NDIA Accountability Project

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Request an internal review of an eligibility decision (s100)

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Request an internal review of an eligibility decision (s100)

This Standard Operating Procedure (SOP) will help you to process a request for an internal review of decision when:

  • an applicant is not eligible for the NDIS (Access not met), or
  • a participant is no longer eligible for the NDIS (revocation).

Recent updates

Date What’s changed
March 2022 • New SOP format to align with Our Guidelines refresh. SOPs include process information only. Use Our Guidelines to help you make decisions and refer to Related procedures or resources. 
         • Guidance updated to align with [Our Guideline – Applying to the NDIS](https://www.ndis.gov.au/).
         • Updated work instructions so an applicant has 100 days, from the decision date, to ask for an internal review of their eligibility decision. This aligns with legislation and allows the applicant time to receive notification of the decision.
         • New instructions to:
           • save evidence as a PDF document
           • use a standard PDF naming convention: Access – <Document name> <Document date> – <First name> <Last name>, DOB <DD/MM/YYYY>.

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Standard Operating Procedure

For Internal Use Only

Checklist

Topic Checklist
Pre-requisites You have:
❑ read and understood [Our Guideline – Applying to the NDIS](Our Guideline – Applying to the NDIS).
❑ received a request for an internal review after an Access not met or revocation decision.
❑ followed instructions in SOP – Complete NDIS application tasks.
Actions
❑ 3.1 Check authority to ask for a review
❑ 3.2 Attach evidence (if required)
❑ 3.3 Consider when the decision was made
❑ 3.4 Offer new application
❑ 3.5 Create s100 review request

Procedure

Note: Both ‘Access Not Met’ and ‘Revocation’ (ER) decisions are reviewable decisions. If a person does not agree with the decision they can ask, over the phone or in writing, for the decision to be reviewed. We call this an internal review of a decision.

Note: We can only accept review requests if the decision was made less than 100 days ago. The legislation states a request for an internal review must be received within 3 months from receiving notice of the decision. 100 days in an internal processing time only. This allows time for the applicant to receive the letter.

3.1 Check authority to ask for a review

3.1.1 If the applicant asks for a review

  1. Go to Step 3.2: Attach evidence (if required).

3.1.2 If someone else asks for a review

Check consent details

  1. In NDIS Account screen: Select Details.
  2. Select Consent.
  3. View Details of Authorised Representative field to determine: • If the person’s name is listed as a legally authorised or an authorised representative

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Standard Operating Procedure

For Internal Use Only

• The nature of the relationship • The scope of the legal authority to act or the consent to act as an authorised representative • How the evidence of legal authority or consent to act was provided.

If listed as an authorised representative

  1. Go to Step 3.2: Attach evidence (if required).

If not listed as an authorised representative

  1. Refer to SOP – Identify authorised representatives at Access to determine if the person is an authorised representative

3.2 Attach evidence (if required)

Note: Complete this step if the applicant provides additional evidence with the request.

Save each document as a PDF and update the file name using the following convention:

Access – <Document name> – , DOB <DD.MM.YYYY>

• For example: Access – ARF 04.08.2021 – John Smith DOB 25.08.1988.

3.2.1 Attach evidence to inbound documents

  1. In the NDIS Account screen: Select Documents.
  2. Select Add Items and then select Inbound Documents.
  3. In Description: Access – <Document/Report name> .

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Standard Operating Procedure

For Internal Use Only

  1. In Site Location: Select National Access Team.

  2. In Status: Select Completed.

  3. In Category 1: Select NDIA Service.

  4. In Category 2: Select Access Request.

  5. In Re: Business Process: Do not select any option (leave blank).

  6. In Employee Responsible: Enter your details.

  7. In Note: Record the specific document attached, and how and when it was received.

  8. Select Upload File.

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Consider when the decision was made

  1. In the NDIS Account screen: Select Pathway.
  2. Select the relevant application.
  3. Select Access.
  4. Select Determine the Access Decision task.

If internal review request relates to Access Not Met decision

  1. Review Approved By date.

If internal review request relates to Revocation decision

  1. Select > next to Revoke or Cease the Participant Status.
  2. Review Effective Date.

If the decision was made less than 100 days ago

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Standard Operating Procedure

For Internal Use Only

  1. Go to Step 3.5: Create s100 review request.

3.3.4 If more than 100 days since decision

  1. Go to Step 3.4: Offer new application.

3.4 Offer new application

  1. Refer to SOP – Send SMS using Whispir Messenger to send ‘Contact attempt SMS template’ to advise you will be calling.

    Note: Only send this SMS before your first attempt to call the person.

    Do not contact the person by SMS if they told the Agency that they do not consent to this form of communication.

  2. Make 3 telephone contact attempts (a maximum of 2 calls per day at different times of day) to the person or their authorised representative. If you reach voicemail and the person identifies themselves, leave a brief message requesting they contact the NDIA on 1800 800 110.

