FOI 25/26-2132 & FOI 25/26 -2133 Document 10

Understand highly likely and commonly associated impairment categories

SGP KP Publishing

Exported on 2026-03-03 05:29:17

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

Table of Contents

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

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

3 Understand impairment categories ………………………………………………………………………… 6 3.1 Impairment categories when the participant meets the disability requirements …………….. 6 3.2 Impairment categories when the participant meets the early intervention requirements … 6

4 Understand highly likely and commonly associated impairment categories ……………. 8 4.1 Highly likely impairment categories ………………………………………………………………………… 8 4.2 Commonly associated impairment categories………………………………………………………….. 8

5 Understand how to assign impairment categories when you make an access decision ………………………………………………………………………………………………………………………. 9 5.1 Example – Multiple sclerosis - neurological and cognitive impairment categories ………… 9 5.2 Example – Multiple sclerosis - neurological and physical impairment categories………….. 9 5.3 Example – assigning impairment categories for multiple impairments that combined meet disability requirements ……………………………………………………………………………………………………. 9 5.4 Example – assigning 2 highly likely impairment categories for multiple impairments that meet the disability requirements…………………………………………………………………………………….. 10 5.5 Example - multiple impairments related to the same impairment category ………………… 10

6 Understand how to add an impairment category after a participant has met access 11 6.1 Example - decision to add an impairment category ………………………………………………… 11 6.2 Example – decision to not add an impairment category ………………………………………….. 11

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

This article provides guidance for an access delegate to:

• understand impairment categories
• understand highly likely and commonly associated impairment categories
• understand how to assign impairment categories when you make an access decision
• understand how to add a new impairment category after a participant has met access

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

1 Recent updates

15 December 2025 New article to support understanding of how highly likely and commonly associated impairment categories are applied based on the participant’s impairments.

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

2 Before you start

Impairment categories information is called a ‘Notice of impairments’ in section 32BA of the NDIS Act (the Act).

A participant can ask to change their impairment categories at any time. This includes to add or remove an impairment category. The Act uses the term ‘vary’, but in correspondence, guidance and when talking to participants, we use the term ‘change’ as it’s plain English.

Only access delegates assign participant’s impairment categories.

You:

• are determining a participant’s impairment categories following an access met decision, or an application to change impairment categories information and

You have read:

• and understood Our Guideline – Applying to the NDIS (external), sections What are the categories of impairments?, What happens after we decide? and How do we weigh evidence of disability?
• article Descriptions of impairment categories.

Note: the examples in this article are for information only. They are provided to support understanding and don’t include all potential scenarios.

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

3 Understand impairment categories

A participant’s impairment categories information may include one or multiple impairment categories.

Where a participant has multiple impairments which relate to a single impairment category, one impairment category is recorded. However, when a participant has one impairment that impacts multiple impairment categories, all relevant impairment categories are recorded. More categories doesn’t mean more support needs.

Note: we use the terms highly likely and commonly associated impairment categories. This is internal language only. When talking to participants, use either impairment categories, or impairment categories information.

When considering adding any impairment categories, they must be:

• supported by the participant’s disability related evidence
• relevant to how the participant meet’s the disability or early intervention requirements.

For more information go to sections Impairment categories when the participant meets the disability requirements, and Impairment categories when the participant meets the early intervention requirements.

3.1 Impairment categories when the participant meets the disability requirements

If the participant meets the disability requirements, the highly likely or commonly associated impairment category needs to cover an impairment that:

• is likely to be permanent
• substantially reduces the participant’s functional capacity
• affects the participant’s ability to work, study or take part in social life
• likely needs NDIS support for the participant’s lifetime.

For more information go to Our Guideline – Applying to the NDIS (external), section Do you meet the disability requirements?

3.2 Impairment categories when the participant meets the early intervention requirements

If the participant meets the early intervention requirements, the highly likely or commonly associated impairment category needs to cover an impairment that:

• is likely to be permanent
• will likely benefit from early intervention supports and
• the early intervention supports needed are NDIS supports.

