FOI 24/25-1912 DOCUMENT 13

Progress a plan change (s47A and s48) request over 21 days

SGP KP Publishing

Exported on 2025-09-16 03:46:41

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FOI 24/25-1912 SGP KP Publishing – Progress a plan change (s47A and s48) request over 21 days

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

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

3 Understand what happens when a plan change request hasn’t met the PSG timeframe of 21 days ……………………………………………………………………………………………………. 6

4 Contact the participant about their request ……………………………………………………………. 7

5 Update plan change request status ……………………………………………………………………….. 8
5.1 Complete the plan change case …………………………………………………………………………….. 8
5.2 Cancel the plan change case ………………………………………………………………………………… 8

6 Create an internal review case …………………………………………………………………………….. 10

7 Create an internal review request ………………………………………………………………………… 11
7.1 Complete the Decisions ………………………………………………………………………………………. 11
7.2 Complete the Add Request Details ………………………………………………………………………. 12
7.3 Complete the Documents ……………………………………………………………………………………. 12
7.4 Complete the Risk Matrix ……………………………………………………………………………………. 12
7.5 Complete the Request Summary …………………………………………………………………………. 12
7.6 Complete the Submit Internal Review Request………………………………………………………. 12

8 Make a decision on an internal review case ……………………………………………………….. 14
8.1 Complete the Decision pop-up …………………………………………………………………………….. 14
8.2 Submit the internal review decision ………………………………………………………………………. 14
8.2.1 Confirm the decision …………………………………………………………………………………………………..–
8.2.2 Set aside the decision …………………………………………………………………………………………………..–

Table of Contents – 2
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This article provides guidance for a planner delegate and national reassessment delegate to:

understand what happens when a plan change request hasn’t met the PSG timeframe of 21 days
contact the participant about their request
update the plan change request status
create an internal review case
make a decision on the internal review case.

Recent updates – 3
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1 Recent updates

17 March 2025
Added new sections on how to complete and how to cancel the plan change case request.

Recent updates – 4
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2 Before you start

You have:

been assigned a participant-initiated plan change request where the PSG timeframe to make a decision in 21 days has not been met
the right delegations and validations to submit and approve internal review decisions in PACE. For this you’ll need Validation Delegation Review of Decisions and Validation Internal Review Decision Preparation skills. If needed, use the PACE User Management case to request the skills be added. Go to intranet page PACE User Management – Troubleshooting guide (external).
read and understood relevant sections of Our Guideline – Changing your plan (external) - for example, for variations What is a plan variation? and for reassessments, What is plan reassessment?
read and understood relevant sections of Our Guideline – Reviewing our decisions (external) - for example, What are internal and external reviews?
reviewed the plan change request. For Participant plan change request types, determine if s47A or s48 is most appropriate for the request.

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3 Understand what happens when a plan change request hasn’t met the PSG timeframe of 21 days

The Participant Service Guarantee (PSG) needs us to make a plan change decision within 21 days of receiving the request. When we don’t meet this timeframe, we are taken to have decided not to reassess or vary the plan. This creates an automatic internal review. Go to section What happens after I request a change to my plan? in Our Guideline - Changing your plan (external).

You need to:

attempt to contact the participant or authorised representative about their request if you need more information
complete or cancel the plan change request
create an internal review case
make a decision on the internal review case to action the outcome for the participant. This includes sending a manual letter with the outcome of your decision.

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4 Contact the participant about their request

To action the plan change request, you may need to contact the participant or their authorised representative to clarify their request or gather additional details.

You must use the relevant scripting in article Discuss a participant plan change request when contacting the participant or their authorised representative.

When you contact the participant or authorised representative, think about their preferred contact method. Go to article Check a person’s preferred contact method. If the participant’s preferred correspondence method is email or letter, you should still attempt to call them to clarify the request.

Note: The exception is if the person has requested no phone calls and to contact them via the National Relay Service, or if they haven’t provided a phone number.

When you contact the participant or their representative, you should:

go to article Send an SMS in PACE to understand SMS options in PACE.
make 3 contact attempts (a maximum of 2 per day, at different times of the day) to the participant or their authorised representative
leave a brief message requesting they contact the NDIA on 1800 800 110, if you reach voicemail and the person identifies themselves.
record each contact attempt on the plan change case. Go to article Log an activity or internal note.

You should also contact the participant to tell them the outcome of your decision. Go to section Confirm the decision or Set aside the decision in this article.

