Understand and choose the right plan change request

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Understand and choose the right plan change request

This article provides guidance for a access delegate, complaints officer, early childhood partner, liaison officers (HLO/JLO), local area coordinator, National Contact Centre, participant support officer, planner (non-partnered area), planner delegate, review officer or technical advisors to understand:

  • why it’s important to complete the Choose the Right Request in an Enquiry case
  • situations that don’t require an internal review or a plan change
  • plan change requests
  • internal review requests
  • how to complete the Choose the Right Request in an Enquiry case.

Before you start

You have:

  • received a request and need to determine the type
  • checked if the request being submitted is with valid consent. Only the applicant, participant, authorised representative or person given express consent can submit a request
  • read and understood relevant sections of Our Guideline – Changing your plan (external) to the request, for example for variations What is a plan variation? and for reassessments What is a plan reassessment?
  • read and understood relevant sections of Our Guideline – Reviewing our decisions (external) to the request, for example What are internal and external reviews?.

Recent updates

22 April 2024

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• Update to include plan change request categories and common situations that don’t require a plan change request or internal review request. • Name change from ‘Review request categories’ to ‘Understand and choose the right plan change request.’

Understand why it’s important to complete a Choose the Right Request in an Enquiry case

You must complete the Choose the Right Request in an Enquiry case for participant requested plan changes and reviews. There are several plan change and review categories, so you need to make sure you choose the right one. This way you create the correct case so there’s no delay in actioning the participant’s request.

The Participant Service Guarantee (PSG) (external) requires us to:

• make a decision about whether or not to change the plan within 21 days of receiving a request. If we don’t make a decision within 21 days, we are taken to have decided not to conduct a reassessment of the plan. This decision will be automatically reviewed. • complete an internal review or review of reviewable decision within 60 days of receiving the request.

You must read the explanations of the questions in the Choose the Right Request Enquiry case in this article. Learn more in sections Situations that don’t require a plan change or internal review of a decision, Plan change requests and Internal review requests.

You need to complete the steps in section Complete the Choose the Right Request Enquiry case in this article.

Situations that don’t require a plan change or internal review of a decision

The participant or authorised representative may request a change to their plan or a review of a decision, but there may be other ways to resolve their request. You need to choose the most appropriate action for the request. Consider if the below options from the Choose the Right Request Enquiry case are more appropriate.

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The participant has received a plan continuation letter and wants their plan reassessed

Participants with plans still in SAP CRM may contact us after they receive a plan continuation letter to ask for a plan reassessment. You don’t need to create new plan change request. You must use the discretionary check-in to determine if the plan meets their needs or they need a plan reassessment. Go to article [Create a check-in case](Create a check-in case).

Note: In Check-In Preparation select Yes to question ‘During this check in, will you be supporting the participant and/or their family to prepare for an upcoming scheduled plan reassessment?’.

If you select reassess the plan in the check-in case, a plan approval case will automatically generate.

Information or evidence provided in preparation for scheduled reassessment or check-in

Information or evidence may need to be considered by a delegate right away or sometimes it’ll be for the next scheduled reassessment or check-in. For example, a participant may want to provide a new assessment from an occupational therapist for their upcoming scheduled reassessment.

Participants or providers can provide information or evidence at any time. When you receive information or evidence make sure you review it carefully and decide on the most appropriate next step.

To learn more about adding documents to a case, go to article [Add documents to a case](Add documents to a case). To link these documents as evidence to a case, go to article [Add and link evidence to a case](Add and link evidence to a case).

Implementation support

Participants may request a change to their plan because they’re experiencing difficulties with implementing their plan.

Check if the participant needs an implementation conversation or plan implementation meeting to help them better understand their supports and how to use their plan. If the participant hasn’t had a plan implementation meeting, you can create this manually. Go to article [Create an implementation case](Create an implementation case). Or you could create a discretionary check-in instead. Go to article [Understand types of check-ins](Understand types of check-ins).

The participant can also contact their My NDIS contact to support them with implementing their plan or to help utilise their budget. This may include linking with community supports or connecting with providers. If the participant needs help to contact the partner supporting them,

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You can create an enquiry case to request implementation support. Go to article [[Create an enquiry case](/foi-library/releases/0f965ec93d25-foi-24-25-0883-disclosure-log-documents/document-014__create-an-enquiry-case/)](https://www.ndis.gov.au/about-us/newsroom/ndis-knowledge-article/create-an-enquiry-or-ncc-knowledge) or NCC knowledge for National Contact Centre staff.

