The Access Request Kit Web

Contents Page Section 1

Why this NDIS Access Kit exists and how to use it

Section 2

The NDIS application process

2.1

The NDIS legal framework and how they assess eligibility

2.2

What are the NDIS eligibility criteria?

2.3

Eligibility requirements for children

2.4

How to know if your condition already meets all or some of the eligibility criteria

2.5

What about other conditions?

Section 3

How to complete the NDIS Access Request application form

Section 4

What happens after I become a NDIS participant?

Section 5

The Support Plus Participant Kit

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.

© Support Plus Access Kit 2023

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Contents Page Section 1

Why this NDIS Access Kit exists and how to use it

Section 2

The NDIS application process

2.1

The NDIS legal framework and how they assess eligibility

2.2

What are the NDIS eligibility criteria?

2.3

Eligibility requirements for children

2.4

How to know if your condition already meets all or some of the eligibility criteria

2.5

What about other conditions?

Section 3

How to complete the NDIS Access Request application form

Section 4

What happens after I become a NDIS participant?

Section 5

The Support Plus Participant Kit

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.

© Support Plus Access Kit 2023

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Section 1

WHY THIS ACCESS KIT EXISTS AND HOW TO USE IT

You may be eligible for the NDIS if: 

you have a permanent and significant disability, and it impacts your ability to perform everyday activities, OR



you need early intervention to reduce your future support needs.

Applying to the NDIS (called an Access Request) is when you ask to become a Participant of the NDIS. The NDIS is a government scheme and it can be a bit tricky to navigate. Around 1 in 4 Access Request applications are not successful.

Even if you do meet the eligibility criteria, it is not uncommon for people to have to lodge multiple applications before they are accepted as a participant. This is mainly due to their initial application not having the evidence the NDIS is looking for. At first it can seem to be an overwhelming task.

To help make the process easier, we have created the Support+ Access Kit . The kit provides stepby-step explanations, examples, tips, and includes Q&A’s to assist in making the process easy to follow, and hopefully a little less frustrating for you.

We suggest you use the Access Kit to understand the eligibility criteria and how to provide the best evidence to support your application. We urge you to read every part of the Access Kit fully before starting your application. It will save you time and frustration and increase your chances of a successful application.

Section 2 provides an overview of the application process - the eligibility criteria, where they fit into the NDIS legislation and how health conditions are assessed for both adults and children.

TIP Download the NDIS ‘Applying for the NDIS book 1’.

‘NDIS book 1’ provides some good introductory information that will be helpful before you start using the Support+ Access Kit.

Section 3 walks you through each page of the NDIS Access Request application form.

It will help you to understand what each question is asking and the guiding notes will make the process as simple as possible for you.

Here is the link.

If you are applying for a child younger than 7, download the ‘Help for your child younger than 7’ fact sheet.

Here is the link.

(Section 1 continued next page)

You will also find more information on applying for children in Section 2.3 of the Support+ Access Kit.

© Support Plus Access Kit 2023

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Section 1

WHY THIS NDIS ACCESS KIT EXISTS AND HOW TO USE IT cont…

If your Access Request is successful (and we sincerely hope it is), Section 4 provides an overview of what comes next and how you can get prepared.

Section 5 introduces the Support+ Platinum Membership and how it can assist you with your first and ongoing planning meetings and to continue navigating your NDIS journey successfully.

And don't forget about the resources we have on offer in Section 6. You’ll find information What to do if your Access Request is not successful, a helpful word list of NDIS terms, and practical examples that can help you submit your application.

Whether you are applying for yourself or a loved one, we wish you every success with your Access Request application. We hope you find The Support+ Access Kit informative and valuable.

Q&A Can I download the Support+ Access Kit? Only the resources in Section 6 can be downloaded.

The Access Kit isn’t downloadable because the contents of the Access Kit may change.

For example, the NDIS releases new information regularly and from time to time the NDIS legislation is tested from a legal perspective and how this results in eligibility is assessed may change.

Having the most up to date version of the Access Kit available and accessible only on the Support+ website is therefore important.

TIP It's a good idea to plan ahead and make sure you have all your paperwork in order.

Documentation is key, so be sure to get the correct documents from an appropriate expert or authority.

Keep copies of everything and maintain records of any phone calls with the NDIA if possible, ask for their responses in written form (email or letter).

Having all this information can be helpful should you need to get a decision reviewed. So take the time to plan ahead and make sure that everything is done properly - it could save you a lot of hassle in the long run!

© Support Plus Access Kit 2023

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Section 2

2.1

THE NDIS APPLICATION PROCESS

The NDIS legal framework and how they assess eligibility

Your eligibility will be assessed against the NDIS legal framework which is made up of 3 parts. They work together and inform how the National Disability Insurance Agency (NDIA) will make a decision on your eligibility.

NDIS Act, 2013 The Act is considered the foundation of the NDIS legal framework.

It sets out the eligibility criteria.

 NDIS (Becoming a Participant) Rules, 2013 The Rules support the Act and provide further details on becoming a NDIS participant.

 NDIS Operational Guidelines (Applying to the NDIS) The Guidelines are not law, however they interpret the Act and the Rules and provide practical guidelines for the NDIA assessor to make decisions on your eligibility.

TIP

Q&A

Becoming familiar with the NDIS legislation and process is a bit scary at first.

Do I need to know all of the legal stuff about becoming a participant?

However, it is helpful to know how it works before you complete and submit your application.

No. At this stage of your NDIS journey, you need to be familiar with the bits of the legal framework that are directly related to applying to the NDIS.

For example, having to become familiar with the NDIS legal framework if your application is not successful is even worse!

If you don’t, you are at risk of not understanding the meaning of what information the Access Request application form is asking for.

The Access Kit will help you become familiar.

The Access Kit will assist you through each step of the application process.

It will assist you through each step of the application process.

Have a look at the next page of the Access Kit. It outlines the relevant legal bits that relate to applying to the NDIS. (Section 2.1 continued next page)

© Support Plus Access Kit 2023

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2.1

The NDIS legal framework and how they assess eligibility cont…

Here are the relevant eligibility bits in the NDIS Act and the Rules:

NDIS Act

NDIS (Becoming a Participant) Rules

Chapter 3, Part 1, page 24 of the Act, ‘Becoming a Participant’.

Part 5, page 9: ‘When does a person meet the disability requirements?’

Part 6, page 11: ‘When does a person meet the Early Intervention requirements?’

Here is the link.

Here is the link.

The Operational Guidelines (Applying to the NDIS) will be used by the NDIA assessor to assess your eligibility:

NDIS Operational Guidelines (Applying to the NDIS)

The Access Kit aims to link the relevant parts of the Operational Guidelines to each part of the application process.

Have a look at the Operational Guidelines before you get started with your application.

Here is the link.

TIP The NDIS Operational Guidelines (Applying to the NDIS) has been shortened to ‘Operational Guidelines’ throughout the Access Kit.

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2.2

What are the NDIS eligibility criteria?

