Around 4.3 million Australians live with disability. To provide support to those who live with disability, so they can live a fulfilling life, the country rolled out the National Disability Insurance Scheme (NDIS) in 2013.
Through the NDIS, eligible individuals can access financial support to reach their goals. Navigating the NDIS can be daunting for many, so we have created this comprehensive guide so you can understand what the NDIS is all about, how you can access the scheme and create a support plan that can help you lead an enjoyable, rewarding life.
What is the NDIS?
The National Disability Insurance Scheme (NDIS) is Australia’s national disability scheme designed to provide people with disability, who meet the eligibility criteria, the support and services they need to live and enjoy their life. When it was launched in 2013, it provided a new way of delivering support, in that it moved away from the State-run, block-funded systems that existed before and provides funding directly to people with disability via an individual, funded plan.
Find out more about the NDIS and how it works.
What does the NDIS do?
The NDIS provides financial support to eligible individuals to help them live a fulfilling life and reach the goals they set for themselves. It provides people with information and connects them to community services that can be of assistance such as education, sporting and recreation, medical and support services.
Find out the types of supports that can — and cannot — be accessed using NDIS funding.
Who is eligible for the NDIS?
Individuals who are aged between 7 and 65 and who have a permanent/ongoing physical, sensory, cognitive, intellectual or psychosocial disability may be eligible for NDIS funding.
An individual must live in Australia, be an Australian citizen, a Permanent Visa holder or a holder of a Protected Special Category Visa.
Eligibility includes impairments and medical conditions that originated from birth or through injury, accident or disease. People with a significant, permanent mental health condition may also be eligible for NDIS support.
Explore the NDIS eligibility requirements for disability requirements and early intervention requirements in detail.
How to apply for the NDIS?
Before you apply for the NDIS, it is important to understand what the NDIS does, check whether you meet the NDIS eligibility qualifications and what the process entails.
If you believe you – or a loved one you care for – is eligible for the NDIS, you can start by making a verbal application by calling 1800 800 110. You may prefer to go straight to the Access Request Form on the NDIS website, request the form to be sent via email or obtain one from the NDIA office.
You’ll need to supply evidence of your age, identity, citizenship status, your permanent Australian residency and your disability. If you need help with any aspect of your application because of speech or hearing loss, or language difficulties, visit the NDIS website for more information.
After providing your application and supporting evidence, you will receive a response within 21 days, letting you know if you have been deemed eligible.
I’ve been approved for NDIS, now what?
If you’re an adult or a carer supporting an adult who’s been approved as eligible for the NDIS, you’ll receive a printed copy of your plan in the mail or in person and you’ll be able to view your plan on the NDIS myplace portal within 24 hours. The next step is to have an NDIS plan arranged. The NDIA will contact you within 21 days of you receiving the letter to organise your first NDIS planning meeting.
This includes information about you and your goals, what supports you need, and funding that the NDIS will give you to pay for these supports and services.Your plan will set out which funded supports you will receive in each support category for which you have been deemed eligible. It will also give you information on services and supports that are funded and delivered by government agencies and community organisations, such as public transport, support groups and health centres.
Your plan will be reviewed, and once NDIS plan approval is given by the NDIA, you can start working towards the goals agreed upon in your NDIS plan. Funding becomes available once you have been approved for the NDIS.
Find out more about what happens after you’ve been approved for the NDIS.
Preparing for the very first meeting with the NDIS
Once you’ve been deemed eligible for access to the NDIS, the next step is to get ready for your first meeting with the NDIS. You will be asked about how you are progressing in various aspects of your life such as your home environment, education, employment, mobility and social engagement.
You’ll be asked about the kind of support you are currently receiving and also about the goals you’d like to achieve in your life. This is your opportunity to spell out what kind of support you feel you need.
Be prepared with a list of questions and also with a list of your goals. Have a think about what you’d like to achieve, either on a daily basis or in the coming months, weeks and years. Your goals can be of all different sizes, from being able to brush your own teeth to embarking on an interstate trip, earning a degree at university, and beyond.
Explore in more detail about preparing for your NDIS planning meeting.
What if I’m not happy with my new NDIS plan?
There could be several reasons you may not be happy with your new NDIS plan — there could be gaps in the types of support you expected to see, the funding might not be what you wanted, etc. Whatever the reason, you are entitled to discuss this with a representative of the NDIA. This is called appealing an NDIS decision.
Find out what you can do if you’re unhappy with your NDIS plan.
A guide to NDIS support purposes and support categories
NDIS funding is intended to facilitate daily life, increase an individual’s independence, promote their social participation, help them achieve goals and more. The three different categories of support budgets that can be included in an NDIS plan are:
- Core Supports budget
- Capacity Building Supports budget
- Capital Supports budget
Core Supports
Core Supports provide funding for daily activities, disability-related requirements and working towards goals. Depending on your requirements, you could receive help with domestic tasks, meal preparation and personal care such as showering, toileting and dressing. You may require transport supports, consumables such as continence products, and assistance with social and community participation.
Capacity Building Supports
Capacity Building Supports help individuals to aim for and reach goals and build their skills and independence. You may be looking to move into your own home and require assistance around budgeting, cooking, housekeeping and mobility, as well as finding and applying for a rental property.
