So you’ve received your plan after a long, arduous and potentially stressful planning journey and it just doesn't cut the mustard. You might be feeling a variety of emotions including anxiety, disappointment and frustration.
However, if your NDIS plan does not meet your disability-related needs or support you to achieve your goals it isn’t the end of the road. There are steps you can take to rectify the situation. It’s important to know that you have the right to request a review of your plan.
This review process will take some effort, time and energy from you and your support network to see the process through. It may be worth discussing the pros and cons of requesting a review with your LAC/Support Coordinator or an advocate and exploring if the current plan can be used flexibly and creatively to progress towards your goals.
So how do you ask for an internal review of your plan?
If you want to review your plan you must ask the NDIA to review the decision within three months from the day you receive your plan. After this 3 month period you can still ask for a new plan but the request will become a full plan reassessment rather than an internal review. Stay with me here…
You can request a review from the NDIA in a few different ways:
- Phone 1800 800 110 and explain you would like to request an internal review of your plan.
- Email enquiries@ndis.gov.au and put the review request in writing.
- Complete the Request for a Review of a Decision Form and email this to enquiries@ndis.gov.au
- Visit an NDIS or Partner in Community office (APM & Mission Australia in WA) to make the request.
- Send a letter with supporting evidence addressed to the CEO of the NDIA at GPO Box 700, Canberra, ACT, 2601.
If you need to make a review request we recommend completing the Request for a Review of a Decision Form and emailing this to the NDIA along with supporting evidence from your Support Coordinator, therapists, medical professionals and other service providers as this will increase the likelihood of the review having a positive outcome. Make sure the evidence and the form clearly outlines which specific supports do not meet your needs and why, and have the evidence and reports to back this up. The NDIS is an evidence-based scheme so the clearer the evidence the better.
The process is outlined in more detail here on the NDIA website How to request an internal review.
What happens then?
Once the NDIA receives the internal review request they aim to resolve this within 60 days (approximately 2 months). If you receive this decision back and the NDIA has decided not to change their decision there are more avenues that you can pursue. Again, this is another point in the process to weigh up the pros and cons of going further down this route.
If you want to appeal the decision you can ask for a decision from the Administrative Appeals Tribunal. These disputes are typically resolved at a case conference prior to a hearing as going to a hearing is both costly and time consuming for everyone involved. In the unlikely event the AAT process doesn’t provide a resolution, your last avenue of appeal is the Federal Court.
We’ve outlined the different stages of the plan review process below.
Stages of Plan Review Process
1. Submit request for review
You have three months after receiving a decision to submit a request for a review.
2. NDIA Internal review
An internal review is conducted within the NDIA by a person not connected to the original decision. This is the NDIA’s chance to decide whether they will stand their ground.
3. Submit request to Administrative Appeals Tribunal (AAT)
If you are not happy with the result of the internal review then you have 28 days to submit a request for a hearing at the AAT.
4. Case conference
Before going to a hearing, the AAT will see if it can encourage you and the NDIA to put your differences aside and settle in a case conference. 90% of cases get resolved before going to hearing so it is essential that you and your Support Coordinator/support network are very prepared for this stage.
5. Evidence submitted
If a hearing is called, all relevant documents need to be submitted at least 14 days prior to the hearing.
6. The hearing
If you and the NDIA cannot reach an agreement then an AAT Member (or in rare cases 2-3 Members) will hear the case.
7. The outcome
The AAT will then make a decision about whether the NDIA’s decision has merit. Please be aware that this ruling will be made public.
8. Taking it further
Both you and the NDIA can then choose to appeal the AAT decision. In most cases, appeals will go to the Federal Court. However, the Federal Court can only hear appeals based on the law, so you can only appeal if you think that the AAT misinterpreted the law. The services of a good lawyer would be much needed by this stage.
Advocacy
If you are going through this process and particularly if you are taking the NDIA to the AAT or Federal Court, we recommend engaging the services of an advocate. Advocates can provide advice, support and represent your interests during this process.
Support Coordinators are a paid support and representing your interests directly would pose a potential conflict of interest which is how they differ from an advocate. Advocates are funded by the Department of Social Services so you will not have to pay to engage one although some may have waiting lists.
Check out the online tool Disability Advocacy Finder for a full list of independent disability advocacy providers in your area. We have put together a shortlist of a few different advocacy agencies operating in WA.