  3. Use this script to guide your conversation with the person:

    • Explain that you are calling about the request for an internal review of our decision that <Applicant’s> is not eligible for the NDIS.

    • Our records show this decision was finalised on .

    • As it has been more than 3 months since we notified them of the decision, they are unable to request an internal review of this decision. However, they have the option to make a new access request.

    • Provide details of their Local Area Coordinators (LACs) or Early Childhood Partners (ECPs), they may be available in their area to connect the person with supports in their community. They do not need to be an NDIS participant to use this service.

      Follow the steps below to find the person’s closest LAC or ECP:

      • Go to the NDIS Website
      • Hover over Contact and then select Office Locations
      • Enter the applicant’s suburb or postcode
      • Select Search
      • Provide details of the LAC or ECP

3.4.1 If a person requests new application

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Standard Operating Procedure

For Internal Use Only

  1. Complete a Verbal Access Request (VAR) using the instructions in SOP – Complete a Verbal Access Request (VAR).

  2. If new evidence was provided, refer to SOP – Attach evidence – Validate access .request to validate the application and allocate for decision.

3.4.2 If all 3 contact attempts are unsuccessful

  1. Refer to SOP – Send SMS using Whispir Messenger to send ‘Unsuccessful contact attempt’ SMS to advise you tried to call.

    Note: Only send this SMS after you make all required call attempts.

  2. Do not contact the person by SMS if they told the Agency that they do not consent to this form of communication.

End of process – no further steps to be completed.

3.5 Create s100 review request

  1. Go to the NDIS Account screen.

  2. Select Add Items and then select S100 Request.

  3. In Reviewable Decision: Select Access Not Met or Access Revoked.

  4. In Available Decision: Select Access Not Met or Access Revoked.

    Note: The Available Decision field will be empty if the request is lodged more than 100 days after receiving written notice of an Access Not Met/Access Revoked Decision. In this case, the decision is no longer eligible for an internal review.

  5. In Requested By: Select the person requesting the review.

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Standard Operating Procedure

For Internal Use Only

  1. In the Date of Request: Enter the date the internal review was requested.

  2. In Supporting Info: Use the template below to record any further evidence or additional information that supports the request.

s100 Internal Review request submitted on <Date>

Submitted by: <Person> (<Applicant / Authorised Representative>)

Review Type: <Access Not Met / Access Revoked>

Risks: Describe any risks that may be present as outlined in the Practice Guide – Review of Decisions.

Additional Documentation Provided: Choose an item.

  1. In Channel: Select the relevant channel (Phone/Contact Centre, Inbound Correspondence, or In Person).

  2. In Reason for Request: Select Access Not Met or Access Revoked.

  3. In Expected Outcome: Enter ‘Access Met Decision’ or ‘Eligibility to continue’.

  4. In Attachments (if any): Select the Add (+) next to Inbound Documents.

  5. Select the evidence uploaded to Inbound Documents (if applicable).

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Add Interaction: S100 Internal Review Request

  1. In the NDIS Account screen: Select Interactions.
  2. Select Add Items and then select Add Interaction.
  3. In Category 1: Select Pathway.
  4. In Category 2: Select Internal Review.
  5. In Category 3: Select Request review of decision under s100 NDIS Act.
  6. In Channel: Select Internal Notes.
  7. In Status: Select Completed.
  8. In Notes:

s100 form submitted on Click or tap to enter a date.

Submitted by: <Person> (<Applicant / Authorised Representative>)

Review Type: <Access Not Met / Access Revoked>

Refer to s100 Review Request in Open Activities for information.

Record any future updates to the s100 Review Request.

Standard Operating Procedure

For Internal Use Only

  1. Select Submit.

End of process – request will be assigned to the next available Internal Review Officer.

  1. Related procedures or resources
  1. Feedback

If you would like to provide feedback about this guidance material, please complete our Feedback form.

  1. Version control

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Standard Operating Procedure

For Internal Use Only

Version Amended by Brief Description of Change Status Date
1.0 JC0075 Class 3: New SOP which explains how to respond to enquiries about requesting an internal review of an eligibility decision APPROVED 2021-02-10
1.0 SM0075 Class 3: ND GM review and approval. APPROVED 2021-02-11
2.0 CH0026 Class 2: NARB BM approval Class 2: SGPB BM approval SMS instructions to use Whispir Messenger. APPROVED 2022-02-09
3.0 CH0026 Class 2: NARB BM approval Class 2: SGPB BM approval Updates to align with new Our Guideline – Applying to the NDIS. Change from 3 months to 100 days from decision for applicant to request an internal review. New instructions to:
  • save evidence as a PDF document
  • use the following standard PDF naming convention: Access – – , DOB <DD/MM/YYYY>.

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