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

Note: if a child is younger than 6 with developmental delay, then the impairment categories don’t apply.

For more information go to Our Guideline – Applying to the NDIS (external), section Do you need early intervention?

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

4 Understand highly likely and commonly associated impairment categories

In most cases, apply the highly likely impairment category or categories for the condition or conditions that meet the disability or early intervention requirements. Other impairment categories can also be relevant to the participant’s condition. Consider the commonly associated impairment category or categories.

Article Impairment categories guide includes the highly likely and commonly associated impairment categories associated with a participant’s condition. You can also add an impairment category not listed in this guide, as long as:

• you have evidence of this, and
• it covers an impairment that meets the disability or early intervention requirements.

Where a participant has more than one impairment, you must assess the functional impact of each impairment in the context of all the participant’s impairments cumulative impact. For example, a person might have an intellectual disability and a different permanent impairment which causes difficulty moving. On its own the impairment that causes difficulty moving might not result in substantially reduced functional capacity in any activity area. But because of the person’s intellectual disability, they may not be able to use recommended strategies or equipment without support. This means we would consider the functional impacts of the physical impairment in the context of the functional impacts of the intellectual disability. For more information, go to section Example – assigning impairment categories for multiple impairments that combined meet disability requirements in this article.

Note: if the participant’s condition isn’t listed in the guide, consider the evidence to determine the most appropriate impairment categories that apply.

4.1 Highly likely impairment categories

Highly likely impairment categories are categories that research tells us are most likely to be associated with a condition. These categories apply to the permanent impairment the participant met the disability or early intervention requirements for.

A participant can have multiple impairments which relate to a single impairment category. In this case, record only one impairment category. For more information go to section Example - multiple impairments related to the same impairment category in this article.

4.2 Commonly associated impairment categories

In addition to the highly likely impairment categories, you must consider applying any commonly associated impairment categories. The evidence must indicate it’s relevant to the permanent impairment the participant meets the disability or early intervention requirements for. Two people with the same condition may have different impairment categories applied because of how the condition presents for them.

If the participant applies to change their impairment categories information, go to section Understand how to add an impairment category after a participant has met access in this article.

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

5 Understand how to assign impairment categories when you make an access decision

The following examples include assigning highly likely and commonly associated impairment categories to a participant’s impairment categories information when you make an access met decision.

5.1 Example – Multiple sclerosis - neurological and cognitive impairment categories

Hailey meets the disability requirements because she has multiple sclerosis. This means the highly likely impairment category is neurological.

Hailey provides evidence that because of her multiple sclerosis, she has difficulty with her memory and concentration causing substantially reduced functional capacity in communication and learning. The delegate decides Hailey has a permanent neurological impairment caused by multiple sclerosis. The delegate also decides that Hailey’s multiple sclerosis causes a permanent cognitive impairment.

This means the delegate will apply the commonly associated category cognitive. Hailey’s impairment categories information will include the impairment categories neurological and cognitive. These apply equally in their impairment categories information and are not defined as highly likely or commonly associated on their record.

5.2 Example – Multiple sclerosis - neurological and physical impairment categories

Alex meets the disability requirements because they have multiple sclerosis. This means the highly likely impairment category is neurological.

Alex also provides evidence that because of their multiple sclerosis, they have a lack of muscle control and coordination of their movements (ataxia). This results in a substantially reduced functional capacity to move around, and Alex needs to use a gait aid to help with walking.

The delegate decides Alex has a permanent neurological impairment caused by multiple sclerosis, and a physical impairment due to difficulty moving their body.

This means the delegate will apply the commonly associated category physical. Alex’s impairment categories information will include the impairment categories neurological and physical. These apply equally in their impairment categories information and are not defined as highly likely or commonly associated on their record.

5.3 Example – assigning impairment categories for multiple impairments that combined meet disability requirements

Joy applies to access the NDIS and provides evidence of impairments associated with moderate intellectual disability and rheumatoid arthritis.