Request for an explanation of a decision

A participant, applicant, or authorised representative may contact us because they don’t understand a decision we’ve made and what it means for them.

A participant or applicant can request an explanation of a decision at any time. It’s important to explain and action these requests for the participant. We have a commitment to Participant Service Guarantee (external) to provide an explanation of a decision within 28 days of the request being made.

You need to create an enquiry case and use the type Review, the category Decision, and the subcategory Explanation of Decision. Go to article Create an enquiry or NCC knowledge for National Contact Centre staff.

The participant wants to change their Statement of Goals and Aspirations (s47)

You don’t need to create a plan change request in PACE for this update. A participant can change their statement of goals and aspirations at any time. It’s not a delegate decision if a participant wants to only change their Statement of Goals and Aspirations, with no other changes to their plan.

For example, the participant indicates they want to engage in sporting activities, this won’t need a change to their disability related supports.

A non-delegate can change the Statement of Goals and Aspirations from the:

  • check-in case. Go to article Create a check-in case.
  • plan implementation case.
  • plan profile update via the case action bar case.

Feedback or complaints

A participant, applicant, or authorised representative may contact us to give feedback about their experience with us but not want a change to their plan. This could be a compliment, a complaint, or general feedback to let us know about something.

To create a feedback or complaint case, go to article Create a feedback and complaints case or NCC knowledge for National Contact Centre staff.

External review

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The participant, applicant or authorised representative can ask for a review of an internal review decision if they don’t agree with it. An internal review can’t be made on the same internal review decision. The Administrative Appeals Tribunal (AAT) will complete the review of the decision. We call this an external review. There must also be an internal review decision made before an external review can be completed.

A participant, applicant or authorised representative needs to request the external review from the AAT within 28 days of the internal review decision.

To learn more about external reviews, go to Our Guideline – Reviewing our decisions.

Plan change requests

The participant or authorised representative may request a plan change. We can also decide to change their plan as part of a CEO initiated variation or reassessment.

When a participant makes a request for a plan change, the delegate will consider the information they’ve given us and make a decision about whether or not to change their plan.

A plan variation or reassessment must be prepared with the participant.

If more information is needed to make the decision, you need to let the participant know what other information they need to provide us and the extra time you have to make your decision. Go to What happens after I request a change to my plan? in Our guideline – Changing your plan.

Plan variation (s47A)

There are some situations where a participant’s current plan can be varied without the need to conduct a plan reassessment. This means we consider a part of their current plan and decide whether to make changes to it. We don’t need to create a new plan for the participant for a plan variation.

For a full list of situations where we might vary a plan, go to section What is a plan variation? in Our Guidelines – Changing your plan.

A plan variation can be requested at any time. When a participant asks for a plan variation it’s c called the ‘participant’s initiative’. When we decide to make a variation, that’s called the ‘CEO’s own initiative’.

A variation request might be for a minor change in funded supports. To learn more, go to section We make a minor variation to your plan which increases your funding in Our Guidelines – Changing your plan.

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Plan reassessment (s48)

A request for plan reassessment can be a participant requested reassessment or a CEO- instituted plan reassessment. This is a request for us to initiate the plan reassessment process outside of the scheduled plan reassessment.

We may decide to reassess the plan where:

  • the participant’s situation has changed significantly, for example a breakdown of informal supports that puts the participant at risk or a change in living arrangements in such as leaving hospital or moving out of home.
  • new information is available about the participant’s disability-related support needs, l ike a new functional capacity assessment.
  • we have varied the participant’s plan several times and the plan isn’t meeting the participant’s needs.
  • the participant’s plan needs to change and the changes don’t meet the s47A legislation requirements.

Note: This list is not exhaustive, for full information about reassessments go to Our Guidelines – Changing your plan (external).

Internal review requests

Internal review (s100)

An internal review can be requested if the participant or applicant doesn’t agree with a decision we’ve made. This is also referred to as review of a reviewable decision (RoRD).

