1. I have applied to the NDIS. What happens now?

How do I know I’ve been accepted into the NDIS?

If your application was by phone:

If the NDIA has conducted your application on the phone with you, they may have told you if you are eligible or not eligible or if they need more evidence before they can make a decision.

The NDIA asking for more evidence is different from being ineligible for the NDIS; it means there is not enough evidence to make a decision either way. Alternatively you may have more evidence that you want to submit to the NDIA before they make a decision.

Once NDIA has all the evidence they need to make a decision, they will inform you of their decision within 21 days.

If the NDIA has found you not to be eligible for the NDIS you can request a review of the decision, you may need to provide further evidence and you will need to make this request within three (3) months of the decision being made.

If you submitted an ‘Access Request form’:

Once the NDIA receives your NDIS Access Request form (your application) they will assess it on the evidence you have provided them.

The NDIA will let you know their decision within 21 days of receiving your application and all evidence. If they have asked you or an organisation they are permitted to for additional information, the NDIA will inform you within 21 days of receiving this information. An application is not considered lodged until the NDIA has all the information they require to make a decision.

If there is a delay in assessing your application for any reason, they will let you know why there is a delay.

Once the NDIA has made a decision they will send you a letter informing you of their decision. If you have a correspondence nominee they will also receive a copy of the letter.

NDIA’s decision will be that you have met their ‘disability requirements’ or ‘early intervention requirements’ or that you are not eligible for the NDIS. If the NDIA has found you not to be eligible for the NDIS, you can request a review of the decision. You may need to provide further evidence and you will need to make this request within three (3) months of the decision being made.

If you are not NDIS eligible, you may be able to receive disability supports elsewhere. Ask the NDIA or the Local Area Coordinator to refer you to services in your local area.

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4a. I’ve been accepted into the NDIS. Developing my NDIS Plan

My NDIS application was successful, what happens now?

The NDIA will have informed you that you have met either their ‘disability requirements’ or their ‘early intervention requirements’.

Meeting NDIA’s ‘disability requirements’ means that your application demonstrated that you need support to manage your everyday activities and that you are likely to need support throughout your life.

While meeting NDIA’s ‘early intervention requirements’ means that although you have demonstrated your need for support to manage your everyday activities and that you are likely to need support throughout your life, NDIA considers that with intervention now, your need for future supports will be reduced.

Whether you have met NDIA’s ‘disability requirements’ or their ‘early intervention requirements’, the next stage is to begin thinking about developing an NDIS Plan.

The NDIA will assign a Local Area Coordinator (LAC) to work with you in developing your NDIS Plan. The NDIA will let you know when to expect to hear from the LAC when you are informed of their decision.

Specialised support in psychosocial disability or any other disability

You can request that the Local Area Coordinator (LAC) assigned to support you have expertise in psychosocial disability. Having an LAC with expertise of how psychosocial disability can impact on your life may help to ensure that the type of supports you need are understood and included in your NDIS.

What is an NDIS Plan?

An NDIS Plan is a document that describes how you would like your life to be and the supports you need to get there.

Your first NDIS Plan may not differ from the support you are currently receiving. Your first NDIS Plan will be reviewed after 12 months and your next NDIS Plan will be developed from the information you provide in your ‘Participant’s Statement of Goals and Aspirations’ and your ‘Statement of Supports’.

Your Participant’s Statement of Goals and Aspirations will describe your:

  • current goals and aspirations
  • current living arrangements
  • informal and formal community supports received or accessed, and
  • current social and economic participation.

Your Statement of Supports will specify the:

  • general supports that will be provided to you
  • reasonable and necessary supports that will be funded by the NDIS
  • date and/or circumstances in which the NDIA will review your plan, and
  • management of the funding of supports in your plan.

You develop both these documents, but you can ask anyone to assist you in their preparation. When you are satisfied that your plan contains the supports you need to manage your everyday tasks and help you reach your goals and aspirations it will be submitted to the NDIA for approval.

If for some reason the NDIA doesn’t approve your NDIS Plan or parts of it, they will tell you why. You can accept their changes or ask for a review of their decision.

