FOI 24/25-2381 DOCUMENT 5
Leaving the NDIS
Quick summary: There are different reasons you might leave the NDIS. For most participants, it’s a choice to leave. You might not want to be a participant anymore because you’ve met your goals. Or you might not meet the eligibility requirements anymore. There are different processes for leaving the NDIS depending on the reason you’re leaving. If you leave, you’re no longer a participant, and won’t be able to get NDIS supports. NDIS supports are the services, items and equipment that can be funded by the NDIS. If you leave, we can still help you connect to other government and community services and if things change, you can apply again.
What’s on this page?
This page covers:
• What do we mean by leaving the NDIS?
• What if you don’t want to be an NDIS participant anymore?
• What if you start getting supports from aged care services?
• Are you still eligible for the NDIS?
• What happens if we check your NDIS eligibility?1
• What happens after you leave the NDIS?
• What happens when a participant dies?
You might also be interested in:
• Younger people in residential aged care
What do we mean by leaving the NDIS?
You can choose to leave the NDIS any time. When you leave the NDIS, you won’t be an NDIS participant anymore. You won’t have an NDIS plan or get NDIS supports.
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Some participants will stay with the NDIS for their lifetime. Other participants may need the NDIS for a shorter period. The length of time you stay eligible for the NDIS depends on your individual situation and the NDIS supports you need for your disability.
There are a number of situations where you might leave the NDIS:
• You don’t want to be a participant any more.2
• You move into residential aged care permanently for the first time after you’ve turned 65.3
• You start getting home care services provided by aged care permanently for the first time after you’ve turned 65.4
• You’re no longer eligible for the NDIS.5 This includes when children with developmental delay turn 6 and no longer meet the requirements for early intervention, disability, or both.
• Your NDIS status is revoked.
Participants also leave NDIS when they die.6 Learn more about what happens with NDIS supports when a participant dies.
What if you don’t want to be an NDIS participant anymore?
You can choose to leave the NDIS at any time, if you no longer want to be a participant.
This might be because you’ve met your goals or have developed your skills and independence and don’t need the NDIS anymore.
You can always contact us if you want to talk about whether leaving the NDIS is the best option for you.
If your situation changes after you leave, you can always apply again, and we’ll let you know if you’re eligible.
How do you let us know you want to leave the NDIS?
If you want to leave the NDIS, you’ll need to let us know in writing.7
You can fill in the Leaving the NDIS form. You can also email or send a letter to let us know you want to leave the NDIS. You can also contact us if you’d like some help.
There are services in the community you can contact if you need supports after you leave. A local area coordinator or early childhood partner can help you find local supports that aren’t
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NDIS supports. This includes mainstream and community services available outside the NDIS. Learn more about mainstream and community supports.
If you choose to leave, remember:
• Your plan ends on the day you let us know in writing that you wish to leave.8
• You can’t use your NDIS funding once you let us know in writing that you wish to leave.9
• You’ll no longer be an NDIS participant.10
If you want to become a participant again, you’ll need to reapply. If you reapply, there’s no guarantee you’ll become a participant again. You’ll need to meet all the eligibility requirements. This includes the requirement that you must be younger than 65 on the day you apply.11
Learn more about the eligibility requirements.
If we stop your NDIS plan because you ask to leave, you can’t ask for an internal review. This is because when you write to us and ask to leave the NDIS, the law says we need to:
• remove you from the NDIS,12 and
• end your plan, without us needing to make a reviewable decision.13
Learn more about what decisions can be reviewed.
What if you start getting supports from aged care services?
Aged care services are funded by the Department of Health Aged Care system14 and include residential aged care services and home care services.
Home care services are supports you can get to help with your daily life. They include things like personal care for you in your home. When we say home care services, we mean services funded by the Department of Health Aged Care system.
What if you move into residential aged care?
You’ll leave the NDIS if you move into a residential aged care service permanently for the first time after you turn 65.15 When we say residential aged care services, we mean services funded by the Department of Health and Aged Care system.16
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The supports you get in residential aged care can be different from NDIS supports outside aged care facilities. Find out more about residential aged care services on the Department of Health and Aged Care website.
If you leave the NDIS because you move into residential aged care permanently, you can’t ask for an internal review. This is because the law says we must remove you from the NDIS, without us needing to make a reviewable decision.17 Learn more about what decisions can be reviewed.
Example
Vish is 66 and is an NDIS participant. Vish was living by himself but decides to permanently move into residential aged care for the first time. The law says Vish then stops being a participant and he leaves the NDIS.18
The aged care system is now responsible for all Vish’s support needs. Vish can’t ask for an internal review of this decision. Vish also can’t become a participant again, as he is older than 65.
What if you were already in residential aged care before you turned 65?
If you were already living in residential aged care before you turn 65, you can still be an NDIS participant after you turn 65.
