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Reviewing NDIS decisions

If youโ€™ve ever been on the receiving end of an unexpected decision made by the National Disability Insurance Agency (NDIA) โ€“ one you didnโ€™t predict or agree with โ€“ youโ€™re not alone. In fact, thousands of people with disability have taken matters to the Administrative Review Tribunal (ART) in recent years, seeking to have Agency decisions reviewed.

From rejected requests for National Disability Insurance Scheme (NDIS) access, to funding cuts and decisions about disability supports, the Tribunal unpacks outcomes delivered by the NDIA to provide clarity for participants, the Agency, and those seeking support from the Scheme.

But how does the ART work, what are its powers, and how can it help? Weโ€™ve done a deep dive to find all the information you need.

Whatโ€™s the ART?

The ART is a federal body that conducts independent reviews of administrative decisions made under a wide range of Commonwealth laws. It impartially assesses each case on its merits.

The Tribunal aims to resolve matters as quickly and cost effectively as possible โ€“ and to do that, it can agree with an original decision, change it, make a new one, or send it back to the decision-maker for further consideration.

The ART reviews decisions made by Australian Government departments, ministers and agencies โ€“ outcomes on everything from visa applications, taxation, and workersโ€™ compensation, through to veteransโ€™ entitlements, Centrelink payments, and child support.

Importantly, it also has the power to review decisions related to the NDIS.

Different to and less formal than a court โ€“ and separate from the NDIA and the NDIS Quality and Safeguards Commission โ€“ the Tribunal and its processes are designed to be fair, efficient, and accessible for all.

Although the Tribunal can review decisions made under more than 400 Commonwealth Acts and legislative instruments, in some cases it canโ€™t do it until thereโ€™s been an internal review of the original decision or a review by a specialist body. Thatโ€™s the case with decisions made by the NDIA.

How to apply for a review by the ART

If you don't agree with a decision you receive from the NDIA, check the decision letter or email the Agency sent you to find out if the decision can be reviewed by the Tribunal.

The ART may be able to look at it โ€“ but before it can, you usually need to ask the NDIA to conduct whatโ€™s known as an internal review of a decision. You can find out more about internal reviews here.

Once the NDIA has reviewed its original decision, if you still donโ€™t agree with the outcome, you have 28 days to lodge an application for an external review with the Tribunal. In some cases, you can apply for an extension of time to make your application.

Applying to the ART for a review of an NDIA decision is free. There are lots of ways to contact the Tribunal and you can also apply for an external review online.

When applying, you need to provide information about the decision you want the Tribunal to review, as well as any supporting documentation youโ€™d like it to consider.

Some of the decisions the ART can review include:

  • decisions to reject a request for NDIS access
  • decisions that disagree with a participantโ€™s statement of supports
  • decisions that deny requests for a plan reassessment or variation
  • decisions related to a child participant in the Scheme
  • decisions about the appointment of plan or correspondence nominees

You can find out more about what happens after you apply to the ART here.

Itโ€™s important to remember that the original decision usually continues to operate while the Tribunal is reviewing it. If you want the Tribunal to suspend the original decision, you need to fill out a Request for Stay Order.

What happens next?

Once youโ€™ve lodged your application, the Tribunal will check it has everything it needs, and let you know if more information is required.

The ART will also get in touch with the NDIA and any other parties involved in the case to let them know youโ€™ve asked for a review of the Agencyโ€™s decision.

Wherever possible, the Tribunal tries to resolve cases through informal processes like conferences, conciliations and mediations. Pre-hearing outcomes can be reached by agreement, or matters can end if you decide to withdraw your case or the ART dismisses it.

Of the 27,500+ NDIS matters referred to the Tribunal since the Scheme first started, 78 per cent were resolved without a hearing.

This page on the ART website explains everything you need to know about Tribunal hearings and case events, which can be conducted in person, by phone, or via a video conference. If you need an interpreter or any adjustments are required to make your participation possible, let the Tribunal know as soon as you can.

Who does the ART talk to?

You can represent yourself in your dealings with the Tribunal or you can ask someone else to do it for you โ€“ like a lawyer, a disability advocate, a family member or a friend.

This page on the ART website includes information about the different supports available to you โ€“ and if you decide youโ€™d like a disability advocate or lawyer to represent you, the NDIS Appeals Program might be able to help.

If you choose to represent yourself, the Tribunal will contact you to let you know how to get ready ahead of a case event (like a directions hearing, interlocutory hearing, conference or conciliation). It will also let you know what you need to do if matters progress to a hearing.

Take a look at this page on the Tribunal website to find out more about getting ready for a hearing.

How do ART hearings work?

If your matter canโ€™t be resolved earlier, the ART will usually schedule a hearing so everyone involved can present information and discuss their views on the decision thatโ€™s being reviewed.

Usually, hearings are conducted by one Tribunal member who listens to you and the other parties, reviews the information presented, and makes a decision. You might receive the decision at the end of the hearing, or it might be provided to you later.

Tribunal staff will also attend the hearing, and your representative, support person, witnesses and anyone summoned by the ART may also be there.

Hearings are usually open to the public, but the ART can order them to be held in private if thereโ€™s a good reason to do so. If you think you need a private hearing, youโ€™ll need to write to the Tribunal to explain why.

If you want to know what happens during a Tribunal hearing, click here.

What happens when a decision has been reviewed?

We understand that not every decision about the NDIS feels like a positive one, but knowledge is power, and it can help you to move forward.

When the ART lets you know its decision regarding your case, it will also tell you what your options are โ€“ and if you arenโ€™t satisfied with the outcome, you might be able to appeal to a court or apply to the ART for a further review.

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