Resources to help with your NDIS Plan

‘Getting Plan Ready’ form
www.ndis.gov.au/sites/default/files/ Getting-Plan-Ready_0.pdf

‘Developing your Participant Statement – Adult’ website page
www.ndis.gov.au/participants/planning- process/developing-participant-statement- adult

NDIS Planning Guide & Workbook
www.ndis.gov.au/sites/default/files/ documents/planning_guide.pdf

My NDIS Pathway
www.ndis.gov.au/participants/planning-process

When you are developing your NDIS plan, talk with people you trust about the supports that will help you increase your independence and reach your goals and aspirations.

You can also bring a support person of your choice with you to any meetings with your Local Area Coordinator.

Remember: the NDIS is life-long support, so think about short-term, medium and long-term supports, that your plan is flexible, it will be reviewed and you can change your service providers if they’re not working out for you.

Developing my NDIS Plan

The NDIA will assign a Local Area Coordinator (LAC).

Your LAC will:

  • work with you to develop your NDIS Plan and prepare it for submission
  • support you in the implementation stage of your NDIS Plan, and
  • provide support throughout your NIDS journey.

How you would like your plan to be managed is part of the planning process.

My first NDIS Plan

In the first year of transferring from your current supports to the NDIS, you will have a ‘First Plan’. Your First Plan will often be a continuation of your current supports. You may get additional support if you can demonstrate it is necessary or that receiving support now could reduce your need for future supports.

While much of your support in the first year of the NDIS may be the same or similar to what you currently receive, the difference is that when available, you can choose the support providers you want – these may be the providers you currently have, or you may choose different providers to support you.

How do I locate support providers?

  • Your Local Area Coordinator (LAC), other support people and/or organisations can help you research who the providers are in your area.
  • You can also find NDIS Registered Service Providers in your area via the NDIA website at www.ndis.gov.au/document/finding-and-engaging- providers/find-registered-service-providers
    At this link, you can either use the tool there to find providers of types of services available in your area or you can download PDF documents that list all Registered Service Providers by the type of support they provide.

Looking for advice?

The Planning stage of your NDIS journey is where you have the opportunity to maximise the benefits being offered through the NDIS.

To enable you to do this, while seeking advice from family, friends or other trusted people will be helpful, it is the support and advice from specialists in your particular disability that will be key to ensuring you obtain the specific supports that you need.

If you are self-managing or having a service provider manage your NDIS Plan, your support providers don’t have to be registered with the NDIS, but they are required to have an ABN and meet all relevant industry standards. There’s more information about this in ‘Can I choose my own support providers?’ in Chapter 5.

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The NDIS has produced a booklet ‘My NDIS Pathway’. It provides an overview of what to expect at different stages of your NDIS journey. The booklet is available at: www.ndis.gov.au/ participants/planning-process

Or call the NDIA and they will send you a copy.

What will my NDIS plan look like?

Your first plan may include:

  • Informal supports – the support you receive from family and friends
  • Community supports – activities and services you receive from people of groups in your community
  • Mainstream supports – the supports you receive from health care and education providers for example
  • Reasonable and necessary funded supports – these are the support services that the NDIS can fund, they relate to your disability and are the things you need to live your life and increase your options for social and economic independence.

It will have the number of hours of support required for each of the six support areas you require that the NDIS funds. You may not need support from all these areas:

  • Mobility
  • Communication
  • Self-care
  • Self-management
  • Social interaction
  • Learning

After your NDIS Plan has been developed this will go to the NDIA for approval. They may approve all the plan, part of it, or none at all. If the NDIA does not approve all of or part of your plan they will tell you why.

If you disagree with the decision the NDIA makes you can ask to have the decision reviewed. See section 4b for more information about how to do this.

4b. My NDIS application was unsuccessful, or I don’t agree with a decision the NDIS has made. What can I do?

My NDIS application was unsuccessful.

