The National Disability Insurance Scheme (NDIS) is the new way of providing support for Australians with a disability, their families and carers.
The team at IDRS provide support, to people with cognitive impairment, to appeal decisions made by the National Disability Insurance Agency (NDIA) to be externally reviewed by the Administrative Review Tribunal (ART). If you are unhappy with a decision made by the NDIA, the following steps outline the process:
- To request an internal review of that decision by the NDIA,
- If you still disagree with a decision after the internal review has been completed, you can apply to the ART to conduct an external merits review within 28 days. An external merits review is an independent assessment of an NDIA decision.
The types of decisions that can be reviewed include, but are not limited to: whether you are eligible for the NDIS; or what has or has not been approved for your NDIS plan.
An internal review must be conducted first by the NDIA before you can appeal to the ART.
When can I ask for assistant from the NDIS Appeal Team?
- An application to be an NDIS participant has been refused
- NDIA funding isn’t meeting the participant’s needs
- The plan required changes and the participant is not sure what to do
- The participant or person responsible have spoken to the NDIA about changing the plan and requires assistance
- The participant is unhappy with an NDIA decision about their plan
- The NDIA has refused to change the plan
- The participant or the person responsible wants to appeal the NDIA decision at the tribunal.
What support will the NDIS Appeals Team provide?
- Foster self-advocacy to support a person to put their case before the ART
- Where self-advocacy is not appropriate provide individual advocacy support developing and implementing an individual plan in partnership with the participant
- Where necessary assist the appeals applicant to navigate the NDIA internal review process
- Assist the appeals applicant to navigate the process of seeking an ART review of NDIA decisions, including:
- Preparing documents for the various stages of the process
- Referring to the Central Assessment Provider (CAP)to apply for legal services
- Attending legal appointments (if legal services are available)
- Attending ART case conferences, conciliation conferences and/or hearings
Case Studies
A middle aged man with intellectual disability who had previously received funding for day programs, respite and personal care supports for 18 years transitioned to the NDIS last year. A family member contacted IDRS because under the man’s NDIS funding package, he could afford less than half his previous disability supports and services. He had become isolated and distressed. He could not understand why he was now confined to his house so often. His family contacted IDRS after a review of the plan resulted in no additional funding being allocated.
We assisted the family by collating the relevant documents and providing support at the first case conference with the Administrative Appeal Tribunal (ART). We applied and were successful in obtaining legal aid assistance which meant the man had legal representation for the rest of the ART process.
At the ART conciliation, the NDIA requested a statement of lived experience from his family and we helped them prepare this document. Legal Aid negotiated a successful outcome prior to a hearing and the man was allocated funding that would support him for all his reasonable and necessary supports. His core funding was increased three fold. The NDIA planner told legal aid that the statement of lived experience was very persuasive to help them understand what his life is really like.
The family of a preschool child who has autism spectrum disorder, with intellectual disability and severe language delay contacted IDRS NDIS appeals staff for help. The child was receiving NDIS funding for therapy supports to help with learning basic skills such as how to speak, how to play and interact with others and how to regulate his emotions.
The funding provided in the package covered less than one fifth of the therapies recommended by health professionals. We were able to assist the child and the family with the NDIS Appeals process. We were also able to assist by applying for CAP funding for legal aid. We had to prove that the case was complex and novel which was successful. We then advocated alongside the solicitor from Legal Aid throughout the administrative law process at the Administrative Review Tribunal. Following conciliation the NDIA agreed to more than four times the amount of funding in the original package for therapies.
