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Escalating a request for an internal review (s100)

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Escalating a request for an internal review (s100)

FOIOFFICIAL23/24-1198 DOCUMENT 9

Knowledge Article

For Internal Use Only The contents of this document are OFFICIAL.

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for all NDIA staff and partners to:

  • identify situations where an internal review needs to be escalated
  • use the escalation and prioritisation matrix to confirm the level of risk
  • escalate an existing request for internal review (s100).

Recent updates

06 May 2024

Minor update to reflect the renaming of the Review Branch.

Before you start

You have read and understood:

  • Our Guideline - Reviewing our decisions (external) to inform your decision to escalate a request for internal review (s100)
  • Our Guideline - Applying to the NDIS - When do we make priority eligibility decisions? (external).

How to escalate a request for internal review (s100)

Identify situations where an internal review needs to be escalated

In some situations, you may need to escalate a request for an internal review. This includes cases where there is evidence of:

  • risk of harm to the health or wellbeing of the applicant or participant
  • risk to stability in the accommodation arrangements of the participant, including the risk of homelessness.

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  • risk to stability in the care arrangements of the participant, including the risk of a primary carer not being able to provide care
  • risk associated with the nature of the applicant or participant’s disability, including the risk of rapid deterioration or progression
  • the participant being in hospital and is awaiting discharge
  • the participant having an active request for Assistive Technology, Home Modifications or Supported Independent Living.

Use the Escalation and Prioritisation Matrix to confirm the level of risk

Go to article [Review the escalation and prioritisation matrix](https://www.ndis.gov.au/about-the-ndis/quality-and-reviews/review-process/escalation-and-prioritisation-matrix) to identify the level of risk associated with the review request.

Select the option that most closely matches the applicant or participant’s situation to identify the risk level. Select the highest risk level identified if there are multiple risks.

The Review Branch will prioritise escalations identified as high or extreme risk.

Escalate an existing request for internal review (s100)

Note: This process is for escalating an existing internal review request in PACE. New internal review requests are escalated during creation. Go to article [Create an internal review (S100) case](https://www.ndis.gov.au/about-the-ndis/quality-and-reviews/review-process/create-an-internal-review-case) if you are escalating a new internal review request.

You must escalate review requests that meet medium or high risk criteria.

To escalate a request for internal review:

  1. You must email INTERNAL.REVIEWS.PLANNING@ndis.gov.au for planning decisions or internal.access.reviews@ndis.gov.au for access decisions.

  2. Use the subject line: Internal Review Escalation: Updated Risk Level .

  3. Include the reason for the escalation, including the risk level.

  4. You must record the contact with the Review Branch in the Log Activity from the Activity Panel. Use the activity type Internal Note when contacting or leaving internal details for the Review Team. For the steps to complete this, go to article Log an activity or internal note.

Note: Due to system limitations, this off-line process must be used to escalate existing internal review requests.

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Next steps

The escalation request will be triaged and actioned by the Review Branch.

Article labels – internal use only

PACE user role names

Delete:

dc_users_reviewofficer

Topics

N/A maintain current topics.

Case names

N/A maintain current case names.

Ownership

N/A maintain current ownership.

Version control

Version Amended by Brief Description of Change Status Date
6.0 JS0082 Class 1 Approval APPROVED 2024-04-29

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