receive support from the Commonwealth aged care system.
How do I access the Scheme?
If you currently receive Federal or State and Territory government supports, you will be contacted by the NDIA when the Scheme is available in your area.
If you do not currently receive supports you may still be eligible for the NDIS. You must contact the NDIS directly on 1800 800 110 to complete an Access Request Form. You do not need a referral.
For more information on accessing the scheme visit the access page on the NDIS website.
Why has my application not been successful through the NDIS?
It is likely because the NDIS does not think you meet the eligibility criteria (see ‘am I eligible?’).
The NDIA may identify that your supports are best delivered by other service systems.
For a list of organisations who can help with support, both nationally and in different states and territories visit the page on the NDIS website about support for people who are not eligible.
What if I believe the NDIS has made a mistake about my eligibility?
So, I’m eligible to access the NDIS. What do I do now?
You’ll need to start preparing for your planning meeting with the NDIS, this is called pre-planning. The NDIS is a new way of doing things and providing supports so preparation is really important in order to understand how it works, how to speak NDIS language and how to ask for what you need, to enable you to get the best outcomes.
What is pre-planning?
Pre-planning is all the preparation work you put in before your planning meeting. It can involve:
- Gathering any necessary assessments, diagnosis and paperwork.
- Showing what supports you currently access and thinking about those you need to live ‘an ordinary life’.
- Starting to think about your goals, and what you would like to achieve in both the short term and long term.
- Using a pre-planning workbook like ‘Mapping My World’ to map out some of the above.
Who can help me with pre-planning?
There are a number of ways we can assist you but ultimately decisions about your life and your plan are yours to make.
Ways we can help:
- We have produced a pre-planning booklet, ‘Mapping My World’, to make it easy for you to think about the supports you want and need – now and in the future – before meeting with your NDIA planner. Please visit our resources page to download your copy. We also have the ‘Discover Guide’, an extensive guide to the NDIS, estate planning, guardianship and legal matters.
- We are able to offer one-on-one pre-planning meetings to our current customers to assist you in preparing for your first meeting with your NDIA planner. We highly recommend this as feedback from people already in the scheme suggests preparation is essential to getting the best result.
- If you are currently receiving services from us, we can provide you with a statement of current supports, which is important to show your planner to ensure you receive at least your existing level of supports.
- Sign up for our monthly NDIS e-newsletter to get all the latest NDIS news and updates.
- Check out our blog which features more detailed information about NDIS and stories from customers who have already moved across to the NDIS.
What is a participant statement?
Each NDIS plan includes a participant’s statement of goals and aspirations. Your participant statement should tell your unique story and provide a picture of your life circumstances. It should include important things like:
- what your life looks like now and what you would like it to look like
- where you live
- what you do during the week
- the important people in your life
- existing supports, including informal and mainstream supports
- your goals and aspirations.
A participant statement will help the NDIS planner build a picture of the person (particularly if they are non-verbal or maybe unable to attend the meeting), so it’s important to think ahead about things to include. You may even seek support from family, friends and/or service providers about what to include.
What is a carer’s statement and do I need one?
The NDIS Carers Statement is designed to inform an NDIS officer about the nature of the care that is given from a primary carer (usually family or friends, called ‘informal supports’). It can form part of the application for an NDIS support package on behalf of their loved one and inform the planner of the impacts of caring on the carer (impacts on work/study, ageing, inability to lift and shower the person, additional insight into the day to day life of the person with a disability etc.).
What is a goal?
Goals describe what you want to achieve, develop or learn. A key part of your plan is identifying short-term and long-term goals. Usually there are two goals in a plan. A short term goal is something you can achieve in 12 months, a long term goals might take a few years.
Goals are one of the most important parts of your plan. This is because all the supports funded in your NDIS plan should directly link back to helping you achieve your goals. For this reason, it is recommended that your goals should be fairly broad so that as many supports as required can be included under the umbrella of that goal.
