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Home > Resources > DARU Publications > National Disability Insurance Scheme (NDIS) review and appeals flow chart
NDIS appeals Flowchart cover

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

Posted March 7, 2019

This quick reference guide outlines the processes for  National Disability Insurance Scheme (NDIS) Internal Review (Review of a reviewable decision) and NDIS Appeals in an easy to follow flow char format. It was updated in March 2019.


 Eligibility and Planning

  • Person with disability contacts National Disability Insurance Agency (NDIA) to apply for NDIS support
  • Person’s eligibility is assessed on functional capacity according to NDIA access criteria
  • If not eligible, person will be notified within 21 days

If eligible, person is accepted as NDIS participant

  • NDIS participant meets with planner to develop a plan
  • Plan is implemented
  • 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
  • NDIA initiates an internal review process

If not eligible, person is not accepted as an NDIS participant

  • If more information can be accessed to prove eligibility, submit a new NDIS access request form (There is no limit to the amount of times you can apply)

  • If all information has been supplied and you think there is an error in the decision participant can submit an internal review
  • NDIA initiates an internal review process

Internal Review

  • NDIA internal review staff member makes a decision to confirm, vary or set aside earlier decision
  • NDIS participant is notified of decision
  • 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

NB: The NDIS has to make a decision in a reasonable and practicable timeframe. There is not set amount of time that a decision has to be made.

Administrative Appeals Tribunal (AAT)

If applying to AAT without an Appeals Officer

  • AAT contact officer makes contact within three days of receiving application to review NDIA decision
  • AAT contact officer notifies NDIA of application
  • NDIA provides relevant documents to AAT and to participant (Tribunal Documents)
  • AAT organises a teleconference to determine what needs to be done and creates a case plan

If agreement cannot be made the AAT will:

  • AAT organises conciliation to determine if case can be resolved by agreement
  • If not resolved, AAT will conduct a hearing

Note: The NDIS participant can access an NDIS Appeals 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 a NDIS Appeals Officer

  • NDIS participant contacts NDIS Appeals agency – Look up Disability Advocate Finder
  • NDIS participant goes through an intake process with their chosen NDIS Appeals agency
  • Advocacy agency allocates next available NDIS Appeals Officer
  • NDIS Appeals Officer meets with NDIS participant
  • NDIS Appeals Officer applies to Victoria Legal Aid (VLA) for funding for a legal aid lawyer
  • NDIS Appeals Officer supports NDIS participant through the AAT process

Victoria Legal Aid

  • If funding for legal support is approved participant is notified in writing
  • A Victoria Legal Aid (VLA) lawyer will be allocated to case
  • VLA lawyer meets with NDIS participant to receive instructions and work through case
  • VLA lawyer will receive Tribunal Documents

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

  • NDIS Act – List of reviewable decisions – Chapter 3, Part 6, Section 99
  • How to review a planning decision, NDIS
  • Applying for a review, Administrative Appeals tribunal (AAT)
  • NDIS Appeals Information, Department of social Services

 


Printing Instructions

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

Download Flowchart (PDF)Download Flowchart accessible version (Word)
Author:
DARU

Date published:
Thu 7th Apr, 2016

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