To become a Participant of the NDIS you will need to:

✓

be younger than 65 (on the day that you apply)

✓

live in Australia as an Australian citizen or hold a permanent or special category visa

✓

meet all of either the Disability requirements OR the Early Intervention requirements:

Disability requirements Section 24(1)(a-e) of the NDIS Act

✓

s24(1)(a) your disability is caused by an impairment, and

✓

s24(1)(b) your impairment is likely to be permanent, and

✓

s24(1)(c) your permanent impairment substantially reduces the way you do things in your daily life activities (called ‘functional capacity’ in at least one of:      

✓

✓

Early Intervention requirements Section 25(1)(a-c) of the NDIS Act ✓

s25(1)(a) you have an impairment that is likely to be permanent, OR you are applying for a child younger than 6 with a developmental delay, and

✓

s25(1)(b) early intervention will help you by reducing your or your child’s future disability needs, and

✓

s25(1)(c) early intervention will help you reduce the impact, prevent the deterioration or improve on the way you, or your child does, things in daily life (called ‘functional capacity’), OR it will help to build the skills of your informal supports (e.g. non paid family, friends, community services)

moving around (mobility) communicating socialising learning undertaking self care self management, and

s24(1)(d) your impairment affects your ability to work, study or take part in social life, and s(24)(e) you will likely need NDIS supports your whole life.

Q&A If I am applying for either the Disability or Early Intervention requirements do I need to satisfy each requirement?

Yes, all requirements will need to be satisfied for either the Disability requirements or the Early Intervention requirements. For example, for the Disability requirements you will first need to satisfy s24(1)(a) and then s24(1)(b) and so on.

The requirements cascade down until you have met each one.

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2.3

Eligibility requirements for children

Age 9 or older

Younger than 9

The NDIA will first decide whether the child will meet the Disability requirements.

The NDIA will first decide whether the child will meet the Early Intervention requirements.

It is likely the child will not meet the Disability requirements.

If the child doesn’t, the NDIA will then decide whether they meet the Disability requirements.

They may only be eligible under the Early Intervention requirements.

If they don’t, the NDIA will then decide whether the child will meet the Early Intervention requirements.

Younger than 9 with developmental delay

Q&A

TIP

What if I have a hearing impairment and I am younger than 25?

Sections 2.4 & 2.5 of the Access Kit provide more information on what evidence you will need to meet the NDIS eligibility criteria for both adults and children.

You may meet the Early Intervention requirements.

Have a look at the Operational Guidelines to learn more about the Early Intervention requirements and whether you will meet the hearing impairment criteria.

Here is the link and go to page 12.

© Support Plus Access Kit 2023

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2.4

How to know if your condition already meets all or some of the eligibility criteria

Before we dive into your application, be aware that some conditions meet all or some of the Disability or Early Intervention eligibility requirements.

There are 3 ‘Lists’ of conditions to be aware of – List A, B and D and they are outlined below. List C is for participants in Western Australia and you can find more information on page 10 of the Access Kit.

List A conditions – relates to the Disability requirements only.

If you have a diagnosed condition on NDIS’s List A you are likely to meet all of the Disability eligibility criteria, i.e. ✓ your disability is caused by an impairment ✓ your impairment is likely to be permanent ✓ your permanent impairment substantially reduces your functional capacity ✓ your impairment affects your ability to work, study or take part in social life ✓ you will likely need NDIS supports your whole life This is because ‘List A’ conditions are considered by the NDIS to cause permanent impairment and disability, resulting in substantially reduced functional capacity.

It is likely you will only need to complete Section 1 of the application form AND provide a letter/report with evidence that your condition has been diagnosed and assessed by your Treating Professional (usually your GP/specialist).

To find out if you have a condition on List A, go to the NDIS website and search for ‘List A conditions OR the Appendices section of the Operational Guidelines has this information.

Here is the link.

Q&A What type of evidence will I need from my Treating Professional for List A conditions?

Here is an example of the evidence your doctor may provide via a letter/report along with their professional details and contact information for List A conditions: “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”.

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2.4

How to know if your condition already meets all or some of the eligibility criteria cont…

List B conditions – relates to both the Disability and the Early Intervention requirements If you have a condition on NDIS’s List B your condition is likely to result in a permanent impairment and meet some of the Disability and Early Intervention requirements.

Disability requirements

Early Intervention requirements

✓ your disability is caused by an impairment ✓ your impairment is likely to be permanent

✓ you have an impairment that is likely to be permanent OR you are a child younger than 6 with a developmental delay.

To fully meet the Disability requirements you will still need to provide evidence that satisfies the remaining criteria:

To fully meet the Early Intervention requirements you will still need to provide evidence that satisfies the remaining criteria:

your permanent impairment substantially reduces your functional capacity and

early intervention will help you by reducing your future disability needs and

your impairment affects your ability to work, study or take part in social life and

early intervention will help you reduce the impact, prevent the deterioration or improve on the way you do things in your daily life OR it will help to build the skills of your informal supports (e.g. non paid family, friends, community services)

you will likely need NDIS supports your whole life

You will need to complete Section 1 and some parts of Section 2 of the application form AND provide a letter/report with evidence that your condition has been diagnosed and assessed by your Treating Professional (usually your GP/specialist). Page… of the Access Kit has further details.

To find out if you have a condition on List B, go to the NDIS website and search for ‘List B conditions’ OR the Appendices section of the NDIS Operational Guidelines has this information.

Here is the link.

Q&A What type of evidence will I need from my Treating Professional for List B conditions?

Here is an example of the evidence your doctor may provide via a letter/report along with their professional details and contact information for List B conditions: “I am a rheumatologist and I assessed (name of applicant) on (date). I confirm his/her diagnosis of Rheumatoid Arthritis. The diagnosis was made by physical examination, blood tests (give details) and imaging (give details)”.

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2.4

How to know if your condition already meets all or some of the eligibility criteria cont…

List D conditions – relates to children younger than 9 and the Early Intervention requirements.

If you are applying for a child younger than 9 and they have a diagnosed condition on ‘List D’, they will likely meet all of the Early Intervention requirements.

You will only need to complete Section 1 of the Access Request application form AND provide a letter/report with evidence that the child’s condition has been diagnosed and assessed by your Treating Professional (usually your GP/specialist).

To find out if the child has a condition on List D, go to the NDIS website and search for ‘List D conditions’ OR the Appendices section of the Operational Guidelines has this information.

Here is the link.

Q&A

Q&A

What type of evidence will I need from my Treating Professional for List D conditions?

Is there a List C?

Here is an example of the evidence the doctor may provide via a letter/report along with their professional details and contact information for List D conditions: “I am a paediatrician and I assessed (name of child) on (date). I confirm his/her diagnosis of Down syndrome via a blood test (chromosomal karyotype).

Yes. There is a ‘List C’ and it relates to individuals already receiving disability support in Western Australia. If this applies to you, you might already meet most of the Disability requirements.

To find out more about List C, go to the NDIS website and search for ‘List C’ OR the Appendices section of the Operational Guidelines has this information.

Here is the link.

© Support Plus Access Kit 2023

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2.5

What about other conditions?