Learn more about younger people in residential aged care.
Once you turn 65, you can also choose to leave and get support from the aged care system instead. If you want to leave the NDIS, you’ll need to let us know in writing.
If you choose to leave the NDIS, you can’t ask for an internal review. This is because if you ask in writing to leave the NDIS, then the law says we must remove you from the NDIS, without us needing to make a reviewable decision.19 Learn more about what decisions can be reviewed.
Example
At age 50, Jane permanently moved into an aged care facility.
She was found eligible for the NDIS when she was 64.
Jane is now 66. She can choose to stay in residential aged care, but she would like to move out and live with her children.
Jane is still an NDIS participant, so she talks to her planner about her goal of moving out of residential aged care. Jane gives assessments and reports from an appropriately qualified person, so we understand her capabilities and support needs.
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Jane and her planner create a plan. Jane’s plan includes the NDIS supports Jane needs. She uses her NDIS supports to work towards her goal of living with her children.
What if you start getting home care services from the aged care system?
Home care services are supports you can get to help with daily life. They include things like personal care for you in your home. When we say home care services, we mean services funded by the Department of Health and Aged Care system.
You must leave the NDIS if you start getting home care services permanently for the first time after you turn 65.20 You can’t ask for an internal review. This is because the law says you must leave the NDIS when this occurs, without us needing to make a reviewable decision.21 Learn more about what decisions can be reviewed.
Home care services can be different from NDIS supports. Find out more about home care services on the Department of Health and Aged Care website.
Example
Kirsty just turned 65 and is an NDIS participant. She uses her NDIS supports to fund 10 hours a week of personal care.
Since she turned 65, she’s now eligible for home care services with aged care funding. She must decide if she’ll start using these aged care services.
If she starts getting home care services with aged care funding permanently, she must leave the NDIS.
She can keep getting NDIS supports until she permanently gets aged care home care services or moves into residential aged care permanently.22
Are you still eligible for the NDIS?
There are different reasons for leaving the NDIS. This might happen if you’re no longer eligible.
You’re no longer eligible for the NDIS if you:
• don’t live in Australia anymore23
• are no longer an Australian citizen or permanent resident24
• no longer meet the early intervention requirements or disability requirements.25
If we have information that tells us you may not be eligible for the NDIS anymore, we may check your eligibility.
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Learn more about What happens if we check your NDIS eligibility?
Do you still live in Australia?
You’ll need to live in Australia to stay an NDIS participant.26 If you leave Australia permanently, you won’t be eligible anymore, and we may decide to revoke your participant status.27 Learn more about when you can be revoked as a participant.
You’ll probably still meet the residence requirements if you leave Australia for a short time. If you’re temporarily outside Australia for more than 6 weeks in a row, you’ll usually still be an NDIS participant but may not be able to use your NDIS funding.28 Learn more about when we suspend your plan.
Are you still an Australian citizen or permanent resident?
To remain a participant, you’ll need to either:29
• be an Australian citizen
• have a permanent residency visa
• have a protected special category visa – this is only for some New Zealand citizens.
For example, you may have to leave the NDIS if your permanent residency visa is cancelled.
If you joined the NDIS from a New South Wales prescribed program and your residency or citizenship status changes, you’ll remain eligible for the NDIS.
Do you still meet the early intervention requirements?
If you’re eligible under the early intervention requirements, your support needs are more likely to change. We’ll check each time we reassess your plan whether you still meet the early intervention requirements.
If you’ve benefitted from early intervention NDIS supports, you might have built your skills and increased your capacity. You may no longer need NDIS supports.
If you no longer meet the early intervention requirements, we’ll check if you meet the disability requirements.
What happens when a child with developmental delay turns 6 years old?
If we decided a child met the early intervention requirements because of their developmental delay, they’re usually no longer eligible after they turn 6.
This is because they’ll no longer meet the eligibility criteria under developmental delay. To remain an NDIS participant after they turn 6, the child will need to meet the requirements for
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disability, early intervention, or both. These requirements include the child to have an impairment that’s likely to be permanent.
We’ll talk to families or carers before a child turns 6. We’ll explain what information we need to decide if the child is still eligible.
Learn more about the disability requirements and the early intervention requirements.
Example
Sarah is 6 years old. Sarah was eligible for the NDIS under the early intervention requirements for developmental delay and has been receiving NDIS supports since age 4.
At age 4, Sarah had a delay with how her speech was developing. Her parents and other children couldn’t understand her, and Sarah found it hard to manage her frustration. Sarah’s parents used her NDIS supports to help them support Sarah to work towards her goals. At age 5, Sarah’s early childhood partner explained to her parents that Sarah would most likely leave the NDIS after she turns 6.
By age 6, Sarah achieved many of the goals her parents set for her, including improved communication, social skills and managing her emotions. Sarah’s early childhood intervention professional reports she no longer needs early intervention supports.