For example, most 25 year olds would want to move out of home and live as independently as possible – it’s no different for people with a disability and the NDIS can support you to ‘live an ordinary life’ in a goal such as this. This is a goal that might take a number of years to achieve with many supports needed along the way such as day to day support, life skills training, transport training, positive behaviour support.
For more information, read our blog on goals.
Do I need evidence of my disability to take to the meeting?
We recommend it, yes. You’ll need a diagnosis of your primary disability from your treating health professional, whether that’s your GP, neurologist, allied health specialist or other specialist, and a list of your current treatments.
Don’t worry if you don’t have everything as the planner will ask you to get anything that they need that you don’t have at the meeting, but it’s better to come as prepared as possible so as not to delay access to the scheme.
Your evidence will need to confirm your disability, describe your treatments and outcomes (current and future) and confirm the impacts of your disability on areas of your life (social interaction, self-care, learning, mobility, communication etc).
If you need help to get your evidence together Local Area Coordinators (LAC) can help you.
For more information view the page about providing evidence of your disability on the NDIS website.
What are informal supports?
Informal supports are those provided by parents, siblings and other family members. The NDIS will take into account the ongoing capacity of family members and carers to provide these and are able to provide alternative supports where needed (e.g. help with showering, transport, short term accommodation aka respite). The NDIS do have guidelines about what is reasonable to expect families to provide. It’s important all informal supports are included in your pre-planning activity as some of these may be able to be funded under NDIS.
For more information view the page on the NDIS website about informal supports.
What are in-kind supports?
Before the NDIS, states and territories paid for providers to deliver services to people with a disability. In cases where these pre-paid supports and services are still in place under NDIS, NDIS participants will continue using these supports which are known as ‘in-kind’. Because they are pre-paid you will not receive funding for them, but they will be listed in your plan.
For more information view the page on the NDIS website about in-kind supports.
How do I manage my NDIS budget and supports? I’m worried it will be too much for me.
You will be asked how you want to manage your funds and supports in your NDIS planning meeting.
Management of your funds is called ‘Plan Management’. Your options for Plan Management are:
- Manage your funding yourself – the NDIS will provide you with the funding to pay directly to the people and organisations that support you. This is called self-managed.
- You can nominate a trusted person to manage your funding, called a ‘plan nominee’
- Use a registered Plan Management provider
- Ask the NDIA to manage your funding for you, which is called agency managed.
Plan Management is funded as part of your plan and does not take away from the funding allocated to the person with a disability. You can read more about Plan Management in our blog “How will you manage your NDIS budget”.
Managing your supports and services is called ‘Support Coordination’.
There are three levels of Support Coordination depending on how complex the support required is. Support Coordination can alleviate some of the day-to-day work of coordinating multiple services and providers and can be funded as part of your plan. You can read more about the various options in our blog “Support coordination – what it is and what to look for before you decide”.
I’ve just been called by the NDIS for a meeting. What happens now?
The first thing we recommend doing is to make sure that the meeting time works for you. Sometimes people are quick to say ‘yes’ even when they ideally need more time to prepare. You may need to get therapist’s reports, diagnoses and other paperwork in order before the meeting. It’s ok to ask to have your meeting pushed back to a later date.
Next, we recommend you start pre-planning as soon as you can (see above ‘pre-planning’) as well as collating any paperwork you need.
Who will conduct my planning meeting?
Planning meetings are either conducted by an NDIS planner or a Local Area Coordinator (LAC). In most cases, it will be an LAC.
Where will my planning meeting be held?
You will likely be contacted by phone initially to arrange your planning meeting and to gather some initial information about you. You’ll then have a meeting for the proper planning session. It is up to you as to where you would like to meet, when you like to meet and who you would like to bring with you. Many people choose to have their meeting at home.
If you feel the meeting is not going well, you have the right to stop the meeting and ask to continue another time.
Who can attend the planning meeting with me?
You can have anyone you choose in attendance, whether it be a friend, family or an advocate. An advocate promotes and protects your rights.