Other conditions – relates to both Disability and the Early Intervention requirements If you don’t have a condition on List A, B or D you will need to supply evidence for all of the Disability or the Early Intervention eligibility criteria, i.e:

Disability requirements

Early Intervention requirements

your disability is caused by an impairment and

you have an impairment that is likely to be permanent OR you are a child younger than 9 with a developmental delay and

your impairment is likely to be permanent and

early intervention will help you by reducing your future disability needs and

your permanent impairment substantially reduces your functional capacity and your impairment affects your ability to work, study or take part in social life and you will likely need NDIS supports your whole life

early intervention will help you reduce the impact, prevent the deterioration or improve on the way you do things in your daily life OR it will help to build the skills of your informal supports (e.g. non paid family, friends, community services)

You will need to complete all parts of Sections 1 and 2 of the application form. Page 12 of tthe Access Kit has further details.

TIP

TIP

Section 3 of the Access Kit provides step by step guidance on what evidence you will need if you don’t have a condition on List A, B or D.

Access to the NDIS will not be approved if the support needed is more appropriately funded or provided by other government and community services, e.g. the health system.

The Operational Guidelines has more information.

Here is the link.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM

This section of the Access Kit guides you through each page of the Access Request application form.

You can download a copy of the Access Request application form from the NDIS website.

Here is the link.

You do have the option of not using the application form. You can apply verbally by ringing the NDIS on 1800 800 110. However you will still need to submit supporting evidence via email, mail or in person.

One of the advantages of using the application form is it ensures you have covered every requirement of the application process.

What parts of the application form you need to complete will depend on your condition. Before you start, refer back to Section 2.4 and 2.5 of the Access Kit and use the following table to see what parts of the application form relate to your situation:

Access Request application form: section, page number & who completes

Other conditions List A

List B

List D

Disability requirements

Early Intervention requirements

(completed by you or your representative)

✓

✓

✓

✓

✓

Section 2, Part A, page 13

X

X

X

✓

✓

X

X

X

✓

✓

✓

X

X

✓

✓

X

✓

✓

✓

X

✓

X

Section 1, Part A-F, pages 2-12

(completed by your GP/specialist)

Section 2, Part B, pages 14 & 15 (completed by your GP/specialist)

Section 2, Part C, page 16 (completed by your GP/specialist)

Section 2, Part D, page 17 (completed by your GP/specialist, you or your representative)

Section 2, Part E, pages 18-23 (completed by your Treating Professional, you, your representative or support worker)

Section 2, Part F, page 24 (completed by your Treating Professional, you or your representative)

Section 2, Part G, page 25 (completed by your Treating Professional)

Attachment A, page 26 (completed by you or your representative)

Attachment B, pages 27-28 ( info only)

X

(E.I only)

X

X

(Disability only)

X

✓

X

✓

✓

X

✓

X

✓

✓

X

✓

X

✓

✓

(not applicable, doesn’t need completing)

© Support Plus Access Kit 2023

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

To ensure that you have every chance of a successful application, it is important and highly recommended, to read through the Access Request Application form and the corresponding Access Kit guiding notes before starting.

This will give you an understanding of what information is required for your application and how to provide it.

Guiding Notes There are many divisions within the NDIA. Your application will be assessed by the ‘National Access Team’ (NAT).

You can ring the NDIA call centre 1800 800 110 if you need further help with completing the form.

If you want to lodge your application in person, your ‘local NDIA office’ will most probably be colocated with your nearest Services Australia (Centrelink) centre.

They are also able to assist with your application form.

Section 6 of the Access Kit, ‘Resources’, has an example email template you can use if you are sending your application via email.

© National Disability Insurance Scheme Agency 2013

TIP Section 6 of the Access Kit, Resources, has a word list to help you understand the NDIS language. You can find it on page 56

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding Notes Section 1 is completed by you or by your representative.

The Operational Guidelines outlines how someone else may apply on your behalf.

Here is the link and go to page 24

Section 1 of the application form is divided up into 6 parts (A-F).

Part A, pages 2 – 4 of the application form is about you and where you live.

This information will determine whether you meet the age and residence eligibility requirements of: ✓ You are younger than 65 (on the day that you apply), and © National Disability Insurance Scheme Agency 2013

✓

You live in Australia as an Australian citizen or hold a permanent or special category visa.

Q&A How do I know what to include with the Access Request application form?

Page 26 of the application form has a handy checklist for you to use prior to submitting your application.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes If you are applying for a child under 9, it is recommended you seek support from an Early Childhood Partner.

You can find your closest Early Childhood Partner by entering ‘local NDIS office’ in the search section of the NDIS website.

Before you do, have a read of the ‘Help for your child younger than 9’ factsheet. You can find this on the NDIS website.

Here is the link.

The NDIA need to determine that you have a long term and meaningful connection to living in Australia.

You will need to provide proof of age, residency including citizenship or visa status. © National Disability Insurance Scheme Agency 2013

OR Instead you can provide your Centerlink customer reference number (CRN) if you have one.

If you have a CRN, you can enter it on page 6 of the application form.

The Operational Guidelines provide more information.

Here is the link and go to page 4.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes

If you are homeless, at risk of homelessness, living at an inpatient facility (e.g. mental health facility) or you are due to be released from a correctional facility, the NDIA will decide your Access Request eligibility within 2-5 days.

Page 61 of the Access Kit outlines how to identify this information so that your application is processed quickly.

If your application is successful and there are other participants living in the same household, the NDIA may consider the total of everyone’s support needs when determining what supports are needed and how it will be funded.

For example, if you become a NDIS participant the NDIA will make decisions based on what is ‘reasonable and necessary’. © National Disability Insurance Scheme Agency 2013

What this means is supports need to be related to your disability, value for money, effective and beneficial, and most appropriately funded by the NDIS. So, in relation to Q15, for example, if you and another participant in your household need a support worker to assist with personal care, you may be able to share the supports.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes Part B of the application form is about your privacy and you giving consent.

It relates to information that the NDIA might need in order to assess your eligibility.

It also relates to your consent for sharing information if you do become a participant.

To assess your eligibility, the NDIA requires evidence regarding your impairment.

The NDIA does not need to know the cause of how you acquired your condition.

For example, you are not required to share personal details about trauma you may have experienced that has resulted in a psychosocial disability.

© National Disability Insurance Scheme Agency 2013

Rather, the NDIA need to know if your disability is permanent, what is the resulting impact, and the support and treatment you require as a result of the trauma.

The NDIS Privacy Policy has more information.

Here is the link.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes If you choose not to provide consent, service providers such as doctors and allied health professionals cannot give information about you if the NDIA makes a direct request to them for information.

It may mean that your Access Request is delayed.

You have 2 options to provide evidence of age and residence: 

If you have a Centrelink CRN and you are happy to provide it, enter it here.

OR



Provide copies of documents from ‘Attachment B’ (refer to pages 27 and 28 of the application form).

© National Disability Insurance Scheme Agency 2013

TIP If you are mailing your application, make sure you make a copy.

If you can, send via Express Post and label it: National Access Team NDIS GPO Box 700 Canberra, ACT 2601 The sooner the NDIA receive your application, the sooner you will receive a response.

Page 48 of the Access Kit provides information on response times.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes Part C of the application form is about how you would like the NDIA to communicate with you.

Typically, the NDIA will ring you (or your representative) in relation to your application. This would occur if they need more information or to tell you the outcome of your application.

If you nominate to be contacted by phone, when the NDIA phones you, the number may be displayed as ‘No Caller ID’.