Sarah’s early childhood partner talks to her parents about the NDIS eligibility requirements and explains that Sarah no longer needs NDIS supports. Sarah’s parents let us know in writing they want Sarah to leave the NDIS.
Sarah leaves the NDIS and continues to receive mainstream and community supports. For example, her teacher can help set up the supports she needs at school. Sarah also joins a gymnastic and dancing class.
If Sarah’s situation changes and she needs NDIS supports in the future, her parents understand they can apply for the NDIS again.
Example
Ayesha was eligible for the NDIS under the early intervention requirements for developmental delay and has been receiving early intervention supports since she was 3.
During check-ins, we discussed Ayesha’s progress and reminded the family that Ayesha’s eligibility will be reassessed at age 6. This is because Ayesha will no longer meet the early intervention requirements under developmental delay once she turns 6.
For Ayesha to remain an NDIS participant after she turns 6, she’ll need to meet the requirements for disability, early intervention, or both. These requirements include Ayesha to have an impairment that’s likely to be permanent.
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Ayesha is now 6 years old and has just started school. Ayesha’s parents are happy with her progress but would like her to be more confident when playing with her peers and interacting with adults. They think Ayesha needs ongoing support for her speech and communication.
The evidence we have makes us think Ayesha is no longer eligible for the NDIS as there’s no evidence to indicate that Ayesha has a condition that is likely to be permanent.
We start an eligibility reassessment.
We contact Ayesha’s family by phone, which is their preferred contact method. We also send them a letter. The letter explains that based on the information we have, Ayesha may no longer meet the eligibility requirements. It explains if Ayesha’s family thinks she’s still eligible, they can give us new evidence to show Ayesha meets the requirements for disability, early intervention, or both. Ayesha’s family is asked to respond within 90 days from the date of the letter. The letter also explains that if Ayesha’s family don’t provide new information and evidence, we’ll make a decision based on the information and evidence we have.
Ayesha’s family send us a report from Ayesha’s early childhood intervention professional which confirms she has made progress towards her goals and Ayesha’s functional capacity has improved. It indicates that Ayesha still needs some help with her communication but that her school and parents can continue to support this. There are no other concerns with Ayesha’s development.
Based on the evidence we have, we decide Ayesha no longer meets the requirements for disability, early intervention, or both. We talk to Ayesha’s parents about the NDIS eligibility requirements and explain that we’ve decided Ayesha is no longer eligible.
We send Ayesha’s family a letter explaining Ayesha’s status as a participant will end. This means Ayesha will no longer be eligible and will leave the NDIS.
Ayesha gets ongoing support for her speech and communication from her school and her parents. They use the strategies Ayesha’s early childhood intervention professionals helped them put into place.
Do you still meet the disability requirements?
If you were eligible under the disability requirements, you’ll likely need NDIS supports for your lifetime. This means you won’t have to prove your NDIS support needs every time we change your plan.
If at any time your disability support needs or situation changes, we may need to check your NDIS supports or eligibility. We’ll contact you if this happens.
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What happens if we check your NDIS eligibility?
We may check your eligibility if evidence suggests you may no longer be eligible. This could mean you no longer meet one or more of the residence, disability, or early intervention requirements.
When you became an NDIS participant, you met the requirements for disability or early intervention, or from 3 October 2024, you may meet requirements for both disability and early intervention.
If you’re not sure which requirements you met, check the access decision letter we sent you when we decided you were eligible. If you’ve been through an eligibility reassessment before and this was updated, you can find it in the eligibility reassessment outcome letter we sent you. You can also contact us.
If we check, and it looks like you may no longer meet the eligibility requirements, we may reassess your eligibility. We call this an eligibility reassessment. If we decide to start an eligibility reassessment, we’ll let you know. We’ll give you the opportunity to give us more evidence about your NDIS eligibility. Learn more about How we let you know we’re doing an eligibility reassessment.
After the eligibility reassessment process has finished, we’ll consider the information and decide if you’re still eligible. Learn more about How we decide if you’re still eligible for the NDIS.
You may have to leave the NDIS if you don’t provide us with the specific information, or the evidence shows you don’t meet one or more of:
• the residency requirements
• the disability or early intervention requirements.30
If you’re still eligible, you’ll remain a participant. You can keep using your NDIS supports.
If we revoke your status, you’ll leave the NDIS. Learn more about when you can be revoked as a participant.
How do we let you know we’re doing an eligibility reassessment?
We’ll send you a letter to let you know we’re doing an eligibility reassessment. We’ll also contact you by your preferred contact method, such as by phone or email, to let you know.
If your plan is being reassessed at the same time as the eligibility reassessment, you might get a new plan while we’re doing the eligibility reassessment. You remain an NDIS
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participant and can continue to use your funding to access NDIS supports while your eligibility is being reassessed.