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5 Update plan change request status

Note: The chevron must be In Progress to complete the following process. You can’t move the chevron manually.

You’ll need to make sure there’s a plan change request submitted. You can check this in the Plan Change case. Select the Decision tab and review the Plan Change Requests table.
The case will be assigned to a plan change routing queue, you’ll need to reassign the case to yourself. In the top right-hand corner of the case, select the Change Case Owner.
At Please select if the case owner is a user or a queue, select User.
At Select User, enter your name in to the field.
Select Change Owner to assign the case to yourself. The case stage will move to In Progress.

5.1 Complete the plan change case

This option is only for Participant requested – s48 initiated requests with the milestone ‘Decide on Participant Requested Plan Reassessment’. For all other plan change requests, you’ll need to cancel the plan change case. Go to section Cancel the plan change request.

In the top right-hand corner of the case, select Complete Case.
Select Next.
At Closure Reason drop-down list, select Lapsed plan change request.
At Closure Comments copy the below comment and paste in the free-text field:

Case completed without making a decision as the request is over 21 days and will progress to an internal review.

Note: you’ll need to remember the Plan Change case number as you need this when creating the Internal Review case.
Select Confirm.
You’ll see a note confirming the case has been completed successfully. Select Done.
The chevron will show as Closed. The plan change case is now closed.

5.2 Cancel the plan change case

Use this option for plan change requests with the milestone ‘Make Plan Change Decision 21 days SLA’.

Note: For Participant requested – s48 initiated requests, you’ll need to complete the plan change case. Go to section Complete the plan change case.

In the top right-hand corner of the case, select Cancel Case.
Select Next.

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At Cancel Reason drop-down list, select Outstanding planning activities in SAP CRM.
At Closure Comments copy the below comment and paste in the free-text field:

Case cancelled without making a decision as the request is over 21 days and will progress to an internal review.

Note: you’ll need to remember the Plan Change case number as you need this when creating the Internal Review case.
Select Confirm.
You’ll see a note confirming the case has been cancelled successfully. Select Done.
The chevron will show as Cancelled. The plan change case is now closed.

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6 Create an internal review case

You need to create an internal review case to make your decision.

From the Person Account:

Select Cases tab.
Select New.
Select Internal Review.
Select Next.
Check Internal is selected for Case Origin.
Select Save. The internal review will now show as Draft.

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7 Create an internal review request

From the Internal Review case, select Request tab.

Select Date review request received. Record the date as 21 days after the plan change request was received.
If you’re backdating the request, record a reason for this in the Provide a reason why the request is being backdated and reference evidence free text field. For example, ‘An automatic internal review has been created as plan change request decision was not made in the PSG timeframe of 21 days’.
Select the relevant Who is requesting review? option. Record this as the person who initially submitted the plan change request.
Select Next.

7.1 Complete the Decisions

Select Decision from SAP CRM.

Note: The decision won’t be available from Decision Log as the plan change request has been automatically declined.
Select Planning from the Type drop-down list.
Select New.
On the Reviewable SAP CRM decisions pop-up screen, select the Decision Name from the drop-down list. This will be Lapsed S47 or Lapsed S48.
Add Original Decision Date, record this as 21 days after the plan change request was received.
Record the Decision Reference as the plan change case number.
Select the checkbox Unable to find original decision maker user ID.
Record your user ID in the Decision user code field. This is because you’re the person who received the plan change request where the decision was not made within the PSG timeframe of 21 days.
- If the request is made within 100 days, go to step 11
- If the request is made outside of 100 days, go to step 9.
Select Other extenuating circumstances from the Reason for selecting decision over 100 days drop-down list.
Record a reason in the Provide details of why you are submitting this request outside of 100 days free text field. For example, ‘An automatic internal review has been created as plan change request decision was not made in the PSG timeframe of 21 days’.
Select Save.
Select Next.

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7.2 Complete the Add Request Details

Record the reason in the Capture Reasons for Review Request free text:
- for a variation: ‘An automatic internal review has been created as plan change request decision was not made in the PSG timeframe of 21 days. The delegate is taken to have decided not to vary the plan’.
- for a reassessment: ‘An automatic internal review has been created as plan change request decision was not made in the PSG timeframe of 21 days. The delegate is taken to have decided not to reassess the plan’.
Select Save.
Select Next.