You may not have had enough evidence to support your application and may have to obtain additional evidence prior to making another application. Making another application may feel like it is a long, arduous process and you may not feel like pursuing this further, but it’s worth remembering that once you are accepted into the NDIS, you’ll generally receive life-long support. So, it’s worth persisting, and there is support for you to do this.

Alternatively, you can request the NDIA review the decision.

You can apply to have an NDIA decision reviewed by:

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  • Submitting a written request; you can use the NDIS ‘Application for Review of a Reviewable Decision’ form if you want to. Using this form will assist you in clarifying the reason/s you believe the decision needs to be changed. It will also assist you in thinking about the type of evidence, if any, you will need to provide to the NDIS or the evidence they might need to obtain to have the decision changed.
  • Talking to someone at an NDIA office. You can find locations of NDIS locations on their website at: http://www.ndis.gov.au/about-us/locations
  • Calling NDIA on 1800 800 110
  • Sending an email to: enquiries@ndis.gov.au

My application was rejected, or I don’t agree with a decision made by the NDIA

NDIS Internal review process

If you think the review of your NDIS application or other decisions made by the NDIA are incorrect, you can request to have the decision internally reviewed. You have three (3) months from the time you receive NDIA’s decision to request a review.

However you decide to request a review of a decision made by NDIA, you will need to provide the NDIA with your contact details – name, address and a contact number, what the decision is you are requesting a review of, when the decision was made and why you think the decision should be changed.

The more information you provide the NDIA, the better they can conduct a review of the decision. For example, you may have additional information you can provide the NDIA that wasn’t available to them at the time the decision was made.

Once you have provided the NDIA with the information you want them to consider in conducting the review, an NDIA staff member (independent from the original decision) will conduct the internal review and make a decision.

The NDIA will make a decision as soon as reasonably practicable. Generally, NDIA’s decisions are made between one and two months. The decision can be to confirm, vary or set aside and substitute the earlier decision.

You can have an advocate support you at all stages of the NDIA internal review process as well as the Administrative Appeals Tribunal process.

Administrative Appeals Tribunal

I don’t agree with the outcome of my review, what can I do now?

If you disagree with the outcome of your review you can apply to have your decision reviewed by the Administrative Appeals Tribunal (AAT).

About the Administrative Appeals Tribunal

The Administrative Appeals Tribunal (AAT) is the agency that conducts independent reviews on a range of administrative decisions made under Commonwealth laws by the Australian Government and some non-government bodies.

The AAT can only review some decisions made by the NDIA.

These include a decision:

  • that a person does not meet the access criteria
  • to approve the statements of supports in a participants plan
  • not to review a participants plan
  • to appoint a plan nominee or a correspondence nominee.

You can have support at all stages in the Administrative Review Process. Support can be from family, friends, advocates, legal support or other people you nominate.

The AAT can organise a teleconference if someone who can provide additional information or evidence cannot attend on the day.

If you decide to lodge an appeal with the AAT you must make your application within 28 days of receiving NDIA’s decision.

Your application for a review of NDIA’s decision must be in writing.

You can use the AAT’s Application for Review of Decision form, available at http://www.aat.gov.au/resources/forms or you can contact the AAT on 1800 228 333 and they will send you one. Using this form helps the AAT make a decision about whether or not they can review the decision made. The AAT can help you with lodging an application.

Your application for a review needs to include:

  • your name, address and telephone number
  • the date you received the decision
  • brief reasons why you think the decision is wrong; and
  • when possible, a copy of the decision

If you can’t provide the AAT with a copy of the decision, then include a brief description of the decision in your letter.

You can lodge your application by mail, fax or email. There is no fee to lodge an application for a review relating to the NDIA decisions.

If you need the time extended to lodge your application for review, you will have to complete and lodge an ‘Extension of Time for Making an Application for Review of Decision’ form within the 28 days and explain why you need more time. This form is available at http://www.aat.gov.au/resources/forms, or you can contact the NDIA on 1800 228 333 to request a form be mailed to you.

After lodging a Review application

When the AAT receives your application they will assign a Contact Officer to you. They will be your AAT contact throughout the review process. The Contact Officer will contact you within three (3) working days of receiving your application.

