The Access Request Kit Resource Bundle

Support+ Access Kit Resources

Section 6

RESOURCES

What to do if your Access Request is not successful – next steps

Word List - understanding the NDIS language Treatment Summary – Evidence of Disability template

How my Impairment Substantially Reduces my Functional Capacity worksheet

Access Review Application email template - GENERAL

Access Request Priority Eligibility Decision Request email template

Letter of Consent template

Applicant Lived Experience Statement guiding notes and letter template

Carer Lived Experience Statement guiding notes and letter template

Preparing to meet with your Treating Professional checklist

Treating Professional Evidence guide

© Intelligent Property Pty Ltd 2023 T/as Support Plus all rights reserved.

No part of this publication may be re-produced or adapted without express written permission of Support Plus.

Where indicated, certain content references the National Disability Insurance Scheme, Commonwealth of Australia, website. This document is not endorsed nor authorised by the NDIS and Support Plus is not associated with the NDIS. The information contained herein is general in nature and does not constitute personal advice. The content of this publication does not constitute legal and/or financial advice and should not be relied upon as such. You should seek your own independent legal and financial advice.

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WHAT TO DO IF YOUR ACCESS REQUEST IS NOT SUCCESSFUL – next steps It can be confusing and disappointing if you receive notification from the NDIA that your application was unsuccessful.

Please don’t give up!

Here are some next steps for you to consider:

Step

Consider doing this

1

Your ‘unsuccessful letter’ from the NDIA will outline which areas of the NDIS Act they consider you didn’t meet the eligibility criteria.

Match up what is in your letter with the information about the NDIS Act eligibility criteria in Section 2.1 of the Access Kit.

2

Then go to the relevant section of the Access Kit that has the ‘Guiding Notes’ on the specific criteria that you were assessed as being not eligible.

Review this area of your application to determine if you did or where you didn’t provide the necessary evidence. This is where you will need to focus on in relation to challenging the decision or providing additional evidence.

Make some notes if you can identify what is missing in your evidence, OR Make some notes if you believe your evidence should have satisfied the eligibility criteria.

3

If you haven’t received verbal feedback from the NDIA assessor, request it. Refer to page 19 of the Access Kit to see how to do this.

When you speak to the NDIA assessor, ask the following questions: 

Why and specifically what part(s) of the legislation does this decision relate to?



What evidence is missing? Request examples of what evidence is needed.



Who would be the best person (i.e. which type of Treating Professional) is best to provide this information?

Request this information be provided to you in writing (email/letter).

(‘Steps’ continued on next page)

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WHAT TO DO IF YOUR ACCESS REQUEST IS NOT SUCCESSFUL – next steps cont…

Step

Consider doing this continued

4

Make a decision on what you would like to do next. Here are some options for you: 1. Accept the NDIA decision and do nothing. The NDIA will help connect you to non NDIS services in your local community.

2. Ask for an internal review of the NDIA assessor’s decision. You may not agree with the reasons given for the decision and want to challenge it and/or you may want to submit additional evidence.

You may find the NDIS ‘Internal review of a decision fact sheet’ helpful.

Here is the link.

A NDIA assessor that was not involved in your original decision will check to see if the right decision was made.

You need to request an internal review within 3 months from when you received your decision in writing.

To submit an internal review, you can complete a ‘Request for a Review of a Decision Form’. You have a few options when submitting your Internal Review along with any supporting evidence: Email enquires@ndis.gov.au

Mail to NDIS, GPO Box 700, Canberra ACT 2601 Call the NDIA on 1800 800 110 Visit an NDIA office (e.g. Services Australia) Send a letter with supporting evidence to the Chief Executive Officer, NDIS, GPO Box 700, Canberra ACT 2601 3. Reapply. You can do this at any time if you have new evidence or if your situation changes in the future. You may for example, have discovered that you didn’t provide enough evidence and you are able to get further evidence from your Treating Professional.

If you reapply you will need to prepare and submit a new Access Request application form.

(‘Steps’ continued on next page)

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WHAT TO DO IF YOUR ACCESS REQUEST IS NOT SUCCESSFUL – next steps cont…

Consider doing this continued

Step

5



Ask the Administrative Appeals Tribunal (AAT) to review the decision.

