Eligibility reassessments

Eligibility reassessments

This factsheet explains:

• what an eligibility reassessment is • why we do eligibility reassessments • what the eligibility requirements are • how we do an eligibility reassessment • what happens if we decide you’re no longer eligible for the NDIS • what to do if you disagree with our decision.

What an eligibility Why we do eligibility reassessment is reassessments An eligibility reassessment is a check to It’s important that we make sure people make sure you’re still eligible to be an who receive supports under the NDIS are NDIS participant and receive funding for eligible participants. NDIS supports. If you met the disability requirements We may check your eligibility if we have when you became an NDIS participant, evidence that suggests you may no longer you’ll likely need NDIS supports for your be eligible. This could be evidence you no lifetime. If your disability, support needs longer meet one or more of the residence, or situation changes, we may need to disability or early intervention requirements. check your NDIS supports or eligibility. We’ll contact you if this happens.

If you met the early intervention requirements when you became an NDIS participant, your NDIS support needs are likely to reduce over time.

Early intervention supports are intended to How we do an eligibility increase your capacity and independence. reassessmentWe’ll check if you’re still eligible for the NDIS after you’ve been receiving early We’ll contact you by your preferred contact intervention supports for a period of method to let you know about the eligibility time. This is a normal part of your plan reassessment. We’ll explain: reassessment. • the eligibility requirements and why All children with developmental delay, we’re doing an eligibility reassessment who are eligible for the NDIS under the • what you need to do, including how youearly intervention requirements will have can provide information and evidencean eligibility reassessment after they turn 6. This is because not all children • what we’ll do with developmental delay go on to • what happens when we make an have a permanent impairment. To be eligibility decision. eligible once a child turns 6, we’ll need We’ll also send you a letter to explain:evidence they have an impairment that’s likely to be permanent and they meet • the eligibility requirements we think you the requirements for disability, early don’t meet intervention, or both. Some children will • what information you might want tohave a diagnosis of an impairment that’s give uslikely to be permanent and they may continue to be eligible for the NDIS. • the date we should receive your information by. What the eligibility If your current plan is about to end while we’re doing the eligibility reassessment,requirements are? we’ll work with you to put a new plan in When we do an eligibility reassessment, place. This means you can continue to we check if you: use your NDIS supports while we do the eligibility reassessment. You’ll get separate • live in Australia letters to explain our decisions for the plan • are an Australian citizen or permanent approval and eligibility reassessment. resident Until we complete the eligibility • meet the disability requirements or reassessment, nothing changes for you. early intervention requirements or both You’ll stay a participant and can still use Learn more about the NDIS eligibility the NDIS supports in your plan. requirements in Our Guideline – Applying to the NDIS.

Factsheet – Eligibility reassessments For more information visit ndis.gov.au

How much time you will have How we make our decision We must receive any information you We’ll look at all relevant information we would like us to consider within 90 days have, including any additional information from the date of the letter telling you we you provide, against the eligibility are reassessing your eligibility. requirements. We’ll use this to decide if you’re still eligible for the NDIS. Let us know if you need more time to provide this information. We’ll need to Once your eligibility has been reassessed, know why you need more time, and how we’ll tell you if you’ll: much extra time you need. We may be • Stay in the NDIS because you continueable to give you more time if your request to meet the eligibility requirements. is reasonable. For example, there could be This means you’ll remain an NDIS a delay in getting information from your participant. treating professional. orIf you don’t respond within 90 days, we’ll make the decision based on the • Leave the NDIS because you no longer information we have. meet the eligibility requirements. This means you’ll no longer be an NDIS Evidence we may request participant and your plan will end. Sometimes if we don’t have enough evidence to make a decision, we may 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. We’ll only ask you to provide this specific information or report if we can’t reasonably get it in a different way.

Factsheet – Eligibility reassessments For more information visit ndis.gov.au

We’ll support you to leave the NDIS byWhat happens if we decide you’re no longer eligible for helping you connect with these supports if you need it. Learn more about mainstream the NDIS and community services and leaving the NDIS. We can also help you sort out your If you no longer meet the eligibility final payment requests. requirements, you’ll no longer receive NDIS supports. What to do if you disagreeWe’ll contact you by your preferred contact method to explain our decision. We’ll also with our decision send you a letter telling you: If you don’t agree with our decision that • our decision you no longer meet the NDIS eligibility requirements you should talk to us. Your• the reasons for our decision my NDIS contact can: • the date your participant status will • help explain our decision be revoked. This date will generally be 28 days from the date the eligibility • answer any questions reassessment decision was made. • help you understand your options and During your time as an NDIS participant, next steps. in addition to receiving NDIS supports, You have 3 months from the date you were you may have been supported to connect notified of the decision that you no longer with other government and community meet the NDIS eligibility requirements to services. Your access to supports outside of ask for an internal review of our decision. the NDIS won’t be affected by our eligibility Learn more about internal and external reassessment decision. reviews.

Factsheet – Eligibility reassessments For more information visit ndis.gov.au

National Disability Insurance Agency For people who need help with English

Website: ndis.gov.au TIS: 131 450

Telephone: 1800 800 110 For people who are deaf or hard of hearing Webchat: ndis.gov.au TTY: 1800 555 677 Follow us on our social channels Voice relay: 1800 555 727

National Relay Service: accesshub.gov.au

DA0887 FACTSHEET – ELIGIBILITY REASSESSMENTS – APRIL 2025