7.3 Complete the Documents

Link any documents provided in the plan change request, if needed. Select Link Documents to link documents from the plan change case to the internal review case. Learn more on adding or linking documents in article Add documents to a case.
Add any new documents provided by the participant or their authorised representative, if needed. Select Add Documents to upload new documents.
Select Next.

7.4 Complete the Risk Matrix

Under Has there been any risk identified that may impact the participant, nominee or NDIS associated with this request?, select Yes or No.
If Yes, you need to select Yes or No to each risk question.
For each risk identified, select the relevant risk level: LOW, MEDIUM, HIGH or EXTREME.
Select Next.

7.5 Complete the Request Summary

Review information recorded.
If any information needs to be corrected or added, select the relevant step to return and update.
Once everything is correct, select Next.

7.6 Complete the Submit Internal Review Request

Record your call notes for conversations with the participant or authorised representative in the Call Notes free text field, if applicable.
Select Submit.
The internal review case stage will change to New. New internal review cases are automatically assigned to the Internal Review Routing Queue and you’ll need to update the case owner to yourself.

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From Change Case Owner (in the top right corner) in Please select if the case owner is a user or a queue select User.
In Select User search and select yourself.
Select Change Owner and Finish.
The chevron will now move to In Progress.

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8 Make a decision on an internal review case

From the Internal Review case:

Select Decision tab.
From the Request for PACE Decisions table, select the hyperlink under Name heading.
On the RORD Request screen, select Make a decision on the right-hand side of the screen.

8.1 Complete the Decision pop-up

Within the decision pop-up, complete the fields that can be completed. Most of the fields will be automatically populated.
From Decision step in Decision Outcome select the relevant option for the plan change request:
- select Set Aside if you disagree with the decision to not change the plan and intend on changing the plan
- select Confirm if you agree with the decision to not change the plan.
Select Next – Justification.
From Justification step, select available Justification.
Select available Sub-justification.
Select Next – Evidence.
From Evidence step, complete Evidence Name free text.
Select Evidence Type from the drop-down options.
If selecting Document, complete Evidence Link. The Evidence Link name can be found in the Evidence tab under the Document Type heading. The evidence linked must relate to your justifications.
Complete Explanation free text.
Select Next.
From the Confirmation step, select Done which will move the decision to the Drafted decision status in the Requests for PACE decisions table.

8.2 Submit the internal review decision

From the Internal Review case:

From the Decision tab select Submit Decisions.
From the Confirmation step, select Next.
From the Summary step, select Done.
Select Confirm manual letter has been sent.
From the Confirmation step, select an appropriate option from Did you speak to the participant about decision. Select Next.

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From the Decision Letter Sent step, select Next.
You’ll now be returned to the Internal Review case.
You send the letter when you either:
- Confirm the decision by following the steps in section Confirm the decision.
- Set aside the decision by following the steps in section Set aside the decision.
You may need to manually close the Internal Review case. For information on closing the Internal Review case, go to article IRT – Complete remaining closure tasks for an internal review.

8.2.1 Confirm the decision

Advise the participant or authorised representative you’ve decided to confirm the automatic decline of their request. You’ll need to explain what this means. Confirm you’ll send them a letter with the outcome of your decision. Tell them that they have Administrative Review Tribunal (ART) rights and if they want a review from the ART, they’ll need to lodge an application within 28 days.
Follow the guidance in article Send a manual letter to send the participant the Letter – s47A and s48 decision outside 21 days manual decline.

8.2.2 Set aside the decision

From the Decision tab, select either:
- Create Budget Update Case, if you decided to vary the plan.
- Create a Plan Approval Case, if you decided to reassess the plan.
Note: Only the option relevant to your decision will be available to select.
A child case will now be created.
Select View Child Case to either:
- progress the Create Budget Update Case, go to article Action a budget update
- progress the Create a Plan Approval Case, go to article Change the draft budget.
Once the plan has been updated, or a new plan is approved, you need to advise the participant or authorised representative of your decision.
Explain to the participant or authorised representative that you’ve decided to vary or reassess the plan. Tell them:
- how the plan will be provided
- what has changed in the plan and offer them support to implement their plan
- advise them that you’ll send a letter with the outcome.
Use the article Send a manual letter to send the manual decision outcome letter:
- for a variation send the participant Letter – s47A and s48 decision manual vary

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for a reassessment send the participant Letter – s47A and s48 decision outside 21 days manual reassess.

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