You can contact the AAT via their website at www.aat.gov.au The AAT process is currently under review by the Federal government. For now, this option is available to you. 

The other option is to request that your decision is referred to the ‘Independent Expert Review Panel’ instead of using the AAT process.

Here is a link to an Independent Expert Review FAQ document.

The FAQ document states you need to have a AAT application in progress before being offered the Independent Expert Review option. Our understanding is you can request an Independent Expert Review (IER) without lodging an AAT application first.

If you want to lodge an external review, this needs to be done within 30 days from when the NDIA made the internal review decision.

6

Consider contacting a disability advocacy organisation to seek advice on how to lodge an internal or external review.

There are organisations across Australia that are funded under the National Disability Advocacy Program.

Here is the link.

You also have the option of seeking private or publicly funded legal services.

Here is the link to legal aid.

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WHAT TO DO IF YOUR ACCESS REQUEST IS NOT SUCCESSFUL – next steps cont…

Q&A Can I make a complaint?

Yes. If at any time in your application process you do not believe you are being or have been treated fairly, you have a couple of options: 1. Lodge a complaint with the Federal Minister for Disability.

Here is the link.

There is a ‘Ministerial Complaints Section’ within the NDIA and your complaint will be referred by the Ministers office direct to this section of the NDIA. The NDIA is required to keep the Ministers office updated.

2. Lodge a complaint with the NDIA. The NDIS website has more information on how to lodge your complaint and what you can expect to happen.

Here is the link.

Q&A What if I can’t get a specialist report due to cost, unavailability of specialist etc.

If the NDIA indicate that you need a specialist to provide evidence, ask your Treating Professional for supporting documentation as to why this is not possible for you.

Here is an example response from a GP where it was recommended by the NDIA to get evidence from a pain specialist to satisfy the Disability requirement of ‘is your impairment likely to be permanent’: “Emily is financially disadvantaged and accessing specialist medical services is not available to her. In any event, the waiting list for a pain specialist is in excess of 6 months.

I am Emily’s GP and I have known her for 15 years. I am able to provide a longitudinal view of Emily’s pain presentation as I have observed her condition closely over an extended period of time.

As a registered medical professional I am qualified to provide the evidence that Emily has exhausted all appropriate and available treatments. Emily’s Treatment Summary, dated …, provides this evidence”.

TIP The NDIS have a ‘Participant Service Charter’ which explains what participants can expect when they deal with the NDIS. The service charter includes a Service Guarantee where you can find information about the internal review process and expected response timeframes. You can download the charter from the NDIS website. © National Disability Insurance Scheme Agency 2013

Here is the link.

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WORD LIST – understanding the NDIS language

To help orientate you to the NDIS language, here are some commonly used words that relate to and are used throughout the Access Request application process:

Access Kit is a resource that has been developed by Support+ to assist you in applying to the NDIS. Access Request application is how you apply to the NDIS and let them know you want to become a NDIS participant.

Administrative Appeals Tribunal (AAT) is an independent body that reviews decisions made by the Australian Government, for example, if you don’t agree with your Access Request decision.

Condition is a disease or medical condition that affects your ability to function with your day to day activities.

Disability is defined by the NDIS as incorporating impairment, activity limitation and reduced participation for a person.

Disability requirements are the eligibility criteria relating to a disability that is caused by an impairment that is permanent, or likely to be permanent, and that results in a substantial reduction in how you function.

Early intervention requirements are the eligibility criteria relating to a disability that will reduce the functional impacts of your impairment through early access to support.

Early Childhood Partner’s are specialist organisations in your local community who deliver early interventions to children under 9.

Eligibility criteria consist of 3 components – age, residency and Disability or Early Intervention requirements. All 3 components will need to be met to become a NDIS participant.

Impairment is when your disability is caused by the loss of ,or significant change in, at least one of the following - physical, intellectual, cognitive, neurological, sensory or psychosocial capacity.

Internal review (called a ‘s100’ in NDIS language) is a review of a decision by the NDIA (for example, if your application is unsuccessful and you would like the decision reviewed).

Informal supports are supports that are not paid, usually family.

Lived Experience Statement is in your own words your experience of your disability and how you live through and respond to those experiences.