If you normally disregard these types of calls, it might be best to answer, especially during your application period.

It is likely that the NDIA will not leave a message for you to call back. You will probably receive a follow up email or letter.

© National Disability Insurance Scheme Agency 2013

Q&A If the NDIA ring me what questions should I ask?

If they are requesting more information, ask:   

What evidence is missing and what eligibility requirment does it relate to?

Can you give me an example of the evidence needed?

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

If your application is not successful, ask:   

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

What evidence is missing? And 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?

TIP It is really important that you understand every part of how the NAT assessor is evaluating your application.

If you miss a phone call and you need more information, call the NDIA call centre on 1800 800 110 and request that the NAT assessor ring you.

The call centre staff member is required to document the date of your call and the details of your request. Ask for a receipt number in relation to your call so that you have a record of your request and keep it with your application papers.

Section 5 of the Access Kit provides additional guidance if your application is unsuccessful.

© Support Plus Access Kit 2023

The call centre staff member will email your request to the NAT and you should expect a call within a week. If you don’t receive a call back, ring the call centre again and make another request.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes Part D of the application form is completed only if someone else is completing the application for you.

For example: 

You are under 18



You are the applicant’s legally authorised representative.



You are the applicant’s representative (such as a family member, friend, disability advocate).

If someone else is completing the application form for you, evidence will need to be included with your application to say that you give authority to that person.

© National Disability Insurance Scheme Agency 2013

If you are an adult, you as the applicant will need to either provide written consent or you can ring the NDIA on 1800 800110 and provide verbal consent.

If you are applying on behalf of a child and you have parental responsibility, complete all of Part D and tick ‘person with parental responsibility’.

Also, refer to pages 27 and 28 of the application form for more information.

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes If you are providing written consent, an example ‘Written Consent’ template is included in Section 6, Resources of this Access Kit. Include the written consent with your application and note its inclusion as an attachment on page 24 and on page 26 (checklist) of the application form.

The Operational Guidelines has more information.

Here is the link and go to pages 24 and 25.

© National Disability Insurance Scheme Agency 2013

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Section 3

HOW TO COMPLETE THE NDIS ACCESS REQUEST APPLICATION FORM cont…

Guiding notes Part E of the application form requires information on your situation and the evidence you will need to provide.

This question states ‘substantially’ which means that if you indicate additional disabilities, each one will need to meet the Disability requirements of: ‘you have a permanent impairment which substantially impacts on your every day life’.

It is important that each disability listed meets the Disability requirements and that you have the required evidence.

If you add secondary disabilities, but do not have the evidence required, they may confuse your application for your main disability. Your application for your main disability and any secondary disabilities will only be accepted if all the disabilities meet all the criteria. © National Disability Insurance Scheme Agency 2013

Section 2 of the application form outlines the evidence you will need.

Compensation for a personal injury should not affect your eligibility.

The aim is to get your application accepted so that you can get the supports you need in place.

If you need more information to understand compensation in relation to the NDIS, Here is the link.

If/when your application is accepted, you always have the option later to add your ‘secondary disabilities’ when you have the necessary evidence to demonstrate their permanency and their impact on your day to day functioning.

TIP

TIP

If you do not meet the Disability requirement criteria, you may meet the Early Intervention criteria.

The term ‘substantially’ is important to understand in relation to the Disability eligibility requirements.

Refer back to Section 2.2 of the Access Kit.

Its meaning is outlined on page 34 of the Access Kit.

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Guiding notes Check to see what information you already have and also ask your Treating Professional(s) for any previous clinical reports or assessments they have on file that might support your application.

For example, when and how your condition was diagnosed, evidence about your disability and its impact on your life.

It is recommended that these reports clearly describe the impact of your disability on your daily life.

Other examples of assessments can be found on page 17 of the application form.

If you do not have access to a regular Treating Professional, for example, you live in a remote area, make sure this is stated in your application.

Pages … to … of the Access Kit provides further information on functional capacity.

© National Disability Insurance Scheme Agency 2013

TIP

TIP

It is recommended to complete Section E and not just rely on attaching reports because existing reports and assessments may not use plain language or describe fully the impact your disability has on your daily life.

The aim is for the NDIA assessor to locate your evidence easily.

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

Download the Access Request form and complete Part A prior to seeing your Treating Professional.

Here is the link.

If they have to search for evidence they are looking for, they may miss it.

Take all supporting information with you. For example, physiotherapy, occupational therapy reports.

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Section 3

Guiding notes Part F of the application form outlines the terms you are agreeing to by signing and submitting your application.

Change in circumstances include: 

Changes in the way your disability impacts on your functional capacity as this may change your eligibility.



Your contact details.



You receive or claim compensation related to your disability.

The NDIA is able to request information that is reasonably necessary of the purpose of making a decision on your eligibility.

© National Disability Insurance Scheme Agency 2013

For example, requesting you undertake an assessment or asking you to provide further information in relation to evidence you have already submitted.

The NDIA generally needs to receive this additional information within 90 days.

The Operating Guidelines provides more information if you need it.

Here is the link and go to page 26.

TIP If you are not the person applying, refer back to page 20 of the Access Kit to check who can complete this section.

Q&A What if I can’t afford the cost of getting the assessment the NDIA is asking for or I don’t have access to getting the assessment due to where I live?

If it is not reasonable due to affordability or where you live, you are not required to. Contact the NDIA assessor (page … of the Access Kit provides guidance on how to do this) and outline your circumstances and discuss alternative ways to obtain the evidence required.

Ask the NDIA assessor to confirm their response to your issue in writing (letter/email).

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Guiding notes Section 2 of the application form is completed by your Treating Professional and it is divided up into 7 parts (A-G).

Part A, is where your Treating Professional provides their qualifications, how long they have known you and their contact details.

If your Treating Professional is unfamiliar with the process of applying to the NDIS, and they request more information the following resources may be helpful and they can be downloaded from the NDIS website: ‘Is your patient eligible for the NDIS’ checklist.

OR, you might like to use the ‘Treating Professional Evidence Sheet’ in Section 6, Resources of the Access Kit.

© National Disability Insurance Scheme Agency 2013

The Evidence Sheet provides a quick summary of what evidence is required from your Treating Professional for Section 2 of the application form.

Before requesting your Treating Professional to complete Section 2, identify, using the information on page….. of the Access Kit if you are already likely to meet the Disability or Early Intervention requirements (i.e List’s A, B or D).

Then discuss with them. This will determine if they will need to complete some or all of Section 2 of the application form.

Include the total length of time you have been receiving treatment from the Treating Professional’s service.

For example, your GP may have only known you for a few months, however you have been a patient at the medical practice for many years and you have a long history with the medical practice.

This is because the NDIA prefers evidence from a Treating Professional that has treated you for a least 6 months.

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Guiding notes Part B of the application form relates to evidence demonstrating that your disability is permanent.

Before you ask your Treating Professional to complete this section of the application form, remember to check if your condition(s) is on List A, B or D. If it is, it is likely you will meet the Disability requirements of: ‘your disability is caused by an impairment’ and ‘your impairment is likely to be permanent’ OR the Early Intervention requirement of: ‘having an impairment that’s likely to be permanent’

© National Disability Insurance Scheme Agency 2013

Ask your Treating Professional to document the condition in Q 1 and Q2 (if appropriate), adding ‘List A’, ‘List B’ or List D’ condition and include:  Date it was diagnosed  How it was assessed and outcome  Who did the assessment (if applicable) OR ask your Treating Professional to supply a letter or report with this evidence.