You can also have an Endeavour Foundation staff member attend who can contribute to the planner’s understanding of your daily life and your needs (please notify them once you receive a meeting date, so they can ensure they are available to attend with you).
For a list of advocates nationally view the Australian Government’s Disability Advocacy Finder website.
What should you bring to your planning meeting?
Preparation will help you get the best outcomes and are likely to access the scheme more quickly without having to find follow up documentation. We recommend you bring:
- Any pre-planning work you’ve done (such as our ‘Mapping My World’ booklet)
- Any evidence of your disability (diagnoses, assessments etc)
- Your bank account details (if you are considering self-managing all or a portion of your NDIS funding)
- Your myGov login and password details. For information on how to set up a my Gov login read the Participant Portal User Guide on the NDIS website.
- A list of any questions you’d like to ask.
A general rule of thumb is if in doubt, bring it!
Will I be able to review my plan before it is finalised?
In short, no. However, the ability to see draft plans is underway as part of the new participant pathways introduced by the NDIS in response to participant and provider feedback. This may take a while to be implemented across the country though.
If the meantime if you are unhappy with your plan, you are able to request a review. There are a few types of review you are able to review if you feel your plan does not offer adequate support for your needs.
What is my ‘first plan’?
Your first plan is, in most cases, a continuation of supports you are currently receiving. To create your first plan, you will have a planning meeting with the NDIS about your current situation and support needs. The NDIS will ask you how you do everyday things like having a shower or cooking food. They will also ask you what your goals are for the short term and the long term. This information will form the basis of your first plan. Your first plan will be in place for 12 months.
How will I receive my plan?
You will receive notification from the NDIS by your preferred mode of communication (usually email or letter) let you know your new plan is active. It will contain your myplace portal activation code, which expires within 10 days.
About 24 hours after your plan has been approved, it will be available on the NDIS myplace portal so it’s worth checking to see if the plan has been uploaded.
You will usually also receive a printed copy of your plan in the mail.
Why is it taking so long for my plan to be approved?
There are a lot of people to move to the NDIS by full transition of the scheme – almost half a million – and a lot of new rules and information for everyone to understand. This means it’s taking longer than anyone had expected.
We know it can be frustrating, but we expect it will get better with time.
At the moment, people get their plans between 2 – 8 weeks after their planning meeting. If you’ve waited more than 6 weeks and don’t have an explanation, we recommend giving your LAC a call.
What are the steps to putting my plan into action?
- Your LAC or Support Coordinator will help you to: understand your plan and what supports and services you can pay for with your NDIS funding, implement your plan, connect you to new supports.
- You’ll need to let your service provider/s know you have received your NDIS plan, even if you are already a customer of theirs. They may ask to have a meeting with you to discuss your NDIS plan to make sure that they are giving you the right supports for your goals and funding.
- To receive services under the NDIS, you will need to fill out what is called a ‘Service Agreement’. This document will simply spell out how and when your supports will be delivered. Service Agreements are different to your NDIS Plan. An NDIS Plan lists your supports and funding, and your Service Agreement outlines how your supports will be delivered and how much they cost.
What is a Local Area Coordinator (LAC)?
LACs are sometimes NDIA staff or NDIA Partners in the Community such as a not for profit organisation. The role of a LAC is to assist you in developing your plan by gathering information about you. It is still the NDIA’s responsibility to approve and finalise all plans.
LACs will also support you in implementing your plan and linking you to supports.
I am having trouble getting through to my LAC – can you help?
Well we can’t put you through to them, but we can help with many of the NDIS questions you might have.
However, your LAC is usually your link to the NDIS who make the decisions about your plan, so sometimes you will need to speak to them to get the answers. You may need to persevere as they have a lot of participants to juggle. Your LAC’s contact details should be listed in your plan.
What is a support coordinator?
If you have requested support coordination and it has been funded in your Plan, you will see it listed. Support coordinators generally provide a higher level support with your plan than LACs; they help you to:
- Understand your plan
- Link you to providers for the supports in your plans
- Help you negotiate with providers, ensure service agreements and service bookings are in place
- Can assist you in planning ahead for your plan review
- Help ensure you get the most out of your plan and funded supports by thinking outside the box.
