Who is Eligible for the NDIS?

The National Disability Insurance Scheme (NDIS) is a groundbreaking Australian government initiative to provide essential support and services to people with disabilities. As a person-centred program, the NDIS tailors eligibility and support plans to each participant’s unique goals, needs, and circumstances. But who exactly is eligible for the NDIS? This comprehensive guide will walk you through the eligibility criteria, the application process, and what to expect from this life-changing disability support program if you’re eligible for the NDIS.

Understanding the NDIS

Before diving into the eligibility criteria, it’s important to understand what the NDIS is and how it operates. The NDIS is a holistic approach to disability support that aims to enhance the lives of Australians with significant and permanent disabilities. Here’s what you need to know:

• The NDIS provides funded supports and services for people with disabilities, including those with multiple sclerosis and progressive neurological diseases.

• It focuses on maximising independence and improving the quality of life for participants.

• The scheme is person-centred, ensuring that each NDIS participant receives tailored support.

Now that we have a basic understanding of the NDIS, let’s explore who is eligible for this support.

NDIS Eligibility Criteria

To access NDIS funding and support, you must meet specific eligibility criteria. These criteria ensure that those eligible for the NDIS need it most. Let’s break down these requirements:

1. Residency and Age Requirements

First, let’s look at the basic residency and age requirements:

• Be an Australian citizen, permanent resident, or hold a Protected Special Category Visa

• Live in Australia

• Be aged between 9 and 65 years old at the time of application

If you meet these initial requirements, the next step is to consider the disability requirements.

2. Disability Requirements

The NDIS is designed to support people with significant and permanent disabilities. To be eligible for the NDIS, you must have a disability that is:

• Permanent and significant

• Substantially impacts your ability to complete daily life activities

• Likely to be lifelong

• Requires significant ongoing support for everyday activities

Types of Disabilities Covered

The NDIS supports a wide range of disabilities, including:

• Physical disabilities (e.g., spinal cord injuries, muscular dystrophy)

• Intellectual disabilities (e.g., autism spectrum disorder, Down syndrome)

• Cognitive impairments

• Psychosocial disabilities related to mental health conditions (e.g., schizophrenia, bipolar disorder)

• Sensory disabilities (vision or hearing impairments)

• Chronic illnesses that result in permanent and significant disability

It’s important to note that the NDIS considers the functional impact of your disability, not just the medical diagnosis.

While these are the main disability requirements, there’s another pathway to NDIS support for those who might not fully meet these criteria.

3. Early Intervention Requirements

If you don’t fully meet the disability requirements, you might still be eligible for the NDIS under the early intervention pathway. This alternative route is particularly important for children and those with conditions that may benefit from early support. You might be eligible under this pathway if:

• You have a permanent impairment or developmental delay

• There’s evidence that getting support now will help reduce your future needs

• You’re a child younger than 9 with a developmental delay

Now that we’ve covered the eligibility criteria, you might wonder how to apply if you qualify. Let’s move on to the application process.

NDIS Access: Application Steps

If you believe you may be eligible for the NDIS based on the criteria we’ve just discussed, here’s how to start your NDIS application:

1. Gather evidence: Collect medical reports and assessments documenting your disability and its impact on your daily life.

2. Complete the Access Request Form: You can either:

   • Call the National Disability Insurance Agency (NDIA) on 1800 800 110 to complete the form over the phone, or

   • Fill out the access request form yourself

3. Submit supporting documentation: Provide all relevant information about your age, residency, and disability.

4. Wait for the assessment: The NDIA will review your application and may request additional information if needed.

5. Receive the decision: You’ll be notified whether you’re eligible for the NDIS. If approved, you’ll become an NDIS participant and move on to creating your support plan.

Once you’ve gone through this process and been approved, you might be curious about what comes next. Let’s look at what you can expect as an NDIS participant.

What to Expect as an NDIS Participant

Congratulations! If you’ve been approved and found eligible for the NDIS, you’re about to embark on a journey of personalised support.

• Personalised planning: You’ll work with the NDIA to create a plan tailored to your goals and support needs.

• Funding for reasonable and necessary supports: This may include assistance with daily activities, therapy services, mobility equipment, and more.

• Choice and control: You can choose your service providers and how you use your funding.

• Regular plan reviews: Your plan will be reviewed periodically to ensure it continues to meet your needs.

While the NDIS provides comprehensive support for many Australians with disabilities, it’s important to note that it’s not the only support system available. Let’s explore other options for those who might not be eligible for the NDIS or need additional support.

Community Supports & Government Assistance

Even if you’re not eligible for the NDIS, or if you need additional support, there are many other services available:

• State and Territory Disability Services: Each state offers Home and Community Care (HACC) programs, assisted transport, and equipment provision. Contact your state’s disability services department for details.