(Word list continued on next page)

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WORD LIST – understanding the NDIS language cont…

National Access Team (NAT) is the division within the NDIA that assesses Access Request applications.

National Disability Insurance Agency (NDIA) is the government organisation that implements and manages the NDIS and decides whether individuals are eligible to join the NDIS. National Disability Insurance Scheme (NDIS) provides funding to support individuals with a significant and permanent disability to take part in everyday activities.

NDIA assessor is the person who assesses your Access Request application.

NDIS Act is a federal government law that includes the Access Request eligibility criteria.

NDIS Operational Guidelines (Applying to the NDIS) are used by the NDIA assessor to make decisions on your eligibility.

NDIS Plan is the goals, your individual circumstances and approved funding you will have access to when/if you become a NDIS participant.

NDIS (Becoming a Participant) Rules supports the NDIS Act by providing further details on the eligibility criteria. Click link here

NDIS website www.ndis.com.au is where you will find current information on everything about the NDIS. Permanent disability is when your disability is likely to be lifelong.

Participants are people who are living with disability, have been assessed as eligible, and have joined the NDIS. Psychosocial disability is when you have reduced capacity to do daily activities due to your mental health.

Services Australia delivers government social services programs such as Centerlink and Medicare.

Significant disability means a disability that has a large impact on a person’s ability to complete everyday activities.

Substantially reduced functional capacity means you are unable to effectively participate in or complete tasks without support for most activities in a particular area of your life (i.e. mobility, communication, socialising, learning, self care or self management).

Supports are services, items and equipment the NDIS provides or funds (i.e. once you have become a participant) to help you with your day to day activities and to be part of your community.

Treating Professional is the most appropriate person to provide evidence of your disability.

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TREATMENT SUMMARY:

Application Form, Section 2, Part B, Evidence of Disability

Applicant name: ……………………………………………………..

Questions 5 - 7:

Current and Past Treatments

Treatment (e.g. medication, therapies, surgeries, pain education etc)

Date started

Date ceased (leave blank if current)

Treatment is likely to or has remedied, i.e.

REMOVED or CURED the impairment?

Yes

No

Not tolerated







Yes

No

Not tolerated







Yes

No

Not tolerated







Yes

No

Not tolerated







Yes

No

Not tolerated







Yes

No

Not tolerated







Yes

No

Not tolerated







Yes

No

Not tolerated







Yes

No

Not tolerated







Comment (e.g. result of treatment, why not tolerated etc)

(use additional sheets as required)

………………………

Signature

……………………………………….

Name

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……………………………

Date

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How my Impairment Substantially Reduces my Functional Capacity worksheet Think about a typical day in your life and the challenges you experience and the different types of help you need to complete ordinary tasks of daily living.

Use the following self assessment to identify where you need a high level of support from other people (physical assistance, guidance, supervision or prompting) or assistive technology/equipment/home modifications in one or more of the following life areas. Add other examples as necessary:

Mobility (or moving around)

Communication

Socialising

How you use your limbs for physical activities e.g. standing, walking, getting in and out of bed, leaving your home

How you understand others and being able to express what you want and need through spoken, written &/or non verbal methods

How you make and keep friends, interact with the community, and behave

I need consistent support to take part in activities or tasks such as:

I need consistent support to take part in activities or tasks such as:

I need consistent support to take part in activities or tasks such as:

 Being understood in spoken, written or sign language  Understanding what people say  Expressing how you feel and what you want  Talking to others  Following instructions   

 Making and keeping friends  Initiating conversations  Understanding feelings and interactions  Interacting with strangers  Coping with feelings and emotions in a social context  Working, volunteering, going to school  

 Getting in & out of bed or a chair  Moving around the home  Leaving the home  Accessing the community e.g. shops  Using public transport   

 Learning

Self care

Self management

How you understand and remember information and use new skills

How you meet personal needs e.g. hygiene, grooming, eating, drinking and caring for your health

How you organise your life, e.g. making decisions, problem solving and managing finances

I need consistent support to take part in activities or tasks such as:

I need consistent support to take part in activities or tasks such as:

I need consistent support to take part in activities or tasks such as:

 Understanding and remembering information  Learning new things  Studying and attending courses  Practicing and using new skills  Concentrating on doing something   

          

Getting dressed Showering & bathing Oral care Going to the toilet Preparing meals Eating Medication management Caring for own health

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     

Planning & making decisions Completing daily tasks Problem solving Managing money Managing a tenancy Taking care of household responsibilities

  

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Access Request Application email template - GENERAL Use this email template format when sending documentation in relation to your Access Request application to the NDIA. The attachments listed below are for EXAMPLE only and will need to reflect your supporting documentation.