If we start doing an eligibility reassessment, we’ll let you know that based on the evidence we have, we’re thinking about whether we should revoke your status as a participant. We’ll also let you know what eligibility requirements we don’t think you meet.
Will we ask you to provide evidence for an eligibility reassessment?
We’ll write to you and give you an opportunity to provide relevant information or evidence you would like considered when we make the eligibility reassessment decision. The letter will explain what evidence we have and the eligibility requirements we think you don’t meet.
Sometimes if we don’t have enough evidence to make a decision, we’ll ask you for specific information or a report in a format that helps us to make a decision about your eligibility. We must tell you in writing when you need to provide this.31 We’ll only ask you to provide this specific information or report if we can’t reasonably get it in a different way32.
How much time will you have to give us evidence?
We’ll give you 90 days from the date of the letter to respond if you think you still meet the NDIS eligibility requirements. You can send us information and evidence you want us to consider when making the eligibility reassessment decision. If you don’t respond within 90 days, we’ll make the decision based on the information and evidence we have.
What if you need more time to give us information and evidence?
If you need more time to provide information or evidence, contact us. We may be able to give you more time if your request is reasonable. You’ll need to tell us why you need more time, and how much time you need. For example, there could be a delay in getting information from an appropriately qualified person. If so, we could give you more time so you can get the information and send it to us.
Generally, we’ll only consider giving you one extension of time. This is because the first extension should give you reasonable opportunity to give us the evidence. If you need another extension, you’ll need to explain why you need more time again and how much extra time you need.
We’ll consider all relevant information and evidence provided against the eligibility requirements to decide if you’re still eligible.
Example
Pai is 6 years old. When she was 4 we decided she was eligible for the NDIS under the early intervention requirements for developmental delay. We developed a plan with Pai’s family
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with early intervention supports that are likely to benefit Pai. The early intervention supports Pai and her family receive are NDIS supports.
We have regular check-ins with Pai and her family. This helps us understand Pai’s progress and the outcomes Pai has achieved. When Pai turns 5, we talk to Pai’s parents about the eligibility requirements. We remind them Pai’s eligibility will be reassessed once she turns 6. This is because Pai will no longer meet the eligibility requirements under developmental delay. To remain an NDIS participant after she turns 6, Pai will need to have an impairment that’s likely to be permanent. Pai will need to meet the requirements for disability, early intervention, or both.
Because Pai is now 6 we start an eligibility reassessment.
We send Pai’s parents a letter. The letter explains that based on the evidence we have, Pai may no longer meet the eligibility requirements. If Pai’s family think Pai continues to meet the requirements, they need to provide us with evidence. The evidence needs to show that Pai meets the requirements for disability, early intervention, or both. Pai’s parents are asked to respond within 90 days from the date of the letter.
The next day, Pai’s parents call her paediatrician to book an appointment. The earliest time they can book an appointment and send us the evidence is 4 months away. Pai’s family send us the booking confirmation for Pai’s paediatrician appointment and ask for more time.
We think about Pai’s current situation. We decide it’s reasonable to give Pai’s family additional time to provide more evidence.
Pai’s parents provide the evidence in 4 months. We review the evidence. We now have enough evidence to make the eligibility reassessment decision.
Example
Jo is 40 years old and lives with cognitive and physical impairments from stroke. We decided Jo was eligible for the NDIS under the early intervention requirements. Jo’s been getting NDIS supports for 14 months and we need to understand if those supports have helped Jo.
We start an eligibility reassessment.
We send Jo a letter. The letter explains that based on the information we have, they may no longer meet the eligibility requirements. If Jo thinks they continue to meet the eligibility requirements, they can provide us with new information and evidence. The information and evidence needs to support our decision on whether Jo meets the requirements for disability, early intervention, or both.
Jo has 90 days from the date of the letter to provide us with the information.
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We may be able to give Jo more time if their request is reasonable. If Jo needs more time, they can contact us to explain why it’s reasonable not to provide the information within 90 days.
Jo provides a neurology report within the 90 days. The report explains that while Jo has benefited from early intervention, they continue to have substantially reduced functional capacity and will require NDIS supports for their lifetime. We use this report to decide Jo is now eligible for the NDIS under the disability requirements. We update Jo’s eligibility and help Jo build a new plan with NDIS supports for their current situation.
How do we decide if you’re still eligible for the NDIS?
We’ll look at all relevant information against the eligibility requirements to decide if you’re still eligible for the NDIS. We’ll do this after:
• we let you know we’re reassessing your eligibility, and what specific eligibility requirements we’re looking at
• we let you know what information we need to make our decision. We’ll only ask you to provide this specific information or report if we can’t reasonably get it in a different way
• you’ve had a reasonable opportunity to give us the information we asked for
• we look at the information you give us.
