NDIA Accountability Project

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Advice Support Tool Theme: Determining eligibility to access the Scheme Sub-Theme(s): s24 of the NDIS Act 2013 — Disability

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Advice Support Tool

Theme: Determining eligibility to access the Scheme

Sub-Theme(s): s24 of the NDIS Act 2013 – Disability

Applicable to - Initial access- Internal review - Review of ongoing disability

References:

Note: All criteria need to be met to satisfy access eligibility to the NDIS.

Criteria for reasonable and necessary supports Are criteria met? Considerations (including evidence used)

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24.1(a)

A person meets the disability requirements if:

  • (a) The person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory, or physical impairments or the person has one or more impairments to which a psychosocial disability is attributable

    • ☐ Yes
      • s47E(d) - certain operations of agencies
        • MET FOR LARYNGECTOMY
        • NOTE THIS EVIDENCE MUST BE FROM A SUITABLY QUALIFIED MEDICAL PRACTITIONER.
        • s47E(d) - certain operations of agencies
    • ☐ No
      • Types of disability evidence | NDIS

  • (b) The impairment or impairments are, or are likely to be, permanent; and Will assist in determining if the disability will remain for the person’s life.

    • INCLUDE EVIDENCE OF ALL TREATMENT UNDERTAKEN INCLUDING WHEN, WITH WHOM, THE DURATION AND FREQUENCY WHERE APPLICABLE,
      • s47E(d) - certain operations of agencies
        • Providing evidence of your disability | NDIS • An impairment is, or is likely to be, permanent (see paragraphs 6.2(a)(i) and (ii)) only if there are no known, available, and appropriate evidence-based clinical, medical, or other treatments that would be likely to remedy the impairment. • An impairment may be permanent notwithstanding that the severity of its impact on the functional capacity of the person may fluctuate or there are prospects that the severity of the impact of the impairment on the person’s functional capacity may improve. • An impairment may require medical treatment and review

before a determination can be made about whether the impairment is permanent or likely to be permanent. The impairment is, or is likely to be, permanent only if the impairment does not require further medical treatment or review in order for its permanency or likely permanency to be demonstrated (even though the impairment may continue to be treated and reviewed after this has been demonstrated).

• The functional capacity of the person may fluctuate or there are prospects that the severity of the impact of the impairment on the person’s functional capacity may improve.

s47E(d) - certain operations of agencies

• If an impairment is of a degenerative nature, the impairment is, or is likely to be, permanent if medical or other treatment would not, or would be unlikely to, improve the condition.

MR25/00038 | FOI 24/25-0317

s47E(d) - certain operations of agencies
s47E(d) - certain operations of agencies
• 24.1(c) the impairment or impairments result in reduced functional capacity to undertake one or more of the following activities:
(i) communication.
(ii) social interaction.
(iii) learning.
(iv) mobility.
(v) self-care.

Key indicators of substantially reduced functional capacity include. • The person is unable to participate effectively or completely in the activity, or to perform tasks or actions required to undertake or participate effectively or completely in the activity, without assistive technology, equipment (other than commonly used items such as glasses) or home modifications; or. • Usually requires assistance (including physical assistance, guidance, supervision or prompting) from other people to participate in the activity or to perform tasks or actions required to undertake or participate in the activity; or. • The person is unable to participate in the activity or to perform tasks or actions required to undertake or participate in the activity, even with assistive technology, equipment, home modifications or assistance from another person.

s47E(d) - certain operations of agencies

s47E(d) - certain operations of agencies
• As per APTOS Health is responsible for intervention post-surgery, and for time-limited, recover-oriented therapy.
• Request evidence from Health re intervention provided and outcomes achieved.

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s47E(d) - certain operations of agencies

language and gestures, to express themselves compared to other people of a similar age.

  • Socialising – ability to make and keep friends, or interact with the community, or how a young child plays with other children. We consider behaviour, and how a person copes with feelings and emotions in social situations.
  • Learning – how a person learns, understands, and remember new things, and practise and use new skills.
  • Mobility, or moving around – mobilising in & outdoors, and transfers.
  • Self-care – personal care, hygiene, grooming, eating, and drinking, and health.
  • Self-management a person’s ability to organise their life. Ability to plan, make decisions, manage day-to-day tasks, solve problems, or manage money. This relates to a person’s mental or cognitive ability to manage their life.

24(1) d Are social and economic participation affected?

Unlike s24 (1) c 24(1) d does not have a stated threshold.

Yes LIKELY MET –
No DOES THE EVIDENCE REFLECT THE PERSON HAS
• ABILITY TO ESTABLISH AND MAINTAIN RELATIONSHIPS

24.1(e) A person must be likely to require support under the NDIS for their lifetime.

Consideration should be given to the nature

of the Applicants long term support needs.

The Applied Principles and Tables of Support to Determine Responsibilities NDIS and other service | Department of Social Services, Australian Government (dss.gov.au)

s47E(d) - certain operations of agencies

  • whether these needs are best met by the NDIS, or by other government and community services.

  • In making determinations under s24 (1) e it is important to understand the responsibilities of other Government service sectors. These include Health Education, Mental health, Child protection and family support. Early childhood development Higher education and Vocational Education and Training (VET), Employment, Housing and community infrastructure, Transport, Justice& Aged care