There are levels of support coordination depending on the complexity of support required. Support coordination can alleviate some of the day-to-day work of connecting with and coordinating multiple services and providers.
Support coordination is a capacity building support and is, in many cases, only available for your First Plan.
To find out more read our blog about support coordination.
How do I find a support coordinator or plan manager?
You can find a support coordinator or plan manager through the Provider Finder in the myplace portal (although these will only be registered providers) or your LAC may be able to assist you.
When selecting a support coordinator or plan manager you might like to ask them:
- How will they help you to achieve your goals?
- What is their experience?
- What are their prices? What is included? How will they charge you?
I don’t understand what the different categories of funding/support budgets mean?
There are three types of support budgets that may be funded in your NDIS plan:
- Core Supports
- Capacity Building Supports
- Capital Supports
It’s worth getting your head around these because in some categories, funding may be used flexibly. For example, if you have used your funding to assist you to become more independent with support to get dressed and cook your own meals and you have progressed so that you no longer need as much support, you can reduce those supports and use the funding for support to do something else.
Also, the categories are called different things in your plan (and price guide) and on the myplace portal, which can complicate things! The tables below provide examples of like for like support categories.
Core Supports help you with everyday activities, your current disability-related needs and to work towards your goals. Your Core Supports budget is the most flexible, and in most cases, you can use your funding across any of the following four support categories. However, there are instances where you do not have flexibility in your funding, particularly for transport funding or where there are stated supports.
The core support budgets are:
IN YOUR PLAN IN THE MYPLACE PORTAL DESCRIPTION Assistance with Daily Life Daily Activities For example, assistance with everyday needs, household cleaning and/or yard maintenance. Consumables Consumables Everyday items you may need. For example, continence products or low-cost assistive technology and equipment to improve your independence and/or mobility. Assistance with Social & Community Participation Social, community and civic participation For example, a support worker to assist you to participate in social and community activities. Transport Transport This is support that helps you travel to work or other places that will help you achieve the goals in your plan. How you can spend your transport funding and how it is paid to you (whether upfront or in regular payments) will be different for each person. Your LAC will explain how you can use this budget.
Capacity Building Supports budget
Capacity Building Supports help build your independence and skills to help you reach your long-term goals. Unlike your Core Supports budget, your Capacity Building Supports budget cannot be moved from one support category to another.
Funding can only be used to purchase approved individual supports that fall within that Capacity Building category.
The Capacity Building categories are:
IN YOUR PLAN IN THE MYPLACE PORTAL DESCRIPTION Support Coordination Support Coordination This is a fixed amount for a Support Coordinator to help you use your plan. Improved Living Arrangements CB Home living Development and training to increase your skills so you can participate in community, social and recreational activities. Increased Social & Community Participation CB Social Community and Civic Participation Development and training to increase your skills so you can participate in community, social and recreational activities. Finding & Keeping a Job CB Employment This may include employment-related support, training and assessments that help you find and keep a job, such as the School Leaver Employment Supports (SLES). Improved Relationships CB Relationships This support will help you develop positive behaviours and interact with others. Improved Health & Wellbeing CB Health and Wellbeing Including exercise or diet advice to manage the impact of your disability. The NDIS does not fund gym memberships. Improved Learning CB Lifelong Learning Examples include training, advice and help for you to move from school to further education, such as university or TAFE. Improved Life Choices CB Choice and Control Plan management to help you manage you plan, funding and paying for services. Improved Daily Living CB Daily Activity Assessment, training or therapy to help increase your skills, independence and community participation. These services can be delivered in groups or individually.
Capital Supports budget
Capital Supports include higher-cost pieces of assistive technology, equipment and home or vehicle modifications, and funding for one-off purchases you may need (including Specialist Disability Accommodation). It is important to remember that funds within the Capital Supports budget can only be used for their specific purpose and cannot be used to pay for anything else.