The person who reassesses your eligibility and decides if you’re still eligible will be one of our staff. They’ll be different from the people who first decided that you’re eligible, and the people who approved your plans. They’ll also be someone who doesn’t have a personal interest in whether you’re a participant or know you, other than through the NDIS.
If there’s information and evidence that shows us you’re still eligible, you’ll remain a participant. You can keep using your NDIS supports.
You may have been eligible under the early intervention requirements but give us evidence that shows you now meet the disability requirements. If so, we’ll change our records to show you now meet the disability requirements. This means we won’t revoke your status as a participant, and you’ll remain an NDIS participant.
When can you be revoked as a participant?
After we’ve assessed your eligibility, there are some situations where we may revoke your status as a participant. This includes where you haven’t provided the information we need.33 This means you won’t be a participant anymore and you’ll leave the NDIS.
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We won’t make a decision to revoke your status as a participant if it was reasonable for you not to have provided the information in the agreed timeframe.34 We’ll consider:
• the timeframe we gave you35
• the timeframe since we were last given relevant information about your eligibility36
• if you or someone representing you has not complied with our requests before37
• if there were things outside your control which meant you couldn’t get the information to give it to us on time38
• any other information that may be relevant.39
We’ll contact you by your preferred contact method to explain our decision. We’ll also send you a letter with our decision and our reasons, and the date your participant status will be revoked. 40 This date will usually be 28 days from the date the eligibility reassessment decision was made.
Revoking - when you’ve had an opportunity to respond
If we check your eligibility, and evidence suggests you may no longer meet the eligibility requirements, we’ll start an eligibility reassessment. We’ll let you know and give you the opportunity to provide us with more evidence about your NDIS eligibility. You’ll have an opportunity to respond within 90 days with the necessary information or request an extension of time to obtain the evidence. We’ll look at the evidence you provide us.41 If, based on the evidence we believe you’re not eligible, we’ll revoke your status as a participant.42
Example
Johan is 7 years old. When he was 3, we decided he was eligible under the early intervention requirements for developmental delay. Marita is Johan’s mother and child representative. We haven’t completed a check-in or plan reassessment in two years. This is because Marita won’t respond to us.
Marita self-manages Johan’s plan and we can see the NDIS funding in Johan’s plan is being used. Because Johan is now older than 6 his eligibility needs to be reassessed. To remain an NDIS participant after he turns 6, we need to have evidence that Johan has an impairment that’s likely to be permanent, and he meets the requirements for disability, early intervention, or both.
We send Marita a letter. The letter explains that based on the information we have Johan may no longer meet the eligibility requirements. If Marita thinks Johan is still eligible for the NDIS, they can choose to provide us with evidence. The evidence needs to show that Johan meets the requirements for disability, early intervention, or both. Marita is asked to respond
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within 90 days from the date of the letter. We try to contact Marita using her preferred contact details several times. We don’t hear back within the 90 days. Marita hasn’t asked for more time to provide information and evidence.
We make the decision based on the information and evidence already available and decide to revoke Johan’s status as a participant. We send Marita a letter explaining Johan is no longer eligible to be a participant. This means Johan will stop being a participant and will leave the NDIS.
If Marita disagrees with our decision, she can ask for an internal review within 3 months of us telling her in writing that we revoked Johan’s status as a participant.
Revoking - when we’ve asked for an assessment or examination report
When we ask you for a report of an assessment or examination, we’ll give you 90 days, or a longer period as requested, to send this to us. We’ll consider whether the report:
• was sent to us on time, or within an agreed timeframe
• is in an approved format
• shows an appropriately qualified person completed the assessment or examination.
If you don’t send the information or report on time, we’ll revoke your access to the Scheme43.
If you do send us the information or report on time and in the correct form, we’ll use it to decide if we:
• think you’re still eligible44
• need more information to make a decision.45
What if you don’t agree with our decision?
If you don’t agree with our decision to revoke your status as an NDIS participant, you should talk to us. Your planner, local area coordinator or early childhood partner can help explain our decision, answer any questions and explore next steps.
You can also ask for an internal review of our decision to revoke your status as a participant.46 This means one of our staff, who wasn’t involved in the original decision, will decide if we made the correct decision.
You’ll need to ask for an internal review within 3 months after we tell you in writing that we revoked your status as a participant.47 You can ask us to stop our internal review at any time.48
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If you don’t agree with the internal review decision, you can then ask for an external review. This means the Administrative Review Tribunal will decide if we made the right decision. Learn more on the Administrative Review Tribunal website.
If we decide you’re not eligible, you can apply again, unless you’ve requested a review of that decision and are waiting for a decision to be made.49
Learn more about internal and external reviews.
What if you become a participant again because of an internal or external review?
If an internal or external reviewer decides you’re eligible for the NDIS, you’ll become a participant again. You’ll become a participant again from the date you stopped being a participant.