When your Contact Officer contacts you they will discuss:

  • What happens with your application
  • How you would like the AAT to communicate with you; email, telephone, SMS, letter etc
  • Who, if anyone is helping you with your application
  • Any assistance you require to enable you to participate in the process
  • The most suitable times and locations for you to attend a Case Conference.

The AAT will send you a letter confirming they have received your application.

The AAT will also let the NDIA know that you have lodged an application with them. The NDIA will then be required to send you and the AAT a copy of all their documents relating to the decision you want reviewed. These documents are called T-documents.

A Case Conference is generally held two to four weeks after the AAT receives the T-documents from the NDIA.

What is a Case Conference?

A Case Conference is an informal meeting facilitated by a member of the AAT to see if you and the NDIA can reach an agreement.

Prior to going to the Case Conference, read the T-documents you have received and if you identify any further information that is relevant to your application, or if you have obtained further relevant information from other sources, where possible send that information the AAT.

Also, think about what outcome you want from the review process; it may be to have the decision set aside and a new decision made or the decision varied.

Bring any relevant documents with you to the Case Conference that you have not already provided to the AAT, and be open to resolving the issues.

What happens at a Case Conference?

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An AAT member will help you and the NDIA reach a decision where possible. If a decision is reached, the AAT will record the agreement in writing.

If no agreement is reached there will be a discussion as to the best way to proceed. Following the discussion a Case Plan will be developed; this outlines what all parties must do prior to the next stage in resolving the issues.

Generally, the next stage is Conciliation unless you decide you want a Fast-Track Hearing.

A Fast-Track Hearing is when you decide you don’t want to go to Conciliation; that you would prefer to go straight to the Hearing stage to have a decision made about the matter.

If you elect a Fast-Track Hearing this will be included in your Case Plan.

Once this is decided, the AAT will prepare a written Case Plan and you and NDIA will be provided with a copy.

What's in a Case Plan?

A Case Plan sets out:

  • Issues that have been resolved and the issues that remain in dispute
  • What will happen next
  • Dates and locations of the Conciliation or Hearing
  • Any additional material that you or the NDIA must give the AAT
  • Who will be attending the Conciliation or Hearing
  • What information you and the NDIA will present at a Hearing and whether other people, such as family members, carers or doctors, who you want the AAT to hear from will be attending or phoning in
  • Any accessibility and communication needs you have
  • Anything else to ensure the process is as fair and as quick as possible.

What is Conciliation?

Conciliation is a form of alternative dispute resolution the AAT uses when Conciliation is part of your Case Plan. Conciliation is generally within four weeks of your Case Conference.

Prior to Conciliation you must do everything your Case Plan requires to be done by you. You will also need to bring any information you have not already given the AAT about your application.

What happens at Conciliation?

The AAT member will work with you and the NDIA to try and reach agreement. If agreement is reached, the AAT will make a written record of the agreement reached.

If no agreement is made or only agreement about some parts of your application, then the AAT will confirm a date and location for a Hearing. It is not compulsory for you to do this.

This will be recorded in your Case Plan and a copy of this will be given to you.

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What is an Administrative Appeal Tribunal Hearing?

The Hearing is where you and NDIA each have the opportunity to tell your side of the case to an AAT member.

Your Contact Officer will contact you seven to fourteen (7-14) days prior to the Hearing to confirm the time, date and location of the Hearing.

Fourteen (14) days prior to the Hearing you are required to have provided the AAT and the NDIA with any additional information or evidence you want them to consider.

If you would like to submit a written summary of your position, you need to provide this to the AAT and the NDIA at least seven (7) days prior to the Hearing.

You must also make sure that any witnesses who will give evidence on your behalf at the Hearing will be available on the day and at the time of the Hearing. If they cannot be there it is important that a written copy of their evidence is provided to the AAT and the NDIA 14 days prior to the Hearing.

What happens at the Hearing?

After listening to each side, asking questions, seeking clarification and reviewing all the information that has been provided to them by both parties, the AAT member will make a decision.

