FOI 24/25-1912 DOCUMENT 11

Discuss a participant plan change request

SGP KP Publishing

Exported on 2025-09-16 03:36:54

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FOI 24/25-1912 SGP KP Publishing – Discuss a participant plan change request

1 Recent updates …………………………………………………………………………………………………….. 4

2 Before you start ………………………………………………………………………………………………….. 5

3 Check supporting information to submit a plan change …………………………………………. 6

3.1 Check authority to request a plan change request ……………………………………………………. 6

3.2 Discuss the plan change request ……………………………………………………………………… 6

3.3 No evidence is available to support the request ………………………………………………………. 7

3.4 No further information or evidence will be provided …………………………………………. 8

4 Discuss a plan change decision …………………………………………………………………………….. 9

4.1 Contact the participant or their authorised representative …………………………………………. 9

4.2 Complete security check ………………………………………………………………………………………. 9

4.3 Discuss the identified issues …………………………………………………………………………………. 9

4.4 Loss of informal support or change beyond participants control ……………………………….. 11

4.5 Insufficient evidence of change in situation ……………………………………………………………. 11

4.6 Explain a decision ………………………………………………………………………………………………. 12

4.7 Explain impact on plan funding ……………………………………………………………………………. 12

4.8 Explain review rights …………………………………………………………………………………………… 13

4.9 Discuss next steps ……………………………………………………………………………………………… 13

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FOI 24/25-1912 SGP KP Publishing – Discuss a participant plan change request

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

check supporting information to submit a plan change request
discuss a plan change decision (for planner delegates only).

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1 Recent updates

4 November 2024

Guidance updated to change Administrative Appeals Tribunal (AAT) to Administrative Review Tribunal (ART). The ART replaced the AAT on Monday 14 October 2024.

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2 Before you start

You have:

received a plan change request from a participant or their authorised representative
read and understood Our Guideline – Changing your plan (external)
read and understood Our Guideline – Your privacy and information (external).

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3 Check supporting information to submit a plan change

Only use the scripting in the below section when you’ve received a plan change request from a participant or their authorised representative.

If you’re a planner delegate contacting the participant or their authorised representative about their plan change request or decision, go to section Discuss a plan change decision in this article.

3.1 Check authority to request a plan change request

Use the below script to check authority of the person requesting the plan change request:

Thanks for reaching out about requesting a change to (your or participants first name) plan. Before we go into more detail, I’ll need to ask you a few questions to verify your identity.

If the person has authority to request a plan change request, go to section Discuss the plan change request in this article.

If the person doesn’t have authority or consent to request a plan change request, you can’t proceed with the request.

To learn more on how to complete a security check, go to section Check authority to request a plan change in article Prepare to submit a plan change request.

3.2 Discuss the plan change request

Use the below script to discuss and understand the participant’s plan change request:

To make sure this process is as simple as possible for you, can you please briefly describe the reason for your request? Thanks for providing that information. What you have explained is (Choose the relevant option):

you’ve experienced a change in circumstances or

there’s a change in your situation that’s impacting your support needs or

you have, or are close to exhausting your plan funds or

you’d like to change the way your funds are managed or

you urgently need to change your supports or

you need additional funding for assistive technology or home modifications.

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Is that correct?

An NDIA delegate will make a decision on your request, using any information and evidence you have provided to us.

Can you please let me know if you have any further information or evidence like:

reports from allied health professionals

any other information you want to tell us to support your plan change request.

Note: Generally we don’t require evidence to make a change to how funds are managed.

If the participant or their authorised representative doesn’t have evidence, including information, for a plan change request, go to section No evidence is available to support the request in this article.

If the participant or their authorised representative have evidence, continue the plan change request by going to section Check supporting information for a plan change request in article Prepare to submit a plan change request.

To learn more about the type of evidence required for each support, go to Fact sheet – What evidence do you need to give us before we create or change your plan? (DOCX 342KB).

3.3 No evidence is available to support the request

Use the below script when no evidence or supporting information has been provided at the time of requesting the plan change request:

For NDIA staff only: Thank you for letting me know you don’t have any further information available right now. For an NDIA delegate to make a decision about your request it’s helpful to provide evidence. As outlined on the NDIS website, if you’re still gathering evidence, it’s best to wait until you have it before making the request for a plan change. Once you gather the information, you can lodge a request for a plan change.

For Partner staff only: Thank you for letting me know you don’t have any further information available right now. For a NDIA delegate to make a decision about your request it’s helpful to provide evidence. As outlined on the NDIS website, we recommend that you wait until you have this evidence before we submit the request for you. Otherwise, when the NDIA delegate considers your request, they may need to request evidence at that time. This may delay your plan change decision.