Refer back to pages 8 to 11 of the Access Kit for further guidance. You will not have to complete the rest of Part B. However, your Treating Professional will need to sign and complete Part G of the application form if they haven’t supplied a signed letter/report.

(Guiding notes for page 14 of the application form are continued on the next page)

TIP Before your meeting with your Treating Professional, it is recommended making some notes on how to best answer the questions in Section 2 of the application form.

You can use this information along with the Treating Professional Evidence Sheet, to discuss what to document on the application form.

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Guiding notes, page 14 continued For Other Conditions: These two questions relate to the Disability requirements, s24(1)(a) and the Early Intervention requirements, s25(1)(a) of the NDIS Act: ‘is your disability caused by an impairment?’

An impairment is a loss or significant change in at least one of the following:   

your bodies function your bodies structure how you think or learn

Therefore, to meet the ‘is your disability caused by an impairment?’ you will need to provide evidence that your disability is caused by at least one of the following impairments:      

© National Disability Insurance Scheme Agency 2013

If your Treating Professional believes your ‘function has reached a baseline and is not likely to improve’, include this in Q 3 along with the length of time.

Guiding notes for Q’s 4 and 5 are on the next page of the Access Kit.

intellectual cognitive, neurological sensory physical OR you have one or more impairments caused by a psychosocial disability

Remember to refer back to what disabilities you listed in Section 1 on page 10 of the application form and make sure it is the same.

This is because each disability listed will need to have the necessary evidence to meet the Disability or Early Intervention requirements.

Including additional disabilities without supporting evidence unnecessarily complicates your application.

(Guiding notes for page 14 of the application form are continued on the next page)

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Guiding notes, page 14 continued Q4 and Q5 relates to the Disability requirement, s24(1)(b) and the Early Intervention, s25(1)(a) of the NDIS Act: ‘is your impairment likely to be permanent’ It is unlikely that time limited (non ongoing) conditions will meet the Disability requirements.

For example, a leg fracture resulting in reduced mobility will not meet the Disability requirements as the condition is likely to resolve.

The NDIA assessor will need detailed evidence on your past and current treatments.

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

To collate this treatment history, you and your Treating Professional may find it useful to use the ‘Treatment Summary’ template which is included in Section 6, Resources of the Access Kit.

© National Disability Insurance Scheme Agency 2013

If you use the ‘Treatment Summary’ template or a letter/report from your Treating Professional, document in Q5 (a) and/or Q6 (a): ‘Refer to attached Treatment Summary’ and note the attachment on page 24 of the application form.

Q&A Who should provide evidence for ‘is your impairment likely to be permanent’?

The NDIA generally prefers evidence from your doctor or specialist to confirm your permanent impairment. Examples of common doctors or specialists include: General Practitioner (GP) Paediatrician Orthopaedic surgeon

© Support Plus Access Kit 2023

Neurologist Psychiatrist

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Guiding notes If you do not have a condition on List A or B, the NDIA is likely to use the ‘Mayo Clinic’ website to establish what is the recommended treatment options for your condition.

Go to www.mayoclinic.com and enter your condition and select ‘treatment’.

The NDIA assessor will likely use this information to see what the known and appropriate evidence based clinical, medical or other treatments that are relevant to your condition.

For some conditions, such as chronic medical conditions the NDIA assessor may also seek advice from the ‘Technical Advisory Branch’ within the NDIA. What this means is a NDIA medical professional will provide advice on whether your evidence meets the requirements of: ‘having an impairment that’s likely to be permanent’

© National Disability Insurance Scheme Agency 2013

Your Treating Professional will need to identify if the known treatments/interventions that are available to you are likely to remove or cure your impairments. If they will not, tick ‘No’.

If ‘Yes’, the expectation is that you will have explored and exhausted these treatments unless you have evidence to say why they are not available and/or appropriate for you.

Specifically, what past and current treatments you have tried that are relevant to your condition and what were the outcomes.

(Guiding notes for page 15 of the application form are continued on the next page)

TIP If the known treatment options are available and appropriate for you, evidence is needed to say you have explored them, i.e. you have tried them and that they have not cured or removed your impairment.

Consider using the ‘Treatment Summary’ template for this.

This is the same template (included in Section 6, Resources of the Access Kit), suggested for Q 5 & 6. You can consolidate all information in the one place. Just make sure you capture all past and current treatments.

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Section 3

Guiding notes, page 15 continued

It is unlikely that the NDIS will provide access for chronic health conditions if any resulting impairment is not permanent and your ability to do everyday activities is not substantially reduced.

For example, for a chronic condition such as emphysema you would need to demonstrate that you have irreversible lung damage and that the resulting difficulty with breathing substantially reduces your ability in one or more of the six life areas.

Refer Section 3, page … of the Access Kit for more information on what the 6 life areas relate to.

TIP In 2022, the Federal Court of Australia clarified what is ‘known, appropriate and available’ for the purposes of the NDIS Rules and meeting the eligibility criteria of there not being any treatments that would likely remedy your impairment.

And if this is the case, the Disability and Early Intervention requirements of ‘is your impairment likely to be permanent’ would be met.

It is important to understand ‘known, appropriate and available’ in the context of meeting this criteria because if it is not met, the other requirements will not be met (refer back to page … of the Access Kit). 

‘known’ - a treatment which can be identified by medical practitioners as a suitable treatment for the person’s particular impairment.  ‘appropriate’ - a treatment which has a capacity to ‘remedy’ (i.e. remove or cure) the impairment and is suitable for the particular individual concerned to undergo.  ‘available’ should be understood as meaning available to a particular individual.

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Guiding notes Part C of the application form relates to the Early Intervention requirements only.

If this doesn’t apply to your condition, your Treating Professional ticks ‘No’ and goes to Part D of the application form.

However, if you don’t meet the Disability requirements you may be eligible under the Early Intervention requirements.

The questions in Part C of the application form relate to the requirements of s25(1)(b) and s25(1)(c) of the NDIS Act: ‘early intervention will help you by reducing your future disability needs’, and ‘early intervention will help you reduce the impact, prevent the deterioration or improve on the way you do things in your daily life (called ‘functional capacity’), OR it will help to build the skills of your informal supports (e.g. non paid family, friends, community services)’

© National Disability Insurance Scheme Agency 2013

What this means is accessing supports early before your impairment further impacts your functioning. It can be for children and adults.

For example, speech therapy, occupational therapy, psychological services and counselling, school or workplace interventions.

If your impairment is, or is likely to be permanent, the aim of Early Intervention is to have a positive impact on your functional capacity as early as possible which ideally will also reduce your need for future support.

For example, accessing supports to minimise the progression of your condition so that you can live as independently as possible.

Your existing supports include family and unpaid carers. Early Intervention may help you by providing support to your family or unpaid carers (this is called ‘informal supports’). For example, by building their skills to support you.