This means we’ll identify the plan you had when you stopped being a participant and put that plan back in place. This plan will continue until we reassess your next plan.
In some situations, you can claim the cost of the NDIS supports you purchased during the period your participant status was revoked. This is the period between the day:
• you stopped being an NDIS participant
• you became a participant again because of the internal or external review decision.
You can only claim funding for NDIS supports purchased when you stopped being an NDIS participant if:
• they were in your plan – the plan that was in place when we revoked your status as a participant50
• there’s enough funding remaining in that plan
• you have proof of buying and using the supports, such as a receipt
• you claim them within 2 years after you become a participant again.
If your NDIS supports are self-managed or plan-managed, you or your registered plan manager can claim the funding for NDIS supports as usual. If your NDIS supports are agency-managed, contact us so we can help you claim the funding for NDIS supports. Learn more about ways to manage your funding.
Example
Charlie is a participant and was eligible for the NDIS under the early intervention requirements.
On 1 July, we decide Charlie isn’t eligible for the NDIS anymore and revoke their status as a participant. We have information that shows Charlie no longer meets requirements for
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disability or early intervention. Once Charlie’s status as a participant ends they can no longer use their NDIS supports.
Charlie asks for an internal review of this decision. They also give us new evidence from their doctor and specialists about their impairments, functional capacity and support needs.
On 1 September, the internal reviewer decides to set aside the decision to revoke Charlie from the NDIS. This means Charlie is eligible for the NDIS and becomes a participant again.
We treat Charlie as if they were a participant the whole time. This means we put back the plan that existed when their status as a participant was revoked. Charlie’s reinstated plan will remain until it’s replaced by a new plan at their next plan reassessment.
Charlie kept using their supports in July and August after their participant status had been revoked. Charlie paid for these supports with their own money and kept the receipts. Charlie can’t claim every support but can claim NDIS supports that were in the NDIS plan before their participant status was revoked.
Charlie self-manages their funding, so they claim the amount they paid for NDIS supports included in their plan on the myplace portal.
What happens after you leave the NDIS?
When you leave the NDIS, you’re no longer a participant and your plan will stop.51 We can’t fund any NDIS supports after you leave.52
We can help you sort out your final payment requests. If you want help, talk to your local area coordinator, early childhood partner or planner. You can also contact us.
If you would like to connect with services in your community, you can ask your local area coordinator or early childhood partner about available supports.
Under the law, we must keep your information on our records. Learn more about your privacy and information.
What happens when a participant dies?
We recognise the importance of supporting family, carers and support networks when a participant dies.
To give the best support we can during this difficult time, we have specialist staff who can help you work through any remaining NDIS matters. Learn more about how we can help after a participant dies.
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When we say ‘you’ in this section, we mean someone who is a verified contact of the participant in our system and is looking after the participant’s matters after they’ve died.
You might be a:
• spouse
• nominee
• parent or child representative
• court appointed trustee or guardian.
It’s important you tell us when a person dies, as they’re no longer an NDIS participant, and we’ll need to finalise their NDIS record.53
You can contact us in person, or by phone, email or letter when the participant dies. Or you can fill in the Leaving the NDIS form.
We’ll ask for the participant’s date of death. We’ll also ask who the executor of the estate is if you have this information. This is the person who’ll be managing the participant’s estate. We use this information to help us finalise the participant’s NDIS record. This means their plan ends and NDIS supports will stop.
We know this is a difficult time. Where appropriate, we’ll offer support to help you work out what you need to do to finalise matters relating to the participant’s plan after they die. You can reach out to a local area coordinator, early childhood partner or planner. You can also contact us.
Learn more about what to do when someone dies.
What happens to a participant’s NDIS funded supports when they die?
The participant’s plan ends the day they die. We can’t fund any NDIS supports purchased or supplied after this date. If the participant’s registered plan manager uses NDIS funds to purchase supports after this date, the registered plan manager will need to repay us.54
Also, an NDIS provider will need to repay us if they receive a payment they’re not entitled to after the participant’s death.55
For example, the participant may have funding for cleaning services in their NDIS plan. A provider can’t claim this funding to purchase cleaning services after the participant dies. If the provider claims the funding, it will need to be repaid to the NDIS.
Sometimes we can pay for NDIS supports that were arranged or ordered in writing before the participant died that haven’t been paid yet. For example:
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• return and payment for rented assistive technology, where the costs are covered by a service agreement entered before the participant died.
• assistive technology that has been purchased by the participant but not paid for or delivered – when it fits with the pre-payments guidance of the Pricing Arrangements and Price Limits.
• home or vehicle modifications that were started but haven’t been finished.
• services that were purchased and provided before the participant died.
• cancellation fees covered by a service agreement.
We’ll make sure access to the portal is available for a period of 90 days from the participant’s date of death. This is so that NDIS supports purchased before the participant’s death can be claimed. When you contact us, we’ll talk to you about who the most appropriate person is to have access to the portal to make these claims.