Note: You can’t refuse to submit a plan change request if no evidence is being provided.

Use the below script if the participant or their authorised representative would still like to submit the plan change request and provide the evidence or supporting information at a later date:

I understand that you’d like to submit a request to change your plan and will provide further information or evidence at a later date.

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We’ll need this information within 21 days in order to proceed with the plan change. Are you able to provide the information by (insert date). It’s important you give us this information by this date so we can make a decision on your request. Otherwise, the delegate will need to make a decision on the information available to them. This may mean that your request for a change to your plan may not be approved. We’ll tell you the outcome of this decision both verbally and in writing. If you do have any additional information, please email it to enquiries@ndis.gov.au or upload it to the NDIS portal.

If the participant or their authorised representative will provide evidence or information at a later date, you must record this discussion in the activity log. To learn more, go to article Log an activity or internal note.

If the participant or their authorised representative isn’t going to provide any evidence or information to support the plan change request, go to section No further information or evidence will be provided in this article.

3.4 No further information or evidence will be provided

Use the below script if no further evidence or information will be provided to support the plan change request:

Thank you for confirming you want to request a change to your plan. An NDIA delegate will now need to make a decision based on the information we have. We’ll tell you the outcome of this decision both verbally and in writing, including any review rights that relate to this decision. Thank you for your time today.

To learn more on how to submit a plan change request, go to article Prepare to submit a plan change request.

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4 Discuss a plan change decision

Note: All scripting in the section below is to be used by planner delegates only.

There’ll be situations where the participant or their authorised representative won’t be able to provide the required evidence to reassess their plan. When this happens, or when there’s a risk involved, you’ll need to take it into consideration and determine whether to reassess the participant’s plan.

It’s important to check that you’ve reviewed all available information on the participant’s record before contacting the participant or their authorised representative about no evidence being provided to support a plan change request.

Only use the scripting in the below section if you’re a planner delegate and are contacting a participant or their authorised representative who has requested a plan change request without providing any evidence.

4.1 Contact the participant or their authorised representative

Use the below script if you’re a planner delegate and are contacting the participant or their authorised representative to discuss their plan change request:

(Good morning or Good afternoon) my name is (first name only), I’m calling from the National Disability Insurance Agency. I am the delegate who is making a decision on your plan change request that we received on (insert date). Is now a convenient time for us to talk?

If the participant or their authorised representative can’t continue with the conversation, record your contact attempt in the Log Activity tab in the plan change case and discuss a suitable time for you to contact.

If the participant or their authorised representative can continue with the conversation, go to section Complete security check in this article.

4.2 Complete security check

Use the below script before completing a security check:

Great, before we go into more detail, can I please ask you some questions to confirm I’m speaking with the right person?

Once you’ve completed a security check and verified the participant or their authorised representatives identify, go to section Discuss the identified issue in this article.

4.3 Discuss the identified issues

Use the below script to discuss the evidence we need to understand a participant’s change in circumstances:

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Thank you for submitting a request to change your NDIS plan. The reason I’m calling is to talk about your plan change request. I want to make sure I understand your current situation. Is it ok if I ask you some questions to help me decide whether I will make a change to your NDIS plan? I can see from your plan change request that you’re seeking (insert reason for plan change request). Is there anything else you’d like to tell me about why you need to change your plan? Is there any change to who is providing your supports?

Note: Ask any further clarifying questions you may need to help you make your decision as a delegate.

I understand the reason for wanting a plan change is (insert reason). Thank you for sharing that information with me. What you’ve explained to me is (choose the relevant option):

your situation has changed or

you require a plan variation or

you require approval to purchase a high-cost Assistive Technology or

you’ve exhausted your plan funding or will very soon exhaust your funding.

Use the below script if the request is to only seek approval to purchase high-cost Assistive Technology:

Could you please provide evidence, reports and quotes so that I can progress your request?

Use the below script if the request isn’t related to seeking approval to purchase Assistive Technology:

Can you please share more details with me about how your situation has changed, and how this has impacted your NDIS plan?

What is it about your situation that have changed since your NDIS plan was approved?

What is it about your support needs that have changed since your NDIS plan was approved?

To learn more about the type of evidence required for each support, go to Fact sheet – What evidence do you need to give us before we create or change your plan? (DOCX 342KB)

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4.4 Loss of informal support or change beyond participants control

Use the below script:

Can you please tell me if you can provide any (choose the best option):

reports from treating health professionals confirming the change to informal supports or

information about how this change to your informal supports has impacted you?