The Capital Supports budget has two support categories: Assistive Technology and Home Modifications. You will usually need quotes for anything over $1,000.
IN YOUR PLAN IN THE MYPLACE PORTAL DESCRIPTION Assistive Technology Assistive Technology This includes equipment items for mobility, personal care, communication and recreational inclusion such as wheelchairs or vehicle modifications. Home Modifications Home Modifications Home modifications such as installation of a hand rail in a bathroom, or Specialist Disability Accommodation for participants who require special housing because of their disability.
Melissa needed help showering as she was unable to do so by herself. In her plan she was able to gain funding for help with showering in the following support budgets:
- Core – was able to fund Support Worker to assist with showering.
- Capital – was able to provide modifications to her shower to make it more accessible with the installation of handrails.
- Capacity Building – was able to access life skills training by a support worker (or be a program to teach) her ways to improve her showering/hygiene, thus increasing her independence.
For more detailed information on support budgets, please click here
What are stated supports?
Where a support is listed as ‘stated’ in plans this support must be purchased as described in your plan. Whereas some categories of funding are flexible, I cannot swap ‘stated’ supports for any other supports even if they are in a flexible funding category.
What does ‘quote required’ in my plan mean?
Where a support is listed as ‘quote required’ additional information such as quotes and/or specialist reports will be required. Once the quote is approved, the funding will be made available in your plan. Often this falls in the assistive technology category.
In general, supports over $1,000 in value will require a quote prior to supply, while lower cost items can be directly authorised (fixed price) through the myplace portal.
For more information view the NDIS webpage about assistive technologies and home modifications under the NDIS.
What is Myplace?
The NDIS participant portal is called myplace. It is a secure website for participants or their nominee to view their NDIS plan, request payments and manage services with providers. You can:
- view and update contact details, view your NDIS Plan, including information about funded supports
- view and manage your current plan budget, including to request payment for self-managed supports
- search and locate registered service providers
- create and manage service bookings with registered service providers
- securely view NDIS messages
- manage consent to share parts of your plan with service providers
- upload required documents
- Immediately cancel a service booking.
Don’t forget you’ll need to add your nominated bank account details to myplace for any payments such as transport that will come directly to you.
How do I access Myplace?
In most cases, when you receive notification of approval, you will be provided with a unique activation code for the first time you access myplace. Once you have an activation code, you can access myplace through the NDIS website or myGov.
Myplace is a secure portal on the myGov website, so you will also require a myGov account to sign in. Visit myGov to find out how to create your myGov account.
For a step by step guide to myplace visit the Participant Portal User Guide on the NDIS website.
How do I pick a service provider?
You may have funds for new supports that you’ve not had before. There are a number of ways you could find a new provider:
- Your LAC
- Support coordinator (if you have support coordination in your plan).
- Ask friends, colleagues or through any support groups you may be in (online or face to face)
- Use the Provider Finder on the myplace portal (this only shows registered providers, if you are plan or self-managed you can use non-registered providers, for example therapists may not be registered).
Generally, you will have more flexibility to find providers if you are plan or self-managed or have a component of this in your plan.
What should I look for in a service provider?
Well, that’s entirely up to you. The most important thing is to find a provider that not only offers the services you are looking for but that feels like a good fit for you.
Some things you might like to consider or questions you could ask are:
- Do they offer the services you are looking for in your area?
- Do they take into consideration your preferences for support and how it is delivered e.g. what you like to do, how you prefer to be showered, how you prefer to be fed etc?
- Do you feel like you’re being respected as an individual?
- What are their values as an organisation?
- How do they measure quality? What will happen if I’m unhappy with anything?
- Can I pick a different support worker if I feel the one I have is not a good fit for me?
- Can I come in and see where the services are delivered (if relevant) e.g. employment, day services etc.
At the end of the day, it’s totally your choice!
What if the services don’t exist in my area?
Unfortunately, in rural and remote areas this is a real problem.