(Guiding notes for page 16 of the application form are continued on the next page)

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Guiding notes, page 16 continued Children younger than 9 with developmental delay: There are different requirements for children younger than 9 with developmental delay.

Page 7 of the Access Kit outlines the requirements.

For more information go to the Operational Guidelines.

Here is the link and go to page 15.

For children younger than 9: If you are applying for a child younger than 9 and they have a condition on List D, refer to the Operational Guidelines and follow the steps on page 10 of the Access Kit. Here is the link to the Operational Guidelines

If you have a permanent hearing impairment: 

You may meet the early intervention requirements if you are aged between 0 and 25 with a permanent hearing impairment (ie auditory neuropathy or hearing loss of at least 25 decibels in either ear at 2 or more adjacent frequencies).



If you are 26 or older, you may be eligible under the ‘Disability’ requirements.

Refer to page 7 of this Access Kit and to page 10 of the Operational Guidelines.

Here is the link.

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Guiding notes

Part D of the application form relates to any relevant assessments you can use for evidence.

It does not matter if you haven’t undertaken one of the listed assessments as these assessments might not be relevant to you.

If you do have a relevant assessment, make sure the date of the assessment and your result is included.

The aim is to prevent the NDIA assessor searching through your assessment report for this information. Sometimes reports aren’t very clear.

Ideally, your assessment should have been done in the last 12 months. If it is older than this you will need to provide a reason why.

© National Disability Insurance Scheme Agency 2013

If you have a relevant assessment that is not listed, for example, the ‘World Health Organisation Disability Assessment Scale’ (WHODAS), include it under ‘Other’.

If you have more than one assessment to include, write ‘refer to Section F for attached assessments’.

Q&A How old should your evidence/assessments be? 

To confirm permanent impairment from your doctor or specialist – can be from any age.



To confirm your functional capacity is substantially impacted – from last 12 months.



To confirm your need for Early Intervention – from last 12 months.

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Guiding notes Part E of the application form relates to the Disability requirement in Section 24(1)(c) of the NDIS Act: ‘Does your permanent impairment substantially reduce your functional capacity or ability to undertake activities in one or more of the 6 domain/life areas’:      

mobility or moving around communication socialising learning self care self management

Part E can be completed by:

© National Disability Insurance Scheme Agency 2013

 your Treating Professional, support workers, family members and carers, OR  providing copies of existing reports, assessments or letters.

It is highly recommended that you do both, i.e. complete all sections of Part E and attach evidence such as reports (if you have them).

You only need to complete the life areas which are substantially impacted by your impairment.

(Guiding notes for page 18 of the application form are continued on the next page)

Q&A What is substantially reduced functional capacity?

Some people experience difficulties with carrying out tasks – this is ‘reduced functional capacity’ and does not meet the eligibility criteria.

The eligibility criteria of ‘substantially reduced functional capacity’ would mean you are unable to effectively participate in or complete tasks without support for most activities in that particular life area.

Specifically:  you need assistance of another person, e.g. physical assistance, guidance, supervision or prompting, OR  you need assistive technology, equipment or home modifications prescribed by your Treating Professional.

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Guiding notes, page 18 continued Check that your reports use plain language (not clinical language) and that they clearly describe the impact of your disability on your daily life.

For example, if your mobility is substantially impacted: ✓ Sam requires 1:1 physical assistance from another person to move around inside his home (plain language) X Sam has unsteady gait and can’t mobilise independently (clinical language)

Note that this NDIS link is incorrect, instead go to the Operational Guidelines, page 8.

Here is the link.

© National Disability Insurance Scheme Agency 2013

Go to the next page of the Access Kit for guidance on how to complete Q 1.

Pages 39 to 43 of the Access Kit provides examples for each of the 6 life areas.

Q&A What if I have more than one impairment?

If you have more than one permanent impairment (refer pages 14 & 15 of the application form) the NDIA assessor will consider them together, to see if they substantially reduce your functional capacity.

Remember, if you have listed more than one disability, each one will need to meet the Disability requirement of ‘your impairment is likely to be permanent’ i.e. s24(1)(b) of the NDIS Act.

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TIP If you live with psychosocial disability, you may find it helpful to use the NDIS ‘Evidence of Psychosocial Disability Form’.

The form is completed by your doctor (e.g. psychiatrist, GP) and your support worker or another appropriate person.

Here is the link.

You will still need to complete the Access Request application form. In Section 2, Part B and E, write: ‘Please refer to attached Evidence of Psychosocial Disability Form’ and include the form as an attachment on page 24 of the application form.

There is also a series of useful ‘mental health access fact sheets’ that have been made available by the NDIS. Here is the link.

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Guiding notes Have a think about how your disability impacts on your everyday life activities and tasks.

It is not considered a substantial reduction in capacity if it just takes you longer to complete an activity or if you carry out activities in a slightly different way.

Refer back to page 39 of the Access Kit for the definition of substantially reduced functional capacity.

The NDIA assessor will consider how you function without support and what you can and cannot do when considering whether your functional capacity is substantially reduced in a particular life area.

© National Disability Insurance Scheme Agency 2013

For example, on a day to day basis in the ‘mobility/moving around’ life area, you may be able to move around the bedroom with stand by assistance from another person.

However, you need physical assistance from another person to get in and out of a bed and chair.

You need a wheelchair to leave the house and access the community safely. As you need consistent support for most activities in this life area it is likely you will meet the eligibility criteria.

(Guiding notes for page 19 of the application form are continued on the next page)

TIP The evidence you provide in Section E: Evidence of Functional Capacity needs to also satisfy the Disability requirements of: s24(1)(d), your impairment affects your ability to work, study or take part in social life, and s24(1)(e), you will likely need NDIS supports your whole life You can include this information under one or more of the life areas.

For example, including information such as you are unable to work, you need support to manage your finances and to manage your tenancy obligations. You would include this evidence under the life area of ‘self management’.

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Guiding notes page 19 continued If you have a recent (last 12 months) functional capacity assessment from a Treating Professional such as an Occupational Therapist or a Physiotherapist, you can:  

use the evidence in the assessment report to complete pages 18-23 of the application form, and include the report with your application. Note the report as an attachment on page 24 of the application form.

If you don’t have a functional capacity assessment, that’s ok. To help you put this evidence together, a ‘How my Impairment Substantially Reduces my Functional Capacity’ worksheet is included in Section 7, Resources of the Access Kit. It has some prompts to help you assess whether you have substantially reduced functional capacity in one or more of the 6 life areas.

© National Disability Insurance Scheme Agency 2013

Lived Experience Statement Along with the worksheet outcomes, composing a lived experience statement may aid you or your care provider in sharing your story about living with a disability.

This statement should highlight your perspective or that of your carer and should include the struggles and the coping mechanisms you employ day-to-day.

Submitting a lived experience statement is encouraged as it can bring a more personal perspective to your application, giving the NDIA assessor a greater understanding of your day-today experiences living with a disability.

To assist with the creation of a Lived Experience statement, a 'Lived Experience Statement Guiding Notes and Template' is included in Section 6, Resources of the Access Kit.

Completing the worksheet can help you to identify what to document in Part E of the application form.

The next page of the Access Kit provides examples of how to document this.

You may find it helpful to take your completed worksheet with you when you meet with your Treating Professional so that they capture this information in their reports/letters.

