Right now, there’s a lot of talk about National Disability Insurance Scheme (NDIS) eligibility reassessments impacting the lives of people with disability.
Although they’ve been around for years, eligibility reassessments have been the talk of the town since changes were made to the NDIS Act in late 2024, and they’re a regular fixture in debates and discussions about access, funding, supports, and all things NDIS.
So, what’s the go? Well, buckle in – because we’ve got you covered!
An eligibility reassessment helps staff of the National Disability Insurance Agency (NDIA) understand if your support needs are being met or if they’ve changed – and whether you still fit the eligibility criteria for the Scheme.
If it looks like you may no longer be eligible for the NDIS, you or your nominee will receive a letter from the NDIA, and you’ll be given the opportunity to provide information to inform the Agency’s decision-making process.
Here’s how eligibility reassessments work:
#1. You’ll receive a letter from the NDIA
If the NDIA decides to look at your eligibility, you’ll receive a letter to tell you which eligibility requirements the Agency is looking at, and you might also be asked to provide evidence– such as reports from your providers.
#2. You’ll have time to gather your documents
Not every eligibility reassessment requires input from the participant, but if there’s information or evidence you want to submit – or if the NDIA asks you for some – then you’ll have 90 days to gather everything you need, and you can request a bit more time if you need it.
Previously, the NDIA required all supporting information to be delivered within 28 days but following feedback from the disability sector and NDIS participants, that timeline was extended to 90 days in early 2025.
The NDIA staff who make the decision about your eligibility will be different from those who first decided you were eligible for the Scheme and separate to those who approved your NDIS plan (or plans). What that means is the decision will be made independently by people who don’t have a personal connection to you or a history of making decisions about your NDIS supports.
“While eligibility reassessments have always been a part of the NDIS, we know the experience is likely to be a new one for most participants,” says NDIA CEO, Rebecca Falkingham. “This means the process can make people feel stressed or unsure.”
“For some participants, their support needs won’t change. For others, they may reduce over time.”
If you’re not sure which requirements you met when you first joined the NDIS, take a look at the access decision letter that was sent to you at the time, or contact the NDIA to find out.
If you’ve had an eligibility reassessment in the past, you should’ve received an outcome letter as part of that process, and that should include details about why the Agency decided you should continue to receive NDIS supports.
#3. The NDIA makes its decision
The legislation says that once the NDIA has all the evidence it’s asked for, it has 14 days to make a decision or to request more information.
If the Agency reassesses your eligibility and decides you still meet the criteria for the Scheme, nothing changes. You can continue using your NDIS funding for the supports you need.
If your status as an NDIS participant is revoked, you can speak to the NDIA to find out more, or you or your nominee can request an internal review.
If you don’t agree with the outcome of the internal review, you can apply to the Administrative Review Tribunal for an external review.
Under new legislation, people appealing decisions about their NDIS eligibility can’t submit a new access request until the review has been completed.
To find out more about what to do if you don’t agree with a decision the NDIA makes, click here.
During a parliamentary hearing held in late 2024, the NDIA confirmed it was conducting some 1200 eligibility reassessments each week, with around 48 per cent of cases resulting in the person having their NDIS eligibility revoked. Eighty per cent of the reassessments related to early childhood participants, with the remaining 20 per cent covering participants of different ages and with a range of disability types.
The NDIA is particularly focused on the ongoing eligibility of people who receive support through the NDIS Early Intervention pathway (usually children). That’s because evidence shows that supporting people early can improve outcomes and reduce the need for supports later in life.
But not everyone who has their eligibility reassessed is a child. Sometimes, the Agency might reassess your eligibility for the Scheme because there are questions about whether you meet the residency or disability requirements of the NDIS. If that applies to you, the NDIA will guide you on the type of evidence it needs to help it make a decision.
Eligibility reassessments aren’t new, but recent changes to legislation mean the NDIA is playing close attention to the support needs of current participants, and considering the most appropriate sources of those supports (including mainstream and community services, as well as the NDIS).
If the Agency notifies you that it’s reviewing your eligibility, you’ll still be able to use your NDIS supports while an audit of the evidence the NDIA has on file is underway. If your plan is being reassessed at the same time as your eligibility, you might get a new plan, so your ongoing supports aren’t interrupted.
The Agency will try to get the information it needs without asking you to provide further evidence, but NDIA staff might also write to you to ask for specific information or a report in a format that helps them to make an eligibility decision.
Make sure you read any letters the NDIA sends to you, so you know exactly why your eligibility is being reviewed, and consider talking to family members, friends, trusted providers, or even a disability advocate to get help with providing information to support your case. You can talk to the NDIA too.
“No matter a participant’s circumstances, we want them to feel supported in every interaction they have with the NDIA,” says Ms Falkingham. “That’s why we are committed to always improving the ways we work.”
In early 2025, the new Minister for the NDIS, Amanda Rishworth, reportedly told The Australian newspaper that the Federal Government isn’t planning to change the NDIS eligibility criteria – which means the reasons why someone can or can’t stay in the Scheme aren’t expected to change.
You can find out more about the NDIS eligibility criteria here.