This is something that has been raised before and becomes especially prevalent outside the major city centres. Your support coordinator or LAC will help you find supports, regardless of the area you live in.
If you live in a rural area and would like some tips, make sure you check out our blog ‘Living rurally under the NDIS’.
What are plan reviews?
There are five types of plan review:
- A ‘light touch’ plan review
A ‘light touch plan review’ is a review with limited scope. Agreed criteria for light touch plan reviews are limited to smaller items like change of plan management type; adding/increasing assistive technology repairs; adding quotes for assistive technology (except home and vehicle modifications).
It can be completed over the phone and usually quite quick to approve if all is in order.
- ‘Internal Review’ – What to do when you’re unhappy with a decision
Many decisions made by the NDIA are reviewable, including things like being accepted as a participant and the provision of reasonable and necessary supports.
- Ask the NDIA to review it by requesting an internal review – also known as a review of a reviewable decision – of the decision.
- You have 3 months after the decision is made to request an internal review, so act as promptly.
- It’s important to consider at the outset that a review will cover your entire plan not just one area that you might be disputing, and this has, in some cases, resulted in a reduction of the funding in the original plan.
- It’s very important to be able to explain why you think the decision is incorrect.
- Think about the facts you feel have not been considered or if there is any additional information that the NDIA did not have at the time of the decision. Also, think about how the decision has affected you and what is your ideal outcome of a review.
- We recommend you put everything in writing, so you have copies of all your documentation and a paper trail should you need them later.
- An NDIA staff member who was not involved in the original decision will review your request and may want to talk to you directly to ensure they fully understand your concern.
- The NDIA will let you know in writing if they have decided to change the decision or leave it unchanged. If you were denied something you requested, you can ask for the reasons in writing before deciding if you wish to appeal through the AAT.
For more information view the page on internal reviews on the NDIS website.
- Change in circumstances
You need to let the NDIA know if there have been any major changes in your life (e.g. you moved house, got a job, were hospitalised for a long period or your carer family member got sick or passed away). This can affect your plan and you may need more funds.
For more information view the page on change in circumstances on the NDIS website.
- Annual Plan Review
Plan reviews happen automatically when your current NDIS plan is due to expire – usually every 12 months. Your plan review is an opportunity for you to check if your supports are working for you and they are helping you work towards and achieving your goals.
- If you’re still not happy with your plan after internal review – The Administrative Appeals Tribunal review
If you are still not happy after the internal review of the decision, you can apply for a review by the Administrative Appeals Tribunal (AAT).
The AAT is a tribunal that exists outside the NDIA.
You can only apply for an AAT review after an internal review has been completed.
The time limit for making an application is usually 28 days after you receive your internal review decision.
For step by step instructions for an AAT review visit the AAT website.
- A ‘light touch’ plan review
What happens if I use up all of my funds before my plan expires?
When your NDIS plan is developed, your funding is designed for the duration of your plan, usually 12 months.
If you are plan or agency managed, they will look after making sure your funds last for you and send you reports regularly.
If you are self managed, you are ultimately in control of how and when your funds are spent during this time.
But if there is a situation where you notice that your plan funding is not going to last, the best thing to do is get in contact with the NDIS.
If your circumstances have changed in that your needs have increased since your plan was issued causing you to require more funds, you can you can submit a change in circumstance form asking the NDIA to reassess your situation.
What date is my plan due for an annual review?
Your review date should be on the front page of your plan. Usually these are every year, but they can also be every two years.
You should get a call from the NDIA to get the ball rolling on your review. If you haven’t heard six weeks before your review date we recommend calling your LAC and find out what’s happening, sometimes the NDIS is running behind and people haven’t had their review on time.
What if my first plan ends before my second plan starts? Can I get funding for that time?
A small number of people have been finding that there is a gap between when their first plan ends and their second plan begins.
If this the case for you, the NDIS will cover the costs as long as they are in line with what you were previously receiving in your plan. For more information please contact the NDIS.
Can I still use my funds and access services whilst I’m going through a plan review?