(Guiding notes for page 19 of the application form are continued on the next page)

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Guiding notes page 19 continued Mobility example (page 18 of application form): John requires assistance from another person to get in and out of bed or a chair. He needs to use a wheelchair to leave the house and access the community safely.

John requires assistance to socialise and take part in community activities.

Communication example: Amy is unable to read, write and speak without assistance. She is unable to make herself understood by others or express her needs to others without assistive equipment and 1:1 help from another person. Amy is unable to work and she is socially isolated.

Socialising example: Dileep requires assistance to meet new people, engage with activities such as shopping, appointments and hobbies. He is unable to cope with his feelings and emotions when around other people. He becomes distressed and angry when he has to wait in line at the shops. Dileep withdraws from social contact.

© National Disability Insurance Scheme Agency 2013

Self Care example: Sally needs assistance with all aspects of her personal hygiene (e.g. going to the toilet, showering, dressing, oral care etc.). Sally is unable to prepare her meals by herself and she needs supervision and prompting during every meal to ensure adequate nutrition and hydration.

Sally is unable to work or leave the home without assistance. She need assistance during the night.

Learning example: Anil is unable to learn and remember the tasks associated with going shopping by himself (he forgets items to purchase), or cooking or being able to predict what is going to happen next. He is unable to organise information in a logical way to make appropriate decisions for himself. Anil is unable to work or study and without assistance he is unable to engage in social activities.

Self Management example: Jane is unable to manage money and all aspects of managing her rental tenancy. Jane has difficulty remembering information and she requires help to plan her day and complete daily tasks. Jane is unable to organise information in a logical way and to make decisions. Jane is unable to work as she forgets job interviews. She has not been able to undertake study due to her not being able to retain information.

The examples given above would also satisfy the remaining two Disability requirements, i.e s24(1)(d), your impairment affects your ability to work, study or take part in social life, and s24(1)(e), you will likely need NDIS supports your whole life, as per the table on page...

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Guiding notes Example: John requires the use of ramps to get in and out of his home and to navigate the community safely. He uses grab rails in the toilet and bathroom. His home needs widened doorways to accommodate his wheelchair.

Example: John requires a wheelchair for all aspects of mobility (inside and outside the home).

He requires an electronic recliner and a high/low bed to assist with transfers.

Example: John requires assistance from another person to get into and out of bed/chair and to access the toilet and bathroom. He requires assistance to access the community and to participate in all life activities.

Example: Amy needs to use activity schedules that are prepared for her daily and placed on the fridge and in her bedroom. She requires consistent prompting throughout the day to follow the schedule. © National Disability Insurance Scheme Agency 2013

Example: Amy requires the use of an iPad with Augmentative and Alternative communication software for reading, writing and speaking.

Q&A Who should provide evidence of your functional capacity?

The NDIA generally prefers evidence from a doctor, allied health or other medical professional to confirm how your permanent impairment impacts your functional capacity.

Examples of common allied health or other medical professionals include:    

Occupational Therapist Speech Pathologist (Therapist) Psychologist Physiotherapist

© Support Plus Access Kit 2023

TIP It is recommended that documentation should include what the risks would be if you were not provided with support.

For example, you are unable to leave the home and access activities in the community.

And if relevant, include reasons for how your impairments might worsen without them.

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Guiding notes Example: Amy is not able to say what she needs and wants or participate in any life activities without assistance from another person.

Example: Dileep requires a calm familiar environment away from other people to be able to interact with friends or family. If this is not available he is unable to cope with his feelings and emotions and he becomes distressed.

Example: Dileep needs to use sensory aids, for example, chew toys, sensory balls etc. when leaving the home or if his home routine changes in any way.

Example: Dileep requires assistance from other people to overcome social phobias and engage in community activities. He needs supervision (monitoring of verbal control) when in unfamiliar situations. © National Disability Insurance Scheme Agency 2013

Example: its ok to leave a section blank if it is not applicable to your situation.

TIP The NDIS considers that many chronic health conditions are most effectively managed or remedied through the health system.

To prevent the NDIA coming to this conclusion, it is recommended to pay particular attention to, and demonstrate that you meet the requirement of s24(1)(b) and then s24(1)(c) ie your condition has caused a permanent impairment that has resulted in substantially reduced functional capacity in one of more of the 6 life areas.

The evidence you provide in Section 2, Part B and Part E of the application form is critical. Use the Access Kit’s guiding notes to check and recheck your evidence.

Also, have a look at page 44 of the Access Kit. It outlines what is considered ‘good evidence’.

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Guiding notes Example: Anil requires software to assist with his task list, his calendar and other daily activities. For example, he needs to use a menu planner to assist him with ensuring his nutritional intake is adequate.

Example: Anil is unable to be left alone within his home or the community as he needs supervision constantly to ensure his safety.

Example: Sally’s home requires modification. In the bathroom, for example, the bath needs to be removed and a flat shower base and rails installed to ensure Sally’s safety. Wider doorways are required to accommodate her wheelchair.

Example: Sally requires the use of a lifter to get in and out of bed and to use the shower chair. She requires adaptive equipment such as large handled cutlery and kitchen utensils. A pressure mattress is needed to prevent skin ulcers. Sally requires continence aids.

© National Disability Insurance Scheme Agency 2013

Example: Sally needs physical assistance from another person to make her meals, manage her medication, transfer from bed to chair and with all aspects of her daily hygiene.

Q 2.5 is not applicable for children 0 - 2 years.

TIP

TIP

To meet the Disability requirements, you will need to have substantially reduced functional capacity across the majority of your day to day life, not just during an acute episodic period.

Other non Treating Professionals in the community including teachers and social workers can also provide evidence on how your functional capacity is affected by your impairment.

Ask them to provide a letter of support that provides examples under the one or more life areas that relates to you.

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Guiding notes Example: Jane requires a single key to access every part of her home, safety devices such as a temperature control to limit the temperature on her hot water service, hard wired smoke alarms and timers on cooking appliances.

Example: Jane requires a hand held device with software to plan, organise and keep track of her daily tasks and activities.

Example: Jane requires constant supervision from another person to ensure all aspects of her daily life are organised and actioned. She requires guidance and prompting to make decisions. Jane is unable to solve problems without assistance from another person. She is unable to be left alone.

Q 2.6 is not applicable for children 0 - 8 years. © National Disability Insurance Scheme Agency 2013

Q&A Do I need to fill out every one of the 6 life areas?

No, you only have to fill out the life area(s) which are substantially impacted by your impairment.

For example, you may have substantially reduced function when moving around (mobility) and self care activities. The other life areas may be unaffected or only minimally affected.

TIP

TIP

A GP clinic practice nurse can assist you to collate existing evidence in your file or request information/reports from other professionals.

It is recommended to make sure all of your evidence is very clear and captures the impact of your disability when you are at home and in the community.

For example, when you are tired, among strangers, in noisy environments, under stress, etc.

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Guiding notes Part F of the application form can be used to record further evidence and/or list the evidence you are attaching to the application form.

