Living with a disability, or caring for someone who does? If you’re in Australia, you’ve likely heard of the National Disability Insurance Scheme (NDIS). The NDIS is a game changer, providing essential support services like physiotherapy, speech therapy, community access programs, supported living and more, to those living with a significant and permanent disability in Australia.
But understanding the system and navigating the application and planning process can feel overwhelming. So, we’ve put together this guide to help you through the application process and answer some questions you may have.
In this article, we will cover:
- Understanding the NDIS
- Eligibility and initial steps
- How to apply
- Essential supporting documents
- Creating a plan
- Management options
- The planning meeting
- Finding a provider
- Funding and what it means
- Plan expiries
Let’s dive in.
Understanding the NDIS
The National Disability Insurance Scheme (NDIS) was created by the Australian Government to revolutionise how people living with a disability in Australia are supported.
This scheme allows people living with a permanent and significant disability to access Government funding to get the support services they need to enable them to reach their full potential.
The NDIS was legislated in 2013 and has been in full operation since 2020.
The National Disability Insurance Agency (NDIA) is responsible for managing the program and deciding who is eligible for support, and what level of funding for those supports they can get.
There are different support categories for funding:
– Core Supports cover things like day to day living activities, community participation, consumables, and transport
– Capacity-Building Supports include skills development, employment transitions, as well as access to a support coordinator if necessary
– Capital Supports cover assistive technology and modifications to your home or building
The NDIS Quarterly Report for 30 September 2022 showed that 554,917 people living with a disability across Australia are benefiting from NDIS support.
Eligibility and initial steps
There are certain criteria you need to meet to be eligible for NDIS funding.
To be eligible, you must:
– Be aged between 9 and 65
– Be an Australian citizen, permanent resident, or Protected Special Category Visa holder
– Reside in Australia
– Have a disability caused by a permanent impairment
– Need disability-specific supports to complete daily life activities
If these all apply to you, you may be eligible.
A good starting point is to check your eligibility by visiting the NDIS’s Am I eligible page.
How to apply
There are two ways of applying.
You can either:
1. Call the NDIS on 1800 800 110 and make a verbal application
2. Complete an Access Request Form. This involves you filling out Section1, while your healthcare provider completes Section 2. Then you submit this to the NDIS.
Essential Supporting Documents
- Proof of age
- Citizenship or residency proof
- Medical evidence confirming your disability and its impact
Visit the NDIS list of health professionals to identify who can best confirm your primary disability.
For your primary disability – the one that affects you most in your day-to-day life – you need to provide documented evidence
It needs to be recent (from the last 6 months) and completed by your treating health professional.
It needs to confirm your primary disability and outline its impact on your life. It also needs to describe your treatments and outcomes now, as well as future options and expected outcomes.
The supporting documents you will need to confirm your disability are:
- Evidence of your primary disability
- Time of diagnosis
- How it impacts your daily life
- Previous and existing treatments
- Future impacts and outcomes
Creating a plan
Once you’ve submitted your application along with all supporting documents, the NDIA will review it and let you know within 21 days of their decision or if they require more information.
If you’re approved, the next step is to have a planning meeting.
To prepare for your planning meeting, there are a number of things to consider.
You will be asked to:
- Outline your current support system
- Define your short and long term goals
- Complete the NDIS’s Booklet 2 – Creating your NDIS plan. This document will help structure your thoughts and focus on your goals
At your planning meeting, you can request how you want your plan to be managed.
You have three options:
Self-managed: This is where you choose your own service providers, negotiate agreements, manage your budget and keep records of what you’ve spent. You can also use your funds to pay for a bookkeeper to do the admin work for you. Keep in mind that you might be audited at anytime.
Plan-managed: This is where you get a plan manager built into your NDIS budget who will manage your payments to providers, your budget and reporting. They can also help you build your skills in finances and learn how to manage your plan yourself one day.
NDIA-managed: This is also called agency-managed and it’s where you can only choose NDIS-registered providers. Providers can then claim payments electronically from your funding and the NDIA does all your bookkeeping and record-keeping for you.
The planning meeting
When you meet with your NDIS planner, they will ask you about your goals and future aspirations, the support services you currently have and how you want to manage your plan.
Your NDIS planner will tailor your plan to match your needs and goals and allocate funding across the different support categories.
They might recommend allocating all your funding towards one type of support like Core Supports or Capacity Supports. Or they might spread your funding over Core, Capacity and Capital Supports, depending on your goals and needs.
It is important in this meeting to be very clear about your needs, goals and aspirations.
You will also need to be able to articulate this clearly to the NDIS planner or have someone with you who can act as your advocate.
Finding a provider
Once your plan is approved, the next step is to find suitable providers.
To help with this, you can consult a Local Area Coordinator (LAC) who is employed by the NDIA or a Support Coordinator.