• Community Health Services: Local centres provide allied health services (e.g., physiotherapy, occupational therapy), mental health support, and chronic disease management. Find your nearest centre via the Health Direct website.

• Mental Health Services: Options include Headspace (for ages 12-25), Beyond Blue (for anxiety and depression), and SANE Australia (for complex mental health issues). Public hospitals also have local mental health teams.

• Education Support: Schools offer integration aides and special education programs. Universities and TAFEs have disability support units. Contact your local institution for information.

• Employment Support: Programs include Disability Employment Services (DES) and Australian Disability Enterprises (ADEs). JobAccess provides information on disability employment.

• Carer Support: Carer Gateway offers counselling, respite care, and financial support. Carers Australia provides advocacy and support for carers.

• Financial Assistance: Options include the Disability Support Pension, Mobility Allowance, and Carer Payment. Visit the Services Australia website for eligibility criteria.

• Community Organisations: Many non-profits offer specialised support, such as Vision Australia (visual impairments), Deaf Services (hearing impairments), and Autism Spectrum Australia (autism).

To access these supports:

• Contact your local council for community service information.

• Consult your GP for health service referrals.

• Visit MyAgedCare for relevant aged care services.

• Use the IDEAS directory to find local disability services.

Remember, your local area coordinator or the NDIA can help connect you with these alternative supports, even if you’re not eligible for the NDIS.

Appealing an NDIS Decision

If your NDIS application is rejected, and you believe you meet the eligibility criteria, you can appeal the decision. Contact the NDIA on 1800 800 110 for information about the appeals process.

Conclusion

Understanding who is eligible for the NDIS is crucial for accessing the support you need to live a more independent and fulfilling life. Whether you have a physical or psychosocial disability or require early intervention support, if you’re eligible for the NDIS, it aims to provide tailored assistance to enhance your participation in daily life and the community. If you think you might be eligible for the NDIS, don’t hesitate to start the application process – it could be the first step towards transforming your life with the right disability support.

Frequently Asked Questions

What is the NDIS?

The National Disability Insurance Scheme (NDIS) is an Australian government program supporting people with permanent and significant disabilities.

Who is eligible for the NDIS?

To be eligible for the NDIS, you must:

• Be an Australian citizen, permanent resident, or hold a Protected Special Category Visa

• Be aged between 9 and 65 at the time of application

• Have a permanent and significant disability that substantially impacts your ability to complete everyday activities

What types of disabilities does the NDIS cover?

The NDIS covers a wide range of disabilities, including physical, intellectual, cognitive, sensory disabilities, and psychosocial disabilities related to mental health conditions.

Can I access the NDIS if I’m over 65?

Generally, you must be under 65 when entering the NDIS. However, if you were an NDIS participant before turning 65, you can continue with the scheme.

How do you get assessed for NDIS?

To get assessed for the NDIS, you must submit an Access Request Form and supporting medical evidence. The NDIA will then evaluate your application based on the eligibility criteria.

Can I access the NDIS if I have a mental health condition?

Yes, you may be eligible for the NDIS if you have a psychosocial disability resulting from a mental health condition. The disability must be permanent and significantly impact your daily functioning.

What if my child is under nine years old?

Children under 9 with developmental delays or disabilities may be eligible for early intervention supports through the NDIS. An early childhood partner can help determine if the NDIS suits your child.

How do I apply for the NDIS?

To apply, you need to:

1. Complete an Access Request Form

2. Provide evidence of your disability from your healthcare providers

3. Submit your application to the National Disability Insurance Agency (NDIA)

What kind of evidence do I need to provide?

You’ll need to provide recent reports from your treating health professionals that detail your disability, its impact on your daily life, and any treatments you’ve undergone. This may include medical reports, allied health assessments, and psychological evaluations. The evidence should be less than 12 months old and demonstrate the permanence and impact of your disability.

How long does the application process take?

The NDIA aims to decide within 21 days of receiving a completed application with all required supporting evidence. However, it may take longer if additional information is needed.

What if my NDIS application is rejected?

If your application is rejected, you can appeal the decision. You can request an internal review within three months of the decision. If you’re still unsatisfied, you can apply for an external review by the Administrative Appeals Tribunal within 28 days of the internal review decision.

Can I get help with my NDIS application?

Yes, you can get free help with your application from a Local Area Coordinator (LAC), Early Childhood Early Intervention (ECEI) partner, or an NDIS support person.

Can I still get support if I’m not eligible for the NDIS?

Yes, other government and community supports are available for people with disabilities who are not eligible for the NDIS. These may include state-based disability services, community health programs, and other social support services.