People ask if they can still use their funds and access services while they go through a plan review.
And the answer is yes – you can so long as you are spending in line with what your existing plan allows.
Do my unspent NDIS funds roll over?
No, they don’t. After every plan review you will receive a new plan outlining supports and funds for the next period of time. While you have the choice and control to spend your funds strategically throughout the year, you cannot roll over unspent money.
We recommend you document the reasons why you haven’t spent the funds (e.g. you were in hospital, you didn’t understand your plan, you needed a support coordinator to help you and it wasn’t funded etc), if there are valid reasons so that the planner/LAC takes this into account at your plan review.
Your NDIS Planner can then factor in additional supports to help you maximise your plan if needed (e.g. if you needed a plan manager or support coordinator to help you implement your plan you may be able to get this in your reviewed plan). Plans are not based on what you spent last year, it’s about what’s reasonable and necessary.
How will my plan review be held?
It’s up to you. It can be done face-to-face or over the phone. If you want face to face, then be sure to say that. Like your first planning meeting you are able to bring along, or include in the call, a family member, friend, advocate or some from Endeavour Foundation. It will usually be conducted by a Local Area Coordinator.
What do I need to do to prepare for my annual plan review?
Much like pre-planning you’ll need to think about your life: what worked well in your plan, what didn’t work well, have you made progress towards your goals or achieved them, what are your future goals and what supports you will need in the future.
To help you do this, we’ve prepared a plan review booklet, ‘Building My World’, which you can complete and take with you to your plan review meeting:
You do not need to pick new goals at each plan review but the NDIS wants to see how your supports and services are helping you progress, achieve new things and eventually, achieve your long-term goals.
Do I need to take any therapist or service provider reports or assessments to the plan review meeting?
Yes. The NDIS wants to see how your supports and services have been helping you achieve your goals, and any recommendations they may have for supports and services you might need in the year ahead.
In particular reports for all of your Capacity Building support categories are useful, and again linked backed to how you’ve used your plan funding to work towards your goals (remembering that all supports have to be reasonable and necessary and link to you achieving your goals).
We recommend requesting reports from your service providers and therapists at least six weeks in advance (longer if you can) to give them adequate time to prepare them.
How do I work out what funds I need for my next plan?
What do I need to take to my NDIS Plan Review?
Here is a list of the key things you should take to your NDIS Plan Review:
- A copy of your NDIS Plan.
- A completed copy of ‘Preparing for your plan review’ workbook.
- Information for your service providers about what supports they have delivered and what supports you need to reach your goals for the next year.
- If you have a decision maker, you should take them to your meeting.
- You can also take a family member, support worker or friend who knows you well and can help you in the review meeting.
Can I request a plan for longer than 12 months? I don’t want to go through the review process every 12 months.
If you feel your needs are unlikely to change and you don’t think you will need a plan review in 12 months’ time, you can request a future plan up to 24 months.
I’ve just gone for my annual plan review meeting, when will I get my new plan?
New plans after your annual plan review usually are approved faster than your first plan. We usually see people get their new plan 2-4 weeks after their plan review. If you’ve waited more than that and don’t have an explanation, you should give the NDIS a call.
Internal reviews can often take a bit longer, so just continue using funding in line with your existing plan until you have a review decision.
How do I make a complaint about the NDIS?
The NDIA welcomes feedback, including complaints.
If you have feedback, give it to your planner, contact your local NDIA office or send an email to firstname.lastname@example.org
To find out more visit the feedback and complaints page on the NDIS website.
Blogs and NDIS information you maybe interested in
Get ready for the NDIS with these pre-planning tools
A pre-planning booklet to help you to think about the supports you want and need – now and in the future – before meeting with your NDIA planner.
Discover guide to the NDIS
A practical, comprehensive guide to the NDIS, to help people understand the various components of the NDIS and how to access them.
NDIS FAQs and Glossary of Terms
A handy guide of NDIS FAQs and a glossary so you can familiarise yourself with NDIS language before your planning meeting.