Consider using the following example format and example content to list your attachments:

Evidence of Disability or Early Intervention  GP, (name), additional information, (date)

Evidence of Functional Capacity  Occupational Therapy Functional Assessment Report, (name), (date)  Physiotherapy Assessment Report, (name), (date)  Lived Experience Applicant Statement, (name), (date) © National Disability Insurance Scheme Agency 2013

 Lived Experience Carer Statement – (name), (date) Evidence of treatments  GP (name), Treatment Summary, (date)

Q&A What is considered good evidence?

It’s suggested to use this check list when sorting and gathering your evidence. Your evidence should be: ✓ Recent (past 12 months). ✓ Completed by a Treating Professional who is relevant to your primary disability and has treated you for a least 6 months. ✓ Confirms your primary disability. ✓ Confirms the impacts of your disability on one or more of the life areas. ✓ Describes past and current treatments and their outcomes. ✓ Describes future treatment options (if relevant) and expected outcomes of those treatments. ✓ Describes how your impairments affect your ability to work, study or take part in a social life. ✓ Describes your overall circumstances and what long term support you need and whether those needs are best met by the NDIS.

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Guiding notes Part G of the application form must be completed by your Treating Professional.

Your Treating Professional will probably be your doctor, specialist or allied health provider.

They need to:  Have known and worked with you for 6 months or longer.  Be the most appropriate type of professional to give evidence of your impairment – refer to pages …and …of the Access Kit.  Be qualified and registered in their area of practice with the Australian Health Practitioner Regulation Agency (AHPRA) or relevant professional authority. © National Disability Insurance Scheme Agency 2013

The Operational Guidelines has more information if you need it.

Here is the link and go to page 23.

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Guiding notes

Use this checklist to make sure you have all sections of your application completed with the right information.

The NDIA assessor can’t make a decision on your eligibility until they have a correctly completed application.

The NDIA assessor will be checking that you have the evidence to meet: ✓ The age requirements.

✓ The residency requirements.

✓ Either the Disability or the Early Intervention requirements. © National Disability Insurance Scheme Agency 2013

Once your Access Request application has been completed, take a copy and keep it somewhere safe.

TIP If you are emailing your application form with attachments, be aware that each file attachment size needs to be under 10MB. If a file is over 10MB, see if you can ‘compress’ it to a smaller file size.

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Guiding notes If you do not have a Centrelink record or you do not wish to provide it, you will need to attach: ✓ Proof of age – you are under the age of 65 on the day you submit your Access Request. ✓ Proof of residence:  if you live permanently in Australia, OR  if you have Australian residency, refer to the next page of the application form.

If you need more information, have a look at the NDIS ‘Proof of Identity Fact Sheet’.

A copy of the fact sheet is included in Section 6, Resources. © National Disability Insurance Scheme Agency 2013

TIP In certain situations, the NDIA can decide if you are eligible within 2 – 5 days.

These situations, called ‘priority eligibility decisions’ are outlined in the Operational Guidelines. It is worth checking to see if it applies to you.

Here is the link and go to page 48.

If you believe you are in one of these situations, ask your Treating Professional to provide a letter demonstrating that your circumstances are urgent.

Consider using the ‘Priority Eligibility Decision Request’ email template, which is included in the Access Kit, Section 6, Resources.

Use the email template to notify the NDIA of your situation.

Include your Treating Professional letter with your application and note its inclusion as an attachment on page 24 of the application form.

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Guiding notes If you do not have a Centrelink record or you do not wish to provide it, you will need to attach: ✓ Proof of residence if you have Australian Residency ✓ Additional proof if you or a child you are applying for is an Australian citizen and was born on, or after, 20 August 1986.

If you are applying on behalf of a child and you are also born after 20 August 1986, you will need to provide proof of Australian Citizenship from one of your grandparents.

© National Disability Insurance Scheme Agency 2013

Q&A How do I submit my access request form and supporting evidence?

You have 3 options:  Email: NAT@ndis.gov.au  Mail: GPO Box 700, Canberra ACT 2601  In person: at your local NDIA office

Q&A When will I get a response?

Make a note of the date that you submitted your Access Request application.

The NDIA is required to decide one of the following within 21 days:  The NDIA needs more information – they believe that your evidence is insufficient. To help your application, promptly submit any new evidence that you may have, along with what they are specifically asking.  Your application is declined – unfortunately they don’t believe you meet the access criteria. Refer to Section 4  You application is approved. Refer to Section 6 The Operational Guidelines provides more information.

Here is the link and go to pages 26 & 27.

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Section 4

WHAT HAPPENS AFTER I BECOME A NDIS PARTICIPANT?

Firstly, congratulations on becoming a NDIS participant!

You will officially become a NDIS participant on the day you are advised via email/letter that you have met the eligibility criteria.

After you receive confirmation, the NDIA will contact you within 21 days to organise your first planning conversation with either a Local Area Coordinator (LAC) or a NDIA planner.

Your disability support needs will be discussed in detail at this meeting, and a plan developed. Your planning conversation will focus on:  What your goals are  Where you live and what your living arrangements are  How you take care of yourself  What your current support network is (friends, family, service providers already in place etc)  What types of support you may need to build your confidence and independence  Whether you work/study (or want to)

Following the meeting, the NDIA will consider what funding should be included in your plan and develop your plan within 56 days (or 90 days for children under 9). You will receive your plan either via email/mail.

TIP Your planning meeting is important. It’s all about you, so spend some time preparing for the meeting and make sure you let them know what you need.

The meeting will be about identifying what level and type of funding you will receive in your plan.

Have a look at Section 5 of this Access Kit. It introduces the Support+ Participant Kit and how it can assist you with your planning meeting and to continue navigating your NDIS journey successfully.

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Section 5

THE SUPPORT PLUS PLATINUM MEMBERSHIP

We hope you are doing well and that our Support+ Access Kit has been a helpful resource for you.

We know that navigating the NDIS can be puzzling, but we’ve got you covered!

Our goal is simple – to empower you and your family to confidently access NDIS supports and funding and to keep your day to day life running smoothly.

We totally get that the NDIS can feel like a maze - like how to get and keep the funding you need or how to set up your plan for future changes.

That's why we've created the Support+ Platinum Membership - an online membership platform that gives you access to a customised dashboard with tailored resources.

Generally your membership can be funded from your NDIS plan budget, at no cost to you.

With a Platinum Membership you will get all the guidance you need to tackle the NDIS with confidence, including tips on how to secure the best outcomes in your NDIS plan and how to plan if there are any sudden changes in your situation or changes to your carer/nominee (if you have one).

Here's what you get when you become a Platinum member: ✓ detailed info and step-by-step guidance about navigating the NDIS maze and making sure you get the best outcomes in your plan, now and in the future. ✓ access to resources and tools that will help safeguard your current needs as well as prepare for any changes in your informal support system in the future. ✓ the latest news on changes in the NDIS and how those changes affect you.

We would love if you considered becoming a Support+ Platinum member. You will gain access to the full library of resources, comprehensive succession planning tools and step by step guidance on navigating the NDIS. If you are already a Support+ Free Member click on any of the ‘padlock’ symbols on your dashboards left-hand menu OR if you are not yet a Support+ Free Member, first sign up as a Support+ free member.

Thanks for considering Support+ as your partner on this journey - we're excited to see where it takes you!

Warmest regards The Support+ Team

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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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