The information in this section is general information only. You should always check the terms of the service agreement made with the provider. The service agreement can help you work out whether you need to pay providers, and who owns assistive technology, home or vehicle modifications, after a participant dies.
What happens to a participant’s assistive technology?
The person managing the estate will need to work with providers to manage the participant’s assistive technology in line with the service agreement that’s in place.
Generally, when we have funded assistive technology for the participant, the participant owns it, unless there’s an arrangement in place where the participant must give it back to the provider. For example, the participant has a rental or leasing arrangement with an NDIS provider.
If the participant owns the item, the equipment becomes part of their estate when they die. The person managing the estate can choose what to do with the assistive technology.
If the participant was renting assistive technology with NDIS funding, you must return the equipment to the provider. This is because the provider still owns it. This includes if the participant rented a group of assistive technology items, such as through a loan pool or equipment library.
If the participant had a service agreement that includes the costs of returning equipment early, we’ll cover costs such as:
• early return fees
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• shipment or delivery costs.
What happens when assistive technology has been ordered but not delivered?
If the participant dies before getting assistive technology that was in their plan, we’ll pay any pre-payment fees that haven’t been paid if:
• the fees are in line with our pre-payment’s guidance in the Pricing Arrangements and Price Limits, and
• the item was ordered before the participant died.
If full payment is made, the assistive technology is the property of the estate.
What if the participant had an assistance animal or dog guide?
The person managing the estate may need to look at any service agreement and may wish to talk to the participant’s provider. They can discuss with them what options are available for the assistance animal or dog guide.
What happens to a participant’s home and vehicle modifications?
The person managing the estate will need to work with the provider to manage the participant’s home or vehicle modifications in line with the service agreement that’s in place.
After the participant dies, you can usually still claim NDIS funding for home modifications or vehicle modifications if the modifications were purchased before the participant died. This is if the provider hasn’t been paid the final payment.
If the participant dies before approved home or vehicle modifications are finished, the provider should discuss options with the nominee or executor within the scope of the service agreement.
This may mean completing modifications to make the building or vehicle safe and suitable for more general use. But if the modifications continue, they shouldn’t include specific features required by the participant who died.
Remember, we can help you work out what to do about the participant’s plan after they die. You can reach out to a local area coordinator, early childhood partner or planner. You can also contact us.
What can service providers claim?
Service providers can claim for NDIS supports purchased before the participant’s death under a service agreement. They have 2 years from the participant’s date of death to make a claim.
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If the funding was plan managed, the registered plan manager will need to claim any funding for NDIS supports purchased before the participant’s death. Registered plan managers can claim the plan management fee for the month of the participant’s death for this purpose, if this forms part of their service agreement.
When can providers claim cancellation fees?
In some situations, providers can claim a cancellation fee if they had short notice of the participant’s death. Providers can claim the fee according to the conditions in the service agreement and the Pricing Arrangements and Price Limits.
If the participant lived in Specialist Disability Accommodation (SDA), the SDA provider can claim vacancy costs in some situations. We have more information in the SDA Pricing Arrangements and Price Limits.
Do we disclose information about a participant’s death?
There are some situations where we may disclose information about the participant’s death. For example, we may need to disclose this information to:
• finalise outstanding service bookings
• help arrange removal or disposal of assistive technology
• stop delivery services.
We can only disclose information about the deceased participant in certain situations, where it’s in the public interest to do so.56
We may disclose information when:
• there’s no reason to think the deceased participant wouldn’t want their information disclosed
• the information is needed for a genuine reason, such as to help administer the deceased participant’s estate
• the information isn’t available from another source.
The people we may talk to include:
• a family member, guardian or support person
• a correspondence nominee, plan nominee or child representative
• a service provider that was providing NDIS supports to the participant – they’ll need to know as soon as possible since they can’t claim funding after the participant dies
• an executor administering the estate
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• a Commonwealth, State or Territory department or authority
• a lawyer or legal representative that was supporting the participant.
If you have any questions about why we’ve disclosed details about the participant’s death, you can always contact us.
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Appendix A: New South Wales prescribed programs
We may have decided you were eligible because you had support from one of the following programs in New South Wales. If so, you’ll remain eligible for the NDIS even if your residency or citizenship status changes. This also includes if you were eligible under one of these programs, but now live in a different state or territory.
These programs were provided to residents of New South Wales and were administered by the New South Wales Department of Family and Community Services for people younger than 65.
New South Wales programs:
Large Residential Centres
• Large Residential Centre/Institution.
Group Home
• Small Residential Centre/Institution.
• Group Homes.
Community High
• Hostels.
• Attendant Care.
• In-home Accommodation Support.
• Alternative Family Placement.
• Other Accommodation Support.