To:

nat@ndis.gov.au

From:

(your email address)

Subject:

RE: (name of applicant) – NDIS Access Request

RE: ***NDIS Access Request*** (name of applicant) We have attached for your review Access Request supporting documentation and evidence: 

Access Request Form, (name of applicant), (date)



(name of assessment/report) – (name of Treating Professional), (date)



Treatment Summary - (name of Treating Professional), (date)



Applicant Impact Statement - (name of applicant), (date)



Carer Impact Statement - (name of carer), (date)

We look forward to your determination and should you require any further clarification or information with regards to this application, please ask or contact (name) on: Mobile: Email: Yours sincerely (name)

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Access Request Priority Eligibility Decision Request email template Use this email template format when sending documentation in relation to your priority application to the NDIA. If you are posting the request include ‘Priority – Urgent Access Decision Required’ on the top of the first page of the Access Request application form.

The attachments listed below are for EXAMPLE only and will need to reflect your supporting documentation.

To:

nat@ndis.gov.au

From:

(your email address)

Subject:

PRIORITY – Urgent Access Decision Required for (name of applicant)

RE: ***PRIORITY NDIS Access Request*** (name of applicant)

(Treating Professional name) letter of (date) provides information in relation to (applicant name) Access Request and why it meets the requirements for priority access and planning due to urgent circumstances as defined in the Operational Guidelines (Applying to the NDIS) i.e. (insert your circumstances from the Operational Guidelines priority eligibility decision list)

Please find attached Access Request application form and supporting documentation: 

Access Request Form, (name of applicant), (date)



Priority Access Information letter, (name of Treating Professional), (date)



(name of assessment/report) – (name of Treating Professional), (date)



Treatment Summary - (name of Treating Professional), (date)



Applicant Impact Statement - (name of applicant), (date)



Carer Impact Statement - (name of carer), (date)

We look forward to your determination and should you require any further clarification or information with regards to this application, please ask or contact (name) on: Mobile: Email: Yours sincerely (name)

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LETTER OF CONSENT template

I, (full name of applicant) ………………………………………………………... of (address of applicant)…………………………………………………………………………… date of birth …………………………………….contact phone number…………………………

Consent to (full name of representative)……………………………………………................... of (address of representative)……………………………………………………………………... contact phone number…………………………………….. email…………………………………

To act on my behalf in connection with my dealings with the National Disability Insurance Agency and my NDIS Access Request application.

Signature of applicant……………………………………..

Print name in full…………………………………………..

Dated………………………………..

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APPLICANT - Lived Experience Statement guiding notes and letter template A lived experience statement is in your own words, your experience of your disability and how you live through and respond to those experiences.

Including a lived experience statement is highly recommended. It will contribute to your evidence by providing the NDIA assessor with insight into what the personal day to day impact is of living with your disability and the support you need to lead your life to its potential.

There are some guiding notes below. Use the prompts from the guiding notes to put together a Lived Experience Statement. Use the letter template format provided and number each of the sections in your letter.

GUIDING NOTES 1. Introduce yourself.

2. From your perspective, describe the hardest thing for you about living with your disability.

3. Describe in detail and provide examples of what you struggle with every day. Focus on the one or more life areas and the evidence that was provided in Part E of the Access Request application form.

Also use the outcomes from the ‘How my Impairment Substantially Reduces my Functional Capacity’ worksheet if you have used this. You will find this worksheet in Section 6, Resources of the Access Kit. Use headings to sort your evidence for each of the relevant life area impacted, i.e.      

Mobility Communication Socialising Learning Self care Self management

If ‘self care’ is substantially impacted, describe exactly what assistance, how much and how often you need. Think about a day where your disability is affecting you the most. Here is an EXAMPLE for self care: “I need help for almost everything to do with care for myself. For example, washing and dressing, getting in and out of the car, getting in and out of bed, getting on and off the toilet.

