DOCUMENT 10 FOI 24/25 - 1670

Check eligibility — DIS — significant functional impact

SGP KP Publishing

Exported on 2025-04-01 03:36:23

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FOI 24/25 - 1670 SGP KP Publishing — Check eligibility — DIS — significant functional impact

Table of Contents

1. Recent updates …………………………………………………………………………………………………………………… 4
2. Before you start…………………………………………………………………………………………………………………. 5
3. Evidence of significant functional impact …………………………………………………………………………….. 6 3.1 Review evidence of the impairment that substantially reduces functional capacity ………. 6
4. Next steps ………………………………………………………………………………………………………………………….. 7

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FOI 24/25 - 1670 SGP KP Publishing — Check eligibility — DIS — significant functional impact

This article provides guidance for all NDIA staff and partners to review evidence of the impairment that substantially reduces functional capacity

Recent updates — 3

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FOI 24/25 - 1670 SGP KP Publishing — Check eligibility — DIS — significant functional impact

1 Recent updates

3 October 2024

• Article title changed from article - Check evidence for a decision - Significant functional impact to Check eligibility - DIS — significant functional impact.
• When we say DIS in a title, we mean disability requirements. We’ve added this to help you quickly identity which articles are for disability or early intervention requirements.

Recent updates — 4

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2 Before you start

You have:

• read Our Guideline — Applying to the NDIS (external) including the section Does your impairment substantially reduce your functional capacity?
• read articles Understand disability requirements, What evidence of disability is required? and Make an access decision.

Before you start — 5

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FOI 24/25 - 1670 SGP KP Publishing — Check eligibility — DIS — significant functional impact

3 Evidence of significant functional impact

3.1 Review evidence of the impairment that substantially reduces functional capacity

We need to learn about the person’s impairment before we can make a decision about their eligibility.

To do this you need to check their application and evidence in PACE.

You need evidence the person’s impairment substantially reduces their functional capacity in one or more of the following areas:

• communication
• social interaction
• learning
• mobility
• self-care
• self-management (if older than 6).

A person’s needs might vary from time to time. This means they may go up and down each day or each month. A good example of this can be progressive multiple sclerosis. We consider a person’s ability over time and take into account how their ability fluctuates.

When a person’s impairment substantially reduces their functional capacity, they usually need disability-specific supports to join in or do these tasks and activities.

These disability-specific supports include:

• support from other people, such as physical assistance, guidance, supervision or prompting.
• assistive technology, equipment or home modifications prescribed by the person’s doctor, allied health professional or other medical professional.

To decide if a person is eligible, you need to determine their capacity and where they need more help. To decide if a support is reasonable and necessary, you need to consider what information you have available to identify if the person meets the NDIS funding criteria (external).

If a person has more than one permanent impairment, you will need to consider them together to see if their functional capacity is reduced substantially.

You need to consider:

• the person’s involvement in different areas of life, like at home, school, work and in the community
• how they carry out tasks and activities
• any other factors impacting their everyday life.

The disability requirements are just one of the eligibility requirements. To be eligible for the NDIS, the applicant must also meet the age and residence requirements. Go to article Check eligibility - Age and residence requirements.

Evidence of significant functional impact — 6

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FOI 24/25 - 1670 SGP KP Publishing — Check eligibility — DIS — significant functional impact

4 Next steps

If you are an access delegate:

• to determine eligibility, continue to follow guidance in article Make an access decision - pre-legislation changes or article Make an access decision — post-legislation changes.
• to check the timeframes to make a decision, follow guidance in article Check decision — Legislative timeframes.

Next steps — 7

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