Capacity building Supports can also support around transitioning between primary school, high school and tertiary education, and for skills training for finding and keeping a job. It aims to improve health, wellbeing and daily living, and can also incorporate behaviour support.
Capital Supports
Capital Supports refers to purchases that help NDIS participants optimise their home and life to achieve independence. The first key support category is Assistive Technology (AT), which could include memory aids, environmental control systems and assistive devices. The second is Home, in which funding may be provided for necessary home modifications.
Explore NDIS support purposes and support categories in detail.
How do I manage my NDIS funding?
As an NDIS participant, you can choose from three different options to manage your plan.
- Self-managed – You can self-manage your funds and receive your NDIS funding directly. This plan gives you complete control over your funds.
- Agency-managed – These plans are managed by the NDIA. The NDIA will work directly with your chosen NDIS registered provider to seek out disability support for you.
- Plan-managed – In this option, you enlist a plan management organisation to administer the financial aspects of your NDIS plan. They will receive and pay your invoices and make claims on your behalf.
It depends on your unique support preferences and lifestyle as to which style of plan management suits you best.
If your NDIS funding is managed by the NDIA:
- you can only use NDIS-registered providers for your support
- you can’t use your NDIS funding to book independent support workers on Mable.
Learn more about managing your NDIS funding.
Using your NDIS funding to connect with supports
Depending on how your NDIS plan is managed, there are various avenues for you to connect with support. If you are self-managing or plan-managing your NDIS plan, you could connect directly with support services through Mable. If you’re agency-managed, you can use a NDIS-registered provider only to deliver your supports. You may also be able to request funding from the NDIS for a Support Coordinator to connect you with your required supports.
Read more about using your NDIS funding to connect with supports, whether you’re self-managed, agency-managed or plan-managed.
When are NDIS plans reviewed?
NDIS plans are typically reviewed every 12 or 24 months, depending on the individual’s circumstances. They are typically pre-scheduled.
Preparing for your NDIS plan review meeting
Once you’ve become an NDIS participant, the NDIA will check to see how your plan is working for you. They’ll want to find out how the funded supports are helping you achieve your goals, build your independence and go about day-to-day life.
Your NDIS plan review may result in an increase or decrease in your plan for the following year, or it may remain the same.
Use your plan review as your opportunity to outline anything you think is not working and how it may be improved. It’s a good idea to gather supporting evidence such as medical reports from your GP, physiotherapist or another health professional. You may or may not have to provide the evidence but it will help you build a picture of how your supports are helping you and whether you’ve achieved the goals you had set for yourself.
You can also use your plan review to review your management options. That is, if you’re currently plan-managed but you’d like to self-manage, this is your opportunity to switch.
Read more about getting ready for your NDIS plan review. Here are some more tips.
How do I request a review of an NDIS decision?
If you feel as though a decision made by the NDIA about you is incorrect, you are welcome to request an internal review by calling 1800 800 110, emailing enquiries@ndis.gov.au or talking to someone at an NDIA office.
The NDIA aims to deliver their decision within 60 days of receiving the request.
When and how to ask for an NDIS plan reassessment
After your plan starts, you will be given your first NDIS plan review at around 12 months. If your personal circumstances change significantly in the meantime, you can contact the NDIA to request a plan review by completing a change in circumstances form.
You can request an early review if you don’t feel as though your plan will adequately fund the supports you require. The NDIS offers four different types of reviews:
- Internal review – If you think the NDIA’s decision concerning your plan is not correct. Learn more.
- External review – If the outcome of the internal review is not satisfactory, you can challenge the decision by applying to the Administrative Appeals Tribunal within 28 days of receiving the result.
- Unscheduled plan review – Legally, if you have a change in circumstances, you must report this to the NDIA. It could be that your informal care arrangements or your disability needs have changed significantly. An unscheduled plan review is to be submitted to the NDIA.
- Scheduled plan review – This pre-scheduled review will take place every 12 or 24 months, depending on your circumstances.
What if I’m not eligible for the NDIS?
After going through the eligibility process and finding out you’ve not been deemed eligible for the NDIS, the NDIA may be able to access support via other systems. Contact your Local Area Coordinator who can point you in the right direction. The NDIS has provided a web page containing links to resources for support for people who are not eligible for the NDIS.
Do I need NDIS funding to get support?
No, even if you are not eligible for NDIS funding, you can still access support, however you will need to pay privately (i.e. out of pocket).
As a client on the Mable platform, you can start accessing support immediately by searching the independent support worker profiles and connecting with someone you feel is a good fit for your needs.
You can begin receiving this support and pay for it privately and if you become eligible for the NDIS in the future, you will be able to transition seamlessly to funded support.
Mable is a platform which helps to connect people who live with disability with independent support workers every single day. We invite you to search the independent support worker profiles to see who is available in your area.
About the author
Catherine has worked in the disability arena for almost 30 years and has co-created and facilitated hundreds of workshops for people with disability and their families. Catherine has two family members with disability, both of whom have a self-managed NDIS plan, with Catherine as their nominee. Catherine acknowledges the generosity of the people who have shared their expertise, time and knowledge with her. Her articles are a combination of what she’s learnt from others and what she’s learnt from putting that knowledge into practice.