Community Support
• Therapy Services for Individuals.
• Early Childhood Intervention.
• Behaviour/Specialist Intervention.
• Counselling.
• Regional Resource and Support Teams.
• Case Management, Local Coordination and Development.
• Other Community Support.
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Community Access
• Learning and Life Skills Development.
• Recreation/Holiday Programs.
• Other Community Access.
Respite
• Own Home Respite.
• Centre-based Respite/Respite Homes.
• Host Family Respite/Peer Support Respite.
• Flexible/Combination Respite.
• Other Respite.
Community Care
• Domestic assistance.
• Social support.
• Nursing care received at home or at centre/other.
• Allied health care received at home or at centre/other by intervention type.
• Personal care.
• Centre-based day care.
• Other food services.
• Respite care.
• Assessment including screening (client).
• Assessment including screening (carer).
• Case management.
• Client care coordination (client).
• Client care coordination (carer).
• Home maintenance.
• Counselling/support, information and advocacy (client).
• Counselling/support, information and advocacy (carer).
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• Meals received at home or at centre/other.
• Goods and equipment (self-care aids, support and mobility aids, communication aids, aids for reading, medical care aids, car modifications, other goods/equipment).
• Formal linen services.
• Transport - Client – number of one-way individual or group trips by purpose.
• Home modification.
Commonwealth programs
• Better Start for Children with Disability.
• Disability Employment Assistance: Australian Disability Enterprises.
• Helping Children with Autism.
• Younger Onset Dementia Key Worker Program.
• Outside School Hours Care for Teenagers with Disability.
• Remote Vision and Hearing Services.
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Reference list
1 NDIS Act s 30A. 2 NDIS Act s 29(1)(d). 3 NDIS Act s 29(1)(b). 4 NDIS Act s 29(1)(b). 5 NDIS Act ss 29(1)(c), 30, 30A 6 NDIS Act s 29(1)(a). 7 NDIS Act s 29(1)(d). 8 NDIS Act ss 29(1)(d), 37(3)(c). 9 NDIS Act ss 29(1)(d), 29(2). 10 NDIS Act s 29(1)(d). 11 NDIS Act s 22. 12 NDIS Act s29(1)(d). 13 NDIS Act ss 99, 100. 14 NDIS Act s 29(1)(b); Residential care service has the same meaning as in the Aged Care Act 1997. 15 NDIS Act s 29(1)(b). 16 NDIS Act s 29(1)(b); Residential care service has the same meaning as in the Aged Care Act 1997. 17 NDIS Act ss 29(1)(b), 99, 100. 18 NDIS Act s 29(1)(b). 19 NDIS Act ss 29(1)(d), 99, 100. 20 NDIS Act s 29(1)(b). 21 NDIS Act ss 29(1)(b), 99, 100. 22 NDIS Act s 29(1)(b). 23 NDIS Act ss 23(1)(a), 30(1)(a). 24 NDIS Act ss 23(1)(b), 30(1)(a). 25 NDIS Act ss 24, 25, 27, 30(1)(b). 26 NDIS Act ss 23(1)(a), 23(2), 30(1)(a). 27 NDIS Act ss 23(1)(a), 23(2), 30(1)(a). 28 NDIS Act s 40. 29 NDIS Act s 23(1)(b). 30 NDIS Act ss 30(1)(b), 30A(1)(a)(b). 31 NDIS Act ss 30(3AA), 30A(5AA). 32 NDIS Act ss 30(3A), 30A(5A). 33 NDIS Act s 30(5). 34 NDIS Act s 30(6). 35 NDIS Act ss 30(6A)(a), 30A(7A)(a). 36 NDIS Act ss 30(6A)(d), 30A(7A)(d). 37 NDIS Act ss 30(6A)(b)(c), 30A(7A)(b)(c). 38 NDIS Act ss 30(6A)(e), 30A(7A)(e). 39 NDIS Act ss 30(6A)(f)(g), 30A(7A)(f)(g). 40 NDIS Act ss 30(7)(8), 30A(8)(9). 41 NDIS Act s 30(3)(a). 42 NDIS Act ss 30(1), 30A(1). 43 NDIS Act ss 30(5), 30A(7). 44 NDIS Act ss 30(4)(a)-(c). 45 NDIS Act s 30(4)(d) 46 NDIS Act s 100. 47 NDIS Act s 100(2). 48 NDIS Act s 102. 49 NDIS Act s 19(2) 50 NDIS Act s 46(1).
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51 NDIS Act ss 29, 37(3)(c). 52 NDIS Act s 29(2). 53 NDIS Act s 29(1)(a). 54 NDIS Act ss 46(1), 182(3). 55 NDIS Act ss 182(1)-(2). 56 NDIS Act s 66(1)(a) – Public Interest Certification For The Release Of Protected Agency Information Relating To Deceased Participants dated 28 April 2020.
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