You’ve decided you want to join the National Disability Insurance Scheme (NDIS), you’ve checked the criteria, and you’re confident you tick every box.
With success in mind, you carefully complete an access request form, gather every piece of evidence you can think of, and send it all off to the National Disability Insurance Agency (NDIA).
But what happens if your hard work doesn’t pay off and the access decision doesn’t go your way? What do you do then?
We explore next steps and options below.
Before you do anything else, it’s vital you understand why the NDIA decided you weren’t eligible for the Scheme. That information will be in the letter the Agency sends you once it’s considered your application.
There’s strict criteria for joining the NDIS – including age, residence, disability and early intervention requirements – so take a look at the NDIA’s eligibility checklist to see if you can learn more.
If a review of the eligibility checklist doesn’t shed any light, it may be that the NDIA decided the supports you need are best provided by mainstream services or the community. If that’s the case, you can still get information and support from a Local Area Coordinator (LAC) or Early Childhood Partner (ECP), and they can help to connect you to the services you need as well.
Mainstream supports come from government funded services like health, housing, mental health and transport, and there are services available through the community too.
Click here to find out more about supports and services provided by government and the community sector for people with disability. You may also be interested in the Information, Linkages and Capacity Building program managed by the Department of Social Services. The program provides funding to organisations to deliver projects in the community that benefit all Australians with disability, their carers, and families.
If you have new evidence to support your eligibility for the NDIS, or if your situation changes significantly, you can submit a new access request to the NDIA – unless you’ve requested a review of the initial decision, in which case you’ll need to wait for the outcome of that review.
When reapplying, it’s important to know why your application was rejected (remember: check the letter the NDIA sent to you), and to gather more evidence to show how your disability affects your life.
Providing insufficient evidence is often the reason NDIS applications are rejected, so if you’re reapplying, be sure to contact your medical and allied health professionals – along with others in your support network – to help you gather what you need. Important evidence includes:
If the NDIA thinks the evidence you’ve provided isn’t sufficient, you’ll be asked to give more information. The Agency explains what it considers to be good evidence here.
To reapply for the NDIS, you can complete this access request form, or you can contact your local NDIS office or partner office, or speak to a LAC or ECP, to ask for the form to be emailed or posted to you. You can also phone the NDIS National Contact Centre on 1800 800 110 to ask for help.
Once you’ve completed your access request form, you can email it to enquiries@ndis.gov.au or print it and mail it to the NDIA. Make sure all your supporting evidence is included. The NDIS Participant Service Guarantee outlines how long it should take the NDIA to get back to you.
If the NDIA decides you’re not eligible for the Scheme and you don’t agree with the decision, you can contact the Agency and ask it to explain how the decision was made, and what your options are.
You have three months from the day you receive the NDIA’s decision in writing to request an internal review. An internal review means and NDIA representative who wasn’t involved in the original decision will check if the Agency decided correctly – based on the information it had at the time – and they’ll also review any new evidence you provide.
Sometimes LACs and ECPs can help you with the internal review request and process, or they may connect you with an advocate who can assist.
There are a few ways you can ask the NDIA to review a decision. You can:
You can also send a letter with supporting evidence to:
Chief Executive Officer
National Disability Insurance Agency
GPO Box 700
Canberra ACT 2601
You can’t ask for an internal review if you miss the three-month window or if the NDIA withdraws your application because you didn’t provide information it asked you for in time.
You’ll find more information about internal reviews of NDIS access decisions here.
If you disagree with the outcome of the NDIA’s internal review, you have 28 days to ask the Administrative Review Tribunal to review it. This is called an external review.
The Tribunal can review an NDIS access decision, but usually it can only do so once the NDIA has reviewed it via an internal review first. However, if the NDIA hasn’t completed its internal review within the required timeframe, the Tribunal may be able to review the decision without waiting for the Agency.
You can visit the Tribunal website or call 1800 228 333 to request an external review. If you want an advocate or legal support at the Tribunal, you may be eligible for assistance via the NDIS Appeals Program.
The NDIS is a complex system, and a rejected access request doesn’t always mean the end of your journey in the Scheme – it may just mean you need to take a different route to get to where you’re going.
Not every outcome is or will be a positive one, but the most important tool to have in your kit is knowledge about your options. And remember, help is available.
We hope this roadmap supports you to navigate your path forward.