Everything, except feeding myself, although someone else has to prepare all my meals. The act of eating or feeding myself is physically draining and I don’t have much of an appetite.

Starting when I wake up, I need help to get out of bed and get to the toilet. I can’t do this by myself. That’s if I can actually get out of bed. Sometimes I can’t and I have to wait until I can.

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APPLICANT - Lived Experience Statement guiding notes and letter template cont...

After getting help to get out of bed, I need help so that I don’t fall. I need help to get on and off the toilet. I need help to get into the shower and to be handed things (toothbrush and face washer) as I can’t bend and reach to get them myself. I need help to wash the rest of me as I can’t bend or twist at all. I then need help to towel dry and dress me and help to get into my chair in the lounge where I get help to put my shoes on or in most cases I need help to get back into bed right after the shower because I am exhausted.

I have to help to move position every couple of hours so that I don’t get a pressure sore. I have had these in the past. I need to help if I drop anything as I can’t bend over to pick it up.

I need help to get my things out of cupboards as I can’t bend or twist to look in them either.

At the end of the day, I need help to get undressed and into bed. During the night I need help to go to the toilet. Then I need help to reposition in bed. I don’t get much sleep and I am exhausted.

Our social life is dependent on people visiting us and that’s not often. I miss going out with friends or seeing my family. I haven’t worked for many years because of my disability. I am not interested in any of my hobbies anymore.

4. State what equipment you need to engage in daily activities. For example, wheelchair, sensory aids, special cutlery etc. What are they used for and how often are they used?

5. Describe who provides you with support (if anyone). For example, who are they, how often and what support do they provide. Is it sustainable and if not, why?

6. Describe the impact on you and the impact on your relationship(s). How does this make you feel? How does it make others feel?

7. Describe what funded supports you believe you need. Here is an EXAMPLE: “This is what support would mean me: 

Having a support worker to help with myself care would mean all of my personal needs would be met, for example, I’m often left waiting because having someone to help me all the time is not possible. It is physically and emotionally impossible for ………. to meet my needs 24/7.



Having a support worker to help with a home exercise program would help prevent me from physically deteriorating further.



Having a support worker would mean I could re-engage with my hobbies.



Assistance with household tasks would mean …………… could spend time with me, not just as my carer.

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APPLICANT - Lived Experience Statement guiding notes and letter template cont... 

Having access to transport and a support worker would mean that I can get out into the community.



Having specific equipment to help me get in and out of bed and chairs would mean I would be safe and a wheel chair would enable me to get out and about and to socialise”.

8. Describe what you believe will happen if you don’t receive support from the NDIS. Here is an EXAMPLE: “I am getting worse because I am not getting the support that I need. I desperately need support to keep me at home. This is what I want. If I don’t receive help from the NDIS, my only option is for me to go to hospital due to the level of support that I need. This would have a devastating impact on me and on my relationships”.

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Applicant Lived Experience Statement guiding notes and template cont...

APPLICANT LETTER TEMPLATE

In regards to the NDIS Access Request of (name of applicant)

Applicant Lived Experience Statement

1. (insert introduction)

2. (insert hardest thing for you about living with your disability)

3. (insert what you struggle with using one or more of the life areas)

4. (insert equipment used) 5. (insert who provides support to you and it’s sustainability)

6. (insert impact on your relationships)

7. (insert funded supports you need)

8. (insert consequences of not getting funded support)

Thank you for taking the time to understand my situation.

Yours sincerely

(signature) (name and date)

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CARER - Lived Experience Statement guiding notes and letter template Your lived experience statement is in your own words, your experience of caring for someone living with disability and how you live through and respond to those experiences.

Including a lived experience statement from you as a carer is highly recommended. It will contribute to the applicant’s evidence by providing the NDIA assessor with insight into what the personal day to day impact is on you as a carer and the support the person you care for needs to lead their life to their potential.

There are some guiding notes below. The prompts from the guiding notes can be used to put together your Lived Experience Statement. Use the letter template format provided and number each of the sections in your letter.

GUIDING NOTES 1. Introduce yourself and what is the relationship you have with the applicant. For example, family member, friend, advocate etc. and how long you have known them.