An internal review must be requested by the participant, applicant, or authorised representative within 3 months of receiving the decision in writing. An internal review of a decision checks if we made the right decision under the law by looking at the facts and circumstances at the time of the internal review decision.

The Reviews Branch manages requests for internal reviews. A delegate who was not involved in the original decision will consider the evidence and information related to the decision and check if that decision is right.

To learn more about internal reviews, go to Our Guideline – Reviewing our decisions (external).

SGP Knowledge Article Template

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Legislation tells us what types of decisions can be reviewed. These decisions are known as reviewable decisions. For information about what decisions we can review go to Appendix 1: What decisions can we review? in Our Guideline – Reviewing our decisions (external).

Complete the Choose the Right Request in an Enquiry case

You use the Choose the Right Request Enquiry case to check if a plan change or internal review is needed.

To do this for a participant go to their Person Account and select Cases. For applicants go to Cases. From Cases:

  1. Select New.
  2. Select Enquiry.
  3. In Who is Making the Request? select Requested By and Case Origin.
  4. Select Next.
  5. Select Review for the Enquiry Type.
  6. Select Choose the Right Request for the Category.
  7. Select Next.
  8. Complete the Risk Matrix and select Next.
  9. From Request Questionnaire follow the on-screen prompts to help you choose the right request. It’ll recommend the most appropriate next action for the participant’s request.
  10. Add Enquiry Notes if relevant.
  11. Select Close Enquiry (Completed or Cancelled) if don’t need to progress this enquiry.
  12. Select the closure reason as Completed – Resolved. Select Next.
  13. Review the information you’ve selected and select Submit.

Note: This won’t automatically create a new plan change or internal review case, you need to create the correct case yourself if that’s your next action.

Next steps

  1. If the request you’ve reviewing is a plan change, go to article Prepare to submit a plan change request.

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  1. If the request you’ve received is for an internal review, go to article Create an internal review case (s100).

Article labels – internal use only

PACE user role names

  • Add: dc_users_localareacoordinator
  • Add: dc_users_earlychildhoodpartner
  • Add: dc_users_plannerdelegate
  • Add: dc_users_reviewofficer
  • Add: dc_users_complaintsofficer
  • Add: dc_users_participantsupportofficer
  • Add: dc_users_accessdelegate
  • Add: dc_users_technicaladvisors
  • Add: dc_users_nationalcontactcentre
  • Add: dc_users_liaisonofficershlo/jlo
  • Add: dc_users_plannernonpartneredarea

Topics

  • Add: t_planchanges
  • Add: t_reviewingdecisions

Cases names

  • Add: dc_case_planchange
  • Add: dc_case_internalreview

Ownership

  • Add: own_sgplanchangesandconnections

Version control

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Version Amended by Brief Description of Change Status Date
1.1 SDO030 Article aligned to SOP Create or update a knowledge article during CI
Transferred from confluence to updated template
DRAFT 2023-05-30
1.2 JLL673 Article aligned to SOP Create or Update a Knowledge Article during CI DRAFT 2023-06-05
1.3 DCM308 Peer review DRAFT 2023-06-06
1.4 JLL673 Peer review actioned DRAFT 2023-06-06
CLEAN for VT
1.5 JLL673 Transferred relevant VT feedback
Action VT feedback
DRAFT 2023-06-07
THG520
Number of long sentences: 9 (11.54%)
Number of Passive Sentences: 9 (11.54%)
Readability: 49
Grade Level: 8.1
Draft sent to Internal review team who will be taking carriage of this knowledge article
1.6 LW0022 IR review and updates made DRAFT 2023-10-11
1.7 MJB576 Discussed with IRT. Action feedback and make changes. This KA will be for wider Agency use and focus on determining the correct request category.
Add sections for s47A and s48.
Rename to Understand review and plan change request categories
DRAFT 2023-10-12
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Version Amended by Brief Description of Change Status Date
1.8 MJB576 Continue changes based on meeting with NARB and IRT feedback.
Add sections for other reasons a participant needs help
Delete IRT’s addition re CRRT.
Sent for peer review DRAFT 2023-10-23
1.9 BCK161 MJB576 Peer review
Action peer review feedback DRAFT 2023-10-31
2023-10-31
1.10 BCK161 Actioned remaining peer review comments.
Restructured to put ‘Situations that don’t require a plan change or review’ at the end after the different types of requests. DRAFT 2023-11-01
1.11 AMK633 Peer review DRAFT 2023-11-03
1.12 BCK161 Action peer review
VT results
Number of long sentences: 25 (12.56%)
Number of Passive Sentences: 18 (9.05%)
Readability: 59
Grade Level: 7 DRAFT 2023-11-03
1.13 EJW711 EL1 review DRAFT 2023-11-07
1.14 BCK161 Action EL1 review DRAFT 2023-11-08