The access delegate considers the combined impact of all of Joy’s permanent impairments. They are satisfied Joy has substantially reduced functional capacity in activity of self-care due to

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

the combined impact of Joy’s intellectual disability and rheumatoid arthritis. On its own, Joy’s rheumatoid arthritis would not cause substantially reduced capacity to self-care. However, due to Joy’s intellectual disability, she is unable to use adaptive strategies to physically complete self-care tasks independently.

The delegate records the highly likely impairment categories intellectual and physical. These categories cover the impairments for which Joy meets the disability requirements.

5.4 Example – assigning 2 highly likely impairment categories for multiple impairments that meet the disability requirements

Ahmed applies to access the NDIS and provides evidence of impairments associated with a moderate intellectual disability and profound hearing loss.

The delegate is satisfied that the impairments caused by Ahmed’s intellectual disability and hearing loss meet the disability requirements.

The delegate records 2 highly likely impairment categories for Ahmed. These categories are Intellectual and Sensory. Ahmed’s impairment category information will state Intellectual and Sensory.

5.5 Example - multiple impairments related to the same impairment category

Mei was diagnosed with fusion of the cervical spine after birth. Later in life, Mei had a below-knee amputation.

Mei provides evidence that they have permanent damage to their body functions. This is due to limited range of motion in the neck and upper spine, and the partial loss of a lower limb.

Although Mei has two separate impairments, Mei’s impairment categories information will include only the physical impairment category This covers the impairments related to Mei’s fusion of the cervical spine and below-knee amputation.

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

6 Understand how to add an impairment category after a participant has met access

A participant can apply to change their impairment categories at any time. This includes adding or removing an impairment category.

When a participant applies to add an impairment category, you don’t need to review the permanence and functional impact of existing impairments. You do need to check the impact of the existing impairment on any new impairments.

As an access delegate, you will consider the available evidence to make a decision about whether you change the impairment categories or not.

The following examples demonstrate adding an impairment category when the participant asks to change their impairment categories information.

6.1 Example - decision to add an impairment category

Omar meets the disability requirements for an intellectual disability.

Omar’s impairment categories information states intellectual and cognitive to cover the impairments they experience associated with intellectual disability.

Omar’s nominee contacts the NDIA to advise that Omar has recently been diagnosed with Parkinson’s disease. They’d like to change Omar’s impairment categories information to reflect this.

As part of the request, Omar’s nominee provides diagnostic information from Omar’s neurologist. This evidence demonstrates Omar’s Parkinson’s disease results in a permanent impairment and is having a substantial impact on his functional capacity. Omar’s nominee also provides evidence of the functional impact Omar experiences from his Parkinson’s disease, impacting his neurological functioning.

The access delegate considers the application and evidence. They decide to change the impairment categories information. This is because Omar’s Parkinson’s disease results in a permanent impairment which causes substantial reduction in functional capacity.

The delegate adds the neurological impairment category. Omar is given a new impairment categories information which now also includes the neurological impairment category, along with the intellectual and cognitive impairment categories.

6.2 Example – decision to not add an impairment category

Ali has autism and meets the disability requirements. Ali’s highly likely impairment category is neurological. Ali also has intellectual recorded as a commonly associated category.

Ali’s child representative applies to add the sensory category to Ali’s impairment categories information. They give us evidence that says due to Ali’s autism, they have sensory processing difficulties.

The delegate reviews the evidence and looks at the relevant guidance including Our Guideline –

FOI 25/26-2132 & FOI 25/26 -2133 SGP KP Publishing – Understand highly likely and commonly associated impairment categories

Applying to the NDIS (external). The delegate confirms that we usually use the sensory category when a participant has a condition such as vision or hearing loss. Sensory processing difficulties however relate to the neurological category, which involves how the brain processes sensory information like sound, touch, movement, and taste.

The delegate decides not to change Ali’s impairment category information. Even though we haven’t added the sensory impairment category, Ali might still get NDIS supports for her sensory processing difficulties. The supports would need to relate to her permanent impairment.