2. From your perspective, describe the hardest thing for the applicant about living with his/her disability.

3. Describe in detail and provide examples of what the applicant struggles with every day.

Focus on the one or more life areas and the evidence that was provided in Part E of the Access Request application form.

Also use the outcomes from the ‘How my Impairment Substantially Reduces my Functional Capacity’ worksheet if you have used this. You will find this worksheet in Section 6, Resources of the Access Kit. Use headings to sort your evidence for each of the relevant life area impacted, i.e.: Mobility Communication Socialising Learning Self care Self management If ‘self care’ is substantially impacted and you provide the applicant with assistance, describe exactly what assistance, how much and how often. Think about a day where his/her disability is affecting him/her the most. Here is an EXAMPLE for self care: “Sally needs me for almost everything to do with herself care. She needs me to wash and dress her, get in and out of the car, get in and out of bed, get on and off the toilet.

Everything, except feed herself, although I prepare all her meals. I also need to prompt Sally to eat as the act of eating or feeding herself is physically draining for her and she doesn’t have much of an appetite.

Starting when she wakes up, I help her out of bed and get to the toilet. She can’t do this by herself. That’s if she can actually get out of bed. Sometimes she can’t and we have to wait until she can. After helping her out of bed, I have to support her so that she doesn’t fall. I help her get on and off the toilet and clean her.

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CARER - Lived Experience Statement guiding notes and letter template cont...

I have to help her into the shower and hand her things for her face (toothbrush and face washer) as she can’t bend and reach to get them herself. I have to wash the rest of her as she can’t bend or twist at all. I then towel her dry and dress her and help her get to her chair in the lounge where I put her shoes on for her or in most cases help her back into bed right after her shower because she is exhausted.

I have to help her move position every couple of hours so that she doesn’t get a pressure sore. She has had these in the past. I need to help Sally if she drops anything as she can’t bend over to pick it up. I need to get her things out of cupboards as she can’t bend or twist to look in them either.

At the end of the day, I help Sally get undressed and into bed. During the night I need to help her go to the toilet. Then I need to help her reposition in bed. I don’t get much sleep and to say I'm exhausted is an understatement.

Our social life is dependent on people visiting us and that’s not often. I miss going out with friends or seeing my family. Sally has not worked for many years because of her disability. I have noticed over the past 12 months that she is not interested in any of her previous hobbies. This worries me as she used to get some enjoyment from them”.

4. State what equipment is needed for the applicant to engage in daily activities. For example, wheelchair, sensory aids, special cutlery etc. What are they used for and how often are they used?

5. Describe who else provides support to the applicant (if anyone). For example, who are they, how often and what support do they provide. Is it sustainable and if not, why?

6. Describe the impact on you and the impact on your relationship with the applicant. How does this make you feel? How does it make the applicant feel? Here is an EXAMPLE: “Sally tells me she is not the wife that’s she wants to be. I can see that upsets her a lot.

I have not been able to work as I need to look after Sally. But I need to work as we need the money. I am so exhausted all of the time that I actually don’t think I could go back to work and it wouldn’t be safe for me to do so. I miss not being able to get out into the community.

I am at breaking point. Being a full-time carer is wearing me down. I don’t get enough sleep and I am physically and emotionally exhausted.

Our situation is not sustainable and I am losing hope. Sally is at risk, and, increasingly I feel that I am also at risk. I am socially isolated and I feel that Sally is not getting the care she needs. I feel terrible about that”.

7. Describe what funded supports you believe the applicant needs. Here is an EXAMPLE: “This is what support would mean to Sally and me: 

Having a support worker to help with Sally’s self care would mean all of her personal needs would be met, for example, she is often left waiting for me because I am busy with other things and I am exhausted. It is physically and emotionally impossible for me to meet her needs 24/7.

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CARER - Lived Experience Statement guiding notes and letter template cont... 

Having a support worker to help with a home exercise program would help prevent her from physically deteriorating further.



Having a support worker would mean Sally could re-engage with her hobbies.



Assistance with household tasks would mean I could spend time with Sally, not as her carer, as her husband.



Having access to transport and a support worker would mean that Sally can get out into the community.



Having specific equipment to help her get in and out of bed and chairs would mean she would be safe and a wheel chair would enable her to get out and about and to socialise”.