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Version Amended by Brief Description of Change Status Date
1.15 EJW711 EL1 review
BCK161 Actioned minor comments in this version.
DRAFT 2023-11-09
1.16 JS0082 EL2 review
BCK161 actioned comment re PSG in Understand why it’s important to use the Choose the Right Request Tool section.
DRAFT 2023-11-14
1.17 BCK161 Transfer and action BiL feedback DRAFT 2023-11-27
1.18 EJW711 EL1 review
BCK161 added version control as missing
DRAFT 2023-12-12
1.19 JS0082 EL2 review DRAFT 2023-12-13
1.20 BCK161 Action EL2 review DRAFT 2023-12-14
1.21 GBD, BCK161, CW0032 Transfer and action BiL Feedback
2024-01-30 actioned additional BiL comments re language consistency.
BM review
DRAFT 2023-12-20
1.22 DCM308, BCK161 Action BM feedback
Added new heading 3 section under Situations that don’t require a plan change or internal review of a decision based on service desk feedback received from Service Delivery BiL.
Transfer CI and action feedback about creating internal reviews.
DRAFT 2024-02-06
1.23 EJW711 EL1 review DRAFT 2024-02-09

SGP Knowledge Article Template

For Internal Use Only

Version Amended by Brief Description of Change Status Date
1.24 BCK161 Action EL1 review
Minor edits based on draft Plan Change Process Review 2024-02-20.
DRAFT 2024-02-14
1.25 JS0082 EL2 review with comments DRAFT 2024-02-22
1.26 BCK161 Action EL2 review DRAFT 2024-02-23
1.27 BCK161 Transfer SME and BiL feedback DRAFT 2024-02-26
1.28 DCM308 Action SME and BiL feedback DRAFT 2024-02-28
1.29 DD0014 EL1 review DRAFT 2024-02-28
1.30 BCK161 Action EL1 review DRAFT 2024-02-29
1.31 BCK161 Action EL1 plan change summary: sequence and updates (March 2024) DRAFT 2024-03-07
1.32 SGH107 Peer review DRAFT 2024-03-08
1.33 BCK161 Action peer review
VT results
Number of long sentences: 44 (10.45%)
Number of Passive Sentences: 31 (7.36%)
Readability: 57
Grade Level: 6.9
DRAFT 2024-03-12
1.34 EJW711 EL1 review DRAFT 2024-03-19

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Version Amended by Brief Description of Change Status Date
1.35 BCK161 Transfer EL1 comments from version not saved to SharePoint. Action EL1 review.
Name change to Understand and complete the Choose the Right Request Enquiry case. Added steps to Complete the Choose the Right Request Enquiry case and Next steps.
Removed sections Plan change categories in PACE and Internal review categories in PACE to merge content into relevant process articles on creating requests. DRAFT 2024-03-19
1.36 JS0082 EL2 review DRAFT 2024-03-25
1.37 DCM308 Action EL1 feedback
Cleaned and sent for BiL review DRAFT 2024-03-25
1.38 CW0032 BM review DRAFT 2024-04-01
1.39 DCM308 Action BM feedback
Cleaned and sent for BiL review DRAFT 2024-04-03
1.40 SGH107 Transfer SME & BIL feedback DRAFT 2024-04-12
1.41 SGH107 Action SME & BIL feedback
DCM308 DRAFT 2024-04-16
1.42 DCM308 Actioned SME feedback
EMN960 Article renamed to Understand and choose the right plan change request based on BiL feedback DRAFT 2024-04-16

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Version Amended by Brief Description of Change Status Date
1.43 EMN960 DCM308 EL2 review Sent for BM approval DRAFT 2024-04-17
2.0 JC0088 Class 3 Approval DRAFT 2024-04-18

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