What to Do if You Are Unhappy with Your NDIS Plan

If your National Disability Insurance Scheme(NDIS) plan is not what you expected, we reveal what you can do about it.

The tense wait is over.

You receive your NDIS plan. You open it up. Your heart sinks.

It is not what you had hoped for.

The disappointment is even stronger considering how much time and effort you put into the application process.

What now?

The short answer is to not despair. There are avenues you can explore in the hope of having your plan amended.

Here are three critical steps to take if you are unhappy with your NDIS plan.

Step 1: Request an Internal Review

The first step is to visit the NDIS website and complete the ‘request for a review of a decision’ form.

You can access the form here.

As part of this process, the form will prompt you to explain why you feel the decision that was made was not correct.

Here are some questions that are included on the form:

• What decision were you expecting?
• Has your situation changed since the decision was made?
• Do you have new evidence, such as medical or therapy reports you would like us to think about?
• Why do you think we should make a different decision?

Remember, the NDIS is all about what is ‘reasonable and necessary’.

So, clearly outline why you think particular funding is both reasonable and necessary to you and your particular needs and talk to that.

Step 2: Wait… but Do Not Sit Idle

The National Disability Insurance Agency (NDIA) will conduct the review.

The NDIA manages the NDIS and is responsible for reviews. It will aim to complete its review within 60 days of your request.

It is best to be aware of this timeline, so that you can prepare for the wait.

During this time, an NDIA employee will consider the information you supplied and decide if your request is reasonable and necessary.

It is important to know that you can – and should – still use any funds you have available to you while this decision is being made.

Participants sometimes worry that the NDIA will view this move as ‘acceptance’ of the plan as it currently stands, but this is not the case.

You do not have to go without supports while you wait for the review outcome.

Following the review, the NDIA will come back to you with its decision.

If necessary, you can ask the NDIA to explain its decision further.

Step 3: Still Not Happy? Ask for an External Review

If you still do not agree with the NDIA’s decision, you can take your case to the Administrative Review Tribunal (ART). This is sometimes called an ‘external review’.

In this review, the NDIA will not consider your case. Rather, it will be conducted by someone who is independent of the agency.

The goal of the ART is to resolve matters through mutual agreement, so it is not a court.

If you want to take your case to the ART, you have just 28 days to do this from the time the NDIA advises you of its decision from the internal review.

You can go to the tribunal only once the internal review process (step 1) has finished.

You can ask a friend, family member, advocate or lawyer to help you to ask for an external review.

If you need help finding an advocate, connect with one via the NDIS Appeals Program.

An outline of the review process, frequently asked questions and other handy information are available here.

Keep Positive

Lastly, it pays to consider that every year, thousands of Australians with disability have their NDIS plans amended.

Unfortunately, like many things with the NDIS, it can take plenty of paperwork and patience to improve your outcome.

But an improved result is worth fighting for.

We Are Here to Help

At Endeavour Foundation, we believe that everyone deserves access to the supports they need.

Among our expert team are NDIS specialists who can help you navigate the complexities of the system, including applying for and requesting more funding.

Looking for support with your NDIS plan, complete with the best in disability support services?

Get in touch with us today.