8. Describe what you believe will happen if the applicant doesn’t receive support from the NDIS. Here is an EXAMPLE: “I can see Sally is getting worse because she is not getting the support that she needs. We desperately need support to keep Sally at home with me. This is what we both want. If Sally doesn’t receive help from the NDIS, our only option is for Sally to go to hospital due to the level of support that she needs. This would have a devastating impact on both of us and on our relationship”.

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CARER - Lived Experience Statement guiding notes and letter template cont...

CARER LETTER TEMPLATE

In regards to the NDIS Access Request of (name of applicant) Name of carer: ……………………………..

Carer Lived Experience Statement

1. (insert introduction) 2. (insert hardest thing for the applicant about living with his/her disability) 3. (insert what the applicant struggles with using one or more of the life areas) 4. (insert equipment used) 5. (insert who provides support to applicant and sustainability) 6. (insert impact on relationships) 7. (insert funded supports needed) 8. (insert consequences of not getting funded support)

Thank you for taking the time to understand our situation.

Yours sincerely

(signature) (name and date)

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Preparing to meet with your Treating Professional checklist Getting the necessary evidence to meet either the Disability or the Early Intervention requirements is essential.

Doing some preparation prior to meeting with your Treating Professional is worth the effort.

Here are 4 things to do prior to meeting with your Treating Professional:

Task

1

Consider doing this Book a long consultation with your doctor for the purpose of completing the Access Request application form.

Download the Access Request form and complete Section 1 prior to seeing your Treating Professional.

Here is the link.

2

Complete the Access Request ‘How my Impairment Substantially Reduces my Functional Capacity worksheet’.

This relates to the Disability requirements only, i.e. Part E of the application form.

If you or a family member is completing Part E, fill in this section of your application form before you meet with your Treating Professional. This would probably be because you don’t have an allied health professional (e.g. OT, physio) to assist with filling out this section.

If, for example, you are meeting with your GP or specialist, having Part E completed provides them with the opportunity of further understanding your reduced functional capacity and they may want to add further information to strengthen your evidence.

3

Take the following with you when you meet with your Treating Professional: 

NDIS Access Request application form – Section 1 completed and Section 2, Part E completed (refer to ‘task number 2’)



Treatment Summary (2 or more copies)



Completed ‘How my Impairment Substantially Reduces my Functional Capacity worksheet’



Treating Professional Summary of Evidence Guide



Supporting information, for example, physiotherapy, occupational therapy reports.

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Treating Professional Summary of Evidence guide Completing the Treating Professional section of the NDIS Access Request application form involves knowing what the NDIS requires so that you express necessary information that feels comfortable to you and that also meets the NDIS decision making criteria. You may need to ask for what you want.

Your patient has used the Support+ Access Kit to better understand the eligibility criteria and how to provide evidence to support their application. The following is a summary of the information that relates to the evidence needed from you.

Section 2, Part B of the Access Request application form Guiding notes Q1 & Q2

Relates to the NDIS eligibility criteria of ‘is your disability caused by an impairment?’ and caused by at least one of intellectual, cognitive, neurological, sensory, physical or psychosocial disability.

Q1

If your patient indicates to you that they have a condition on the NDIS’s recognised list of conditions that meet all or some of the eligibility criteria, document the diagnosis and include the date it was diagnosed, how it was assessed and the outcome and who did the assessment. Here is an example: “I am a paediatrician and I assessed (name of child) on (date). I confirm his/her diagnosis of Autism. The DSM-V diagnostic criteria was used and his/her severity is Level 2”. The assessment report is attached”.

Q2

If you add other disabilities, each one will need to have the evidence of meeting the eligibility criteria of ‘your impairment is permanent and it contributes to substantially reducing your functional capacity’, i.e. Part E, questions 5-7 of the application form.

Q3

If you believe your patient’s ‘function has reached a baseline and is not likely to improve’, include this along with the length of time.

Q4

It is unlikely that time limited (non ongoing) conditions will meet the eligibility requirements.

Q 5, 6& 7

Only list treatments that are known, available and appropriate to your patient’s impairment.

To collate the treatment history, consider using the attached ‘Treatment Summary’ template. If you use the Treatment Summary template, insert ‘refer to attached Treatment Summary’.

