DOCUMENT 25 FOI 24/25 - 1670

What evidence of disability is required

SGP KP Publishing

Exported on 2025-04-03 03:09:18

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FOI 24/25 - 1670 SGP KP Publishing — What evidence of disability is required

Table of Contents

1 Recent updates …………………………………………………………………………………………………………………… 4 2 Before you start…………………………………………………………………………………………………………………. 5 3 Who can provide evidence of disability? …………………………………………………………………………………. 6 4 What evidence does the NDIA require? …………………………………………………………………………………. 7 5 How to check evidence……………………………………………………………………………………………………….. 8 6 What if the person lives in a remote region? ……………………………………………………………………………. 9 7 Next steps ………………………………………………………………………………………………………………………. 10

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FOI 24/25 - 1670 SGP KP Publishing — What evidence of disability is required

This article provides guidance for all NDIA staff and partners to understand:

• who can provide evidence of disability
• what evidence the NDIA requires
• how to check evidence
• what to do if the person lives in a remote region.

Recent updates — 3

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1 Recent updates

1 January 2025

Guidance updated to apply to the Update Impairment (category) and Eligibility Reassessment cases.

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2