The NDIS (National Disability Insurance Scheme) is intended to provide long-term support for people living with a permanent and significant disability.
However, understanding who qualifies for funding and where to get started is a task all of itself, so we’ve made a guide to NDIS eligibility to help you with those first steps.
Who is eligible for NDIS funding?
There are three main criteria to be eligible for the NDIS: residency status, age, and disability. If you meet these criteria, you can apply for NDIS funding.
Let’s go over these eligibility requirements in a little more detail:
1. What are the NDIS Residency requirements?
You must be an Australian Citizen or hold a Permanent or Protected Special Category Visa (SCV) to qualify for the NDIS.
You’ll need to supply evidence that you live in Australia-that this is your home, and you spend most of your time based here. If you consent to the NDIS using your Centrelink record, this typically provides all the relevant information they would need.
2. What are the NDIS Age Requirements?
If you are aged 9-65, you are in the age group that is eligible to apply for NDIS funding (assuming you also meet the other criteria).
Groups outside of this have alternate support options:
Children under 9 can be supported under the NDIS early childhood approach. This helps children under 6 with developmental delay and children under 9 with disabilities to get support.
People over 65 can benefit from programs for older people, including continuity of support, Commonwealth Home Support, and Home Care Packages.
3. What are NDIS Disability Requirements?
To meet this criteria for NDIS funding, you must be able to supply evidence that:
Your disability is caused by an impairment.
Your impairment is likely to be permanent.
Your permanent impairment significantly reduces your functional capacity in regards to everyday activities.
Your ability to work, study, or take part in social life is affected by your permanent impairment.
It’s likely you will need support under the NDIS for your whole life.
You won’t need to prove your disability every time your plan is reassessed, though if your situation changes or your needs are not being met, you should reach out to your LAC (Local Area Coordinator).
How to Access the NDIS
Once you have determined your eligibility, you can fill out an Access Request form. This confirms your identity and suitability and confirms your consent for the NDIS to seek information from third parties (like Centrelink). You can do this:
Verbally, by calling the NDIA on 1800 800 110. You can request the application form to be posted or emailed to you, then fill it out and return it to the NDIS. Your LAC can help if you have difficulty making the call or filling out the form.
In person, by visiting your nearest NDIS office. If you would prefer to pop in and you have an NDIS office or LAC in your area, you can collect the form there.
Online, via the downloadable Access Request Form. Once you have completed the form, you can return it by email (NAT@ndis.gov.au), post it to GPO Box 700, Canberra ACT 2601, or return it to your nearest NDIS office.
Sometimes you might be limited by your physical location, like if you don’t live near an NDIS office or you don’t have an LAC in your area. In this case, we’d recommend going straight to calling the NDIS or downloading the form online.
The Application: What you need to include
You will need to provide proof of identity, age, residency, and evidence of your impairments.
Proof of identity includes copies of valid identity documents; you can find examples of these in the Evidence of Identity Factsheet. If you can’t provide any of these documents, you will need to contact the NDIS to see what can be done in your situation to check your identity.
For your age and residency status, you can either give consent for the NDIS to view and use your Centrelink record or supply copies of documents and other evidence directly to the NDIS.
Providing evidence of impairments
Your treating professional can provide evidence of a permanent and significant disability. That might be your GP, a specialist, or an allied health service provider.
An ideal treating professional will have worked with you for at least six months, is qualified and registered in their relevant profession, and is the most appropriate type of professional to give evidence about your impairment.
NDIS impairment notices
From January 1, 2025, all new access requests will receive an impairment notice, which will list their impairment(s) in relation to whether they meet disability or early intervention requirements (in some cases, it may be both). Current participants will receive their notice as part of the transition to new framework plans.
This change aims to create clearer identification and communication around a participant’s impairment(s) as part of access and planning.
What happens if you are not eligible for NDIS funding?
If your Access Request is unsuccessful, there are other avenues for services and support you might consider.
Another option is to apply again. If you have new evidence to support the impact of your disability on your everyday life or your situation has changed, you can make a new access request. You also have the right to request an internal review of your access decision from the NDIA.
Note: If your access request is under review or you have had your participant status removed and you request a review of that decision, you must wait for this process to be completed before you can submit a new request.
What happens once you’re approved?
If your Access Request has been successful, great! This is when you will be able to start working with your LAC or NDIS Planner to set up planning conversations and get the structure of your plan put into place to provide reasonable and necessary NDIS supports.
During this time, you should also consider how you want to manage the financial aspects of your plan. There are three options (self-managed, plan-managed, or agency-managed) with varying levels of administrative responsibility and flexibility.
If you would like to maintain control over which support providers you can engage but leave time-consuming financial administration to someone who better knows the NDIS system and its intricacies, plan management might be the most appealing option.
See related: NDIS Self Managed vs Plan Managed vs Agency Managed Explained
Changes to plan management in 2024
The NDIA has the authority to change the way your plan is managed, particularly if you, your nominee, your current plan manager, or your child representative are assessed as potentially mismanaging NDIS funds. This change currently applies to self-managed participants but will eventually include individuals using a plan management provider.