Use the below script if the participant or their authorised representative doesn’t have written confirmation of the change to their informal support arrangement:

Can you please tell me how this change or loss of informal support has impacted you?

what support is no longer able to be met by your informal supports?

who is available to provide this support for you now?

is there funding you can continue to use in your plan for this change to your support needs? There are some tools on the NDIS website such as the Budget calculator (external) that I can link you to.

can community and mainstream support meet your needs?

Note: If the participant or their authorised representative is unsure, discuss the options available to them in relation to their individual situation.

4.5 Insufficient evidence of change in situation

You’ll need to make a delegate decision if there isn’t information provided which meets the criteria to vary or reassess a participant’s plan. Use the below script if there’s insufficient evidence for a change in circumstances, and insufficient evidence of an immediate risk of harm to the participant:

Thank you for taking the time to talk with me today. From the information you have provided to me, I, as the NDIS delegate, have made the decision not to (vary or reassess) your plan at this time.

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If the participant or their authorised representative is unhappy with your decision, you can guide them to section When would we decide not to change your plan? in Our Guideline – Changing your plan (external) to learn more.

4.6 Explain a decision

Use the below script to explain the reasoning behind your decision:

We have guidelines about changing a plan in Our Guideline – Changing your plan (external), that we follow when making a decision on your request. I have decided not to (vary or reassess) your plan as (choose the relevant option):

there isn’t any new information or evidence about your request or

you have a new diagnosis but no change to your functional capacity or

your request is about wanting more supports that other participants have, but we don’t have any evidence to support a change in your situation or

your informal, community or mainstream supports can help you meet your support needs or

your plan is suspended or has ceased.

4.7 Explain impact on plan funding

Use the below script when funding is exhausted or soon to be exhausted:

I understand that you don’t have much funding left in your plan. When we approve a plan, we provide funding for the length of that plan. This means you won’t be able to access any more funding until your next scheduled plan reassessment date.

Use the below script when there’s funding available but a change to the existing model of support is needed:

I can see that if you continue to use your funding at the current rate, your funding is likely to be exhausted before your scheduled reassessment date. We have some tools on our website to help participants manage their budgets. You can use:

the Plan implementation directory (external) located under the For participants drop-down on the NDIS website or

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the Budget calculator (external) located under the For participants drop-down, in the Plan implementation directory page on the NDIS website.

These tools can show how much support can be purchased with the funding in your plan. Your (Early Childhood Partner or Local Area Coordinator or Support Coordinator or Plan Manager) may be able to support you to understand how to manage your remaining funding until your scheduled reassessment. I need to let you know that any supports that you use beyond the funding in your plan will remain your responsibility. Providers can’t be paid by the NDIA for supports when there are no funds left in your plan.

4.8 Explain review rights

Use the below script to explain a participant’s review rights for a plan change decision made within 21 days:

This decision is a reviewable decision. That means that if you don’t agree with the decision I’ve made, which is to not (vary or reassess) the plan at this time, you have the right to request an internal review of my decision. You’ll also receive a letter which explains how you can request a review of this decision, and you can also find information on this on the NDIS website. Your (Local Area Coordinator or Support Coordinator or Early Childhood Partner) may be able to help you in this process if you wish to explore it further.

Use the below script to explain a participant’s review right for a plan change decision made over 21 days:

Once we’ve received your plan change request, we have 21 days to make a decision on your request. If we can’t make a decision within 21 days, your request automatically gets declined. When this happens, we automatically review your request. I’ve now completed an internal review on your request and can confirm that the original decision to not (vary or reassess) your plan is correct. This decision is a reviewable decision. That means that if you don’t agree with the decision I’ve made, which is not to (vary or reassess) your plan at this time, you have the right to request an external review of my decision. You have 28 days from the date I’ve made this decision to ask the Administrative Review Tribunal (ART) for an external review of this decision. You’ll also receive a letter which explains my decision and how you can request an external review if you don’t agree with the decision I have made.

4.9 Discuss next steps

If you’ve decided not to (vary or reassess) the plan, it’s important a discretionary check-in is booked to reduce risks and add safeguards. This will allow you to review the participant’s situation and check if there’s any change in the participant’s risk profile and whether any further action is needed. To learn more, go to article Book change or cancel a check-in.

Use the below script if you’ve booked a check-in with the participant or their authorised representative:

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We’ll contact you in (2 weeks or 1 month or suitable timeframe) to check in with you.

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