The decisions the AAT member can make are to:

  • Affirm the decision–this means the decision is not changed; or
  • Vary the decision – this means part of the decision is changed; or
  • Set aside the decision and make a new decision in its place or they can send the decision back to the NDIA to make a new decision.

The AAT member will give you a decision at the Hearing if that’s possible. If the decision can’t be made immediately they will send it to you as soon as possible and no later than 60 days after the Hearing.

I disagree with the AAT’s decision, can I appeal this?

You have 28 days to lodge and appeal with the Federal Court. If you decide you want to lodge an appeal with the Federal Court, it is advisable to get legal assistance before doing this, as there are many rules about Federal Court appeals.

What happens if the NDIA does not do what the AAT ordered?

The NDIA has 28 days to appeal to Federal Court if it thinks the AAT’s decision is wrong.

If the NDIA has not complied with an AAT decision during this time, it might be because it is considering an appeal to the Federal Court.

If the 28-day appeal period has expired and the NDIA has not done what the AAT said it is to do, contact the person who represented the NDIA at the hearing. They should be able to find out what is happening and explain why there might be a delay.

If you are not sure whom to contact, call the AAT and they will help you. If there has been no appeal and you are unhappy about the delay, you can seek the assistance of the Commonwealth Ombudsman.

You can contact the Commonwealth Ombudsman on 1300 362 072 or you can make your complaint online. Links to information about how to make a complaint to the Commonwealth Ombudsman and their online Complaint Form are at: www.ombudsman.gov.au/making-a-complaint/online-complaint-form. The AAT may also be able to help you with this as well as any support people that assisted you in with your AAT Review.

How do I make a complaint?

If you are unhappy about the service you are receiving or the way you are being treated by any person, organisation or service provider who is working with you at any stage in the NDIS journey, you have a right to make a complaint.

Before you make a formal complaint, and when possible, see if you can resolve the complaint you have with the person or organisation. If this isn’t possible, or after talking to them, the complaint hasn’t been resolved then contact the NDIA on 1800 800 110 and make the complaint to them.

If the complaint is about the NDIA, follow their complaint process. You can make a complaint by talking to someone at any of their offices or you can fill in an online complaint form on their website.

There’s more information on the NDIA’s website about how to make a complaint at www.ndis.gov.au/about-us/contact-us/feedback-complaints

There’s also a link to their online complaint form at this site. Alternatively, you can email your complaint to feedback@ndis.gov.au

You can make a complaint in your preferred language.

There are also organisations that can assist you in having your complaints resolved or that can assist you in making a complaint and support you through the processes of this. These are listed in the ‘Resources to help with the NDIS’ section in Chapter 7.

If you’re making a formal complaint, it’s best to do this in writing, that way there is an official record of your complaint.

Whether you are formally or informally making a complaint there a few things that might help you resolve the complaint:

  • Be clear about what your complaint is
  • Have one or more examples to demonstrate the complaint, and if you can, include the date/s it happened
  • Let the person know how the issue you are raising affects you
  • Think about ways the issue could be resolved to your satisfaction – what would work for you?
  • Listen to the other person, there may be a reason something happened that made you unhappy about the service or the way you were treated
  • If you can, make a written record of the date you raised the complaint with the person, what was discussed and any decisions made – you can give a copy to the other person if you want to.

Also be sure to include in your letter:

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  • Your name and contact details
  • The name of the person and/or organisation the complaint is about
  • The date you will send the letter
  • Any evidence there is to support your claim, such as any witnesses to the incident, photographs etc
  • Anything you have done to try and resolve the issue, for example talked to the person or the organisation about your concerns
  • What you think should be done about your complaint
  • The date that you expect to get a reply in writing – you need to be realistic about this.

If you have made a complaint to the NDIA about them or about another person or organisation and you are not happy with outcome or the how the complaint was handled, you can contact the Commonwealth Ombudsman. The Commonwealth Ombudsman can only look into complaints about certain organisations. If your complaint is about a person or an organisation that they can’t look into, they will direct you to the right place.