image of NDIS flow chart first page

National Disability Insurance Scheme (NDIS) review and appeals flow chart

This flow chart was developed in response to a session on the NDIS review and appeals process that was part of an Advocacy Sector Conversations forum held on 1 March 2016. As the review process is new and complicated, this flow chart provides a simplified step by step guide to assist advocates and NDIS participants to navigate this process.

 

NDIS eligibility and planning

  1. Person with disability contacts National Disability Insurance Agency (NDIA) to apply for NDIS support
  2. Person’s eligibility is assessed on functional capacity according to NDIA access criteria
  3. If not eligible, person will be notified within 21 days
  4. If eligible, person accepted as NDIS participant
  5. NDIS participant meets with planner to develop a plan
  6. Plan is implemented
  7. If the NDIS participant is unhappy with the plan, an ‘Application for a review of a reviewable decision’ form
    must be lodged within three months. This can be completed by the participant online, or by an NDIA officer
    over the phone, or in person
  8. NDIA initiates an internal review process

Internal review

  1. NDIA internal review staff member makes a decision to confirm, vary or set aside earlier decision
  2. NDIS participant is notified of decision
  3. If the NDIS participant remains dissatisfied with the decision, an application for review by the Administrative Appeals Tribunal (AAT) is lodged – this must be done within 28 days

Administrative Appeals Tribunal (AAT)

  1. AAT contact officer makes contact within three days of receiving application to review NDIA decision
  2. AAT contact officer notifies NDIA of application
  3. NDIA provides relevant documents to AAT
  4. AAT organises conciliation to determine if case can be resolved by agreement
  5. If not resolved, AAT will conduct a hearing

Note: The NDIS participant can access an External Merits Review support officer to assist them to go through the AAT process and to apply for funding for a legal aid lawyer, or they can work with an advocate, family member, support person, or legal representative

Accessing an External Merits Review (EMR) support officer

  1. NDIS participant contacts EMR officer at Rights, Information and Advocacy Centre (RIAC)
  2. EMR officer meets with NDIS participant
  3. EMR officer applies to the Department of Social Services (DSS) for Central Assessment Provider (CAP) funding for a legal aid lawyer
  4. EMR officer supports NDIS participant through the AAT process

Victoria Legal Aid

  1. When DSS approves CAP funding, it notifies Commonwealth Entitlements Team at Victoria Legal Aid
  2. Commonwealth Entitlements Team allocates the matter to a Victoria Legal Aid lawyer
  3. Victoria Legal Aid lawyer receives case files
  4. Victoria Legal Aid lawyer meets with NDIS participant to receive instructions and work through case

Quick reference summary process

summary of process using emogies. The frownie face follows through to the next step. The steps are planning/decision (NDIA, internal review of a reviewable decision (NDIA), appeal reviewed decision through concilliation (AAT)and hearing (AAT.

References

 

Printing Instructions

 

This is a two page brochure. For best effect, print the download below double sided in full auto colour. For professionally printed copies, contact DARU to arrange delivery.

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Author:
DARU

Date published:
Thu 7th Apr, 2016