Q7

You will need to identify if the known treatments are available and if they are likely to remove or cure your patients impairments. If they will not, tick ‘No’.

If ‘Yes’, the expectation is that they have been explored and exhausted unless you provide evidence to say why they are not available and/or appropriate. You can provide this information on the Treatment Summary template. For example, your patient can’t afford the treatment and it is therefore unavailable to them. The evidence needs to conclude that all treatment options have been exhausted or rationale given as to why they haven’t.

Only include treatments that will remove or cure your patient’s impairment.

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Treating Professional Summary of Evidence guide cont...

Section 2, Part C of the Access Request application form Guiding notes Q1

If your patient doesn’t meet the eligibility requirements in Part B, they may be eligible under the Early Intervention requirements. If not, tick ‘no’.

Q2

Existing supports refers to unpaid support (e.g. family).

Q3

Examples include speech/occupational therapy, psychology, school or workplace interventions.

Section 2, Part E of the Access Request application form This section of the application form can be completed by you, an allied health professional, the applicant or their family or a support worker.

‘Substantially reduced functional capacity’ means being unable to effectively participate in or complete tasks without support for most activities in a particular life area.

‘Support’ means needing the assistance of another person OR needing assistive technology, equipment or home modifications.

Attached is a ‘How my Impairment Substantially Reduces my Functional Capacity worksheet’ that has been completed by your patient to identify where they need a high level of support. This information can be used to help complete:     

What the person can not do without support due to their impairment How this impacts their day to day function, employment and/or interaction with the wider community What supports are already being received (family/carers, services, community) and how the person has or has not benefited The type and intensity/frequency of supports needed and how they will build functional capacity and/or halt the progression of the impairment How these supports will improve their social and economic participation

If for example, your patient has pulmonary fibrosis causing irreversible lung damage, their chronic difficulty with breathing substantially reduces their mobility and self care and participation in community life. The other life areas may be unaffected or only minimally affected and therefore, no evidence is required.

An example of substantially reduced functional capacity for mobility would be: “John requires assistance from another person to get in and out of bed or a chair and to access the toilet and bathroom. He uses grab rails in the toilet and bathroom. His home needs widened doorways to accommodate his wheelchair. He requires an electronic recliner and a high/low bed to assist with transfers. He needs to use a wheelchair to leave the house and access the community safely. John is unable to work and he requires assistance from another person to socialise and take part in community activities”.

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Treating Professional Summary of Evidence guide cont...

Section 2, Part C of the Access Request application form Guiding notes Q1

If your patient doesn’t meet the eligibility requirements in Part B, they may be eligible under the Early Intervention requirements. If not, tick ‘no’.

Q2

Existing supports refers to unpaid support (e.g. family).

Q3

Examples include speech/occupational therapy, psychology, school or workplace interventions.

Section 2, Part E of the Access Request application form This section of the application form can be completed by you, an allied health professional, the applicant or their family or a support worker.

‘Substantially reduced functional capacity’ means being unable to effectively participate in or complete tasks without support for most activities in a particular life area.

‘Support’ means needing the assistance of another person OR needing assistive technology, equipment or home modifications.

Attached is a ‘How my Impairment Substantially Reduces my Functional Capacity worksheet’ that has been completed by your patient to identify where they need a high level of support. This information can be used to help complete:     

What the person can not do without support due to their impairment How this impacts their day to day function, employment and/or interaction with the wider community What supports are already being received (family/carers, services, community) and how the person has or has not benefited The type and intensity/frequency of supports needed and how they will build functional capacity and/or halt the progression of the impairment How these supports will improve their social and economic participation

If for example, your patient has pulmonary fibrosis causing irreversible lung damage, their chronic difficulty with breathing substantially reduces their mobility and self care and participation in community life. The other life areas may be unaffected or only minimally affected and therefore, no evidence is required.

An example of substantially reduced functional capacity for mobility would be: “John requires assistance from another person to get in and out of bed or a chair and to access the toilet and bathroom. He uses grab rails in the toilet and bathroom. His home needs widened doorways to accommodate his wheelchair. He requires an electronic recliner and a high/low bed to assist with transfers. He needs to use a wheelchair to leave the house and access the community safely. John is unable to work and he requires assistance from another person to socialise and take part in community activities”.

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