A Support Coordinator is usually employed by an NDIS provider and can assist with finding you the right support services within the service offerings they have.
Both these people are here to provide you with information on the different services and providers that are available in your local area.
The NDIS also has a website that has a provider finder tool.
It’s a good idea to research and make a shortlist of providers in your area and then compare their services and experience with your specific disability-related needs.
It’s also important to make sure any providers you consider are registered under the NDIS, so you can be sure they offer the quality support you need. You will also need to research whether they can cater to your individual needs.
Like any industry, there are a few unscrupulous providers out there, so be sure to look at their Google reviews, ask for references or to speak with other participants.
Most NDIS service providers will also offer an opportunity to ‘try before you buy’ where you can trial their programs before committing to a longer-term plan.
You should also check the fine print on any documentation you are being asked to sign and know that it is well within your rights to give notice to terminate services at any time for any reason.
The NDIA has very clear guidelines for providers ensuring that you have full advocacy over your plan, funding and goals.
Should you have any issues with a provider, you can notify the NDIA who will look into the issue for you.
Funding and what it means
Your plan may be 12 or 24 months long. The total costs of your support services are calculated to cover the length of time of your plan, based on the needs identified in your planning meeting.
It is important that you, or whoever is managing your NDIS plan and funding does this responsibly, with your best interests in hand and maintains meticulous records.
Should you run out of funds due to a change in your circumstances or conditions, you can request a reassessment of your plan with an NDIS planner. These usually take at least 90 days to initiate. It is important to ensure that your funding is managed carefully, to ensure there is no interruption to your services or programs due to lack of funding.
In the reassessment meeting, the NDIS planner will review the alignment of your goals and the initial level of funding and make a recommendation based on the findings. This may or may not be approved, and is assessed on a case by case basis.
What happens when my plan expires?
Your plan will automatically be reassessed prior to the expiry date.
At this time, an NDIS planner will speak with you and/or your advocate, to evaluate the outcomes of the expiring plan and assess your changing needs, in preparation for your next plan.
There is no guarantee that the same level of funding will carry over from plan to plan as your needs will change as you get older, transition from school, and possibly enter the workforce.
In some cases, people’s disabilities may remain the same or deteriorate as they get older, and therefore, the level of support may need to change.
Each person’s case is different and will be assessed differently.
In any case, it is important for you to ensure you are prepared for the planning meeting, and have all the relevant information prepared ahead of time. Also ask your advocate to be there with you and be prepared to outline what you think you need in order to achieve your goals.
A final note
The NDIS is designed to empower people living with significant and permanent disabilities to unlock their full potential to access essential support services that might otherwise have been unavailable.
Whatever your goals – to become more independent, learn valuable life skills, get out and about in the community, or have therapy sessions to improve your quality of life, the NDIS system can help.
At Advanced Disability and Respite Services, we are a registered NDIS provider based in the Western suburbs of Sydney.
We offer Day Programs for people with both higher and lower care needs, Supported Independent Living to help transition to life outside the family home, and Respite care services, all of which can be included in your NDIS plan.
If you need more information, simply give us a call on 02 8328 0679 and we would be happy to discuss the different options with you.
Q1. Who is eligible for the NDIS?
The NDIS is available to Australians under the age of 65 who have a permanent and significant disability that affects their daily life and requires support.
Q2. Is the NDIS only for physical disabilities?
No, the NDIS covers a broad range of disabilities, including physical, intellectual, sensory, and psychosocial disabilities.
Q3. Can I choose my support workers under the NDIS?
Yes, the NDIS allows participants to have choice and control, including the ability to select their support workers.
Q4. Can I modify my NDIS plan if my needs change?
Yes, NDIS plans can be reviewed and modified if there are changes in your circumstances or support needs.
Q5. Can I apply for the NDIS if I have a temporary disability?
No, the NDIS is designed to provide support to individuals with permanent and significant disabilities. It does not cover temporary disabilities.
Q6. Can I have both an NDIS plan and receive other government support?
Yes, you can have an NDIS plan while also receiving other government support, such as the Disability Support Pension. However, you need to make sure you understand how these different supports interact and coordinate them to avoid any potential overpayments or conflicts.
Q7. What happens if my circumstances change after my NDIS plan is approved?
If your circumstances change, you need to notify the NDIA immediately and you can request a plan review. The NDIS is flexible and allows for adjustments to your plan to better meet your changing needs.
Q8. Can I switch to a different NDIS plan if I’m not satisfied with my current one?
Yes, if you’re not satisfied with your current NDIS plan, you can request a plan review and discuss your concerns with the National Disability Insurance Agency (NDIA). They will work with you to make the necessary changes.
Q9. Can I use NDIS funding for any purpose I want?
No. NDIS funding is meant to be used for the support and services outlined in your approved NDIS plan. While there’s flexibility within the plan, the funds should align with your disability-related needs and goals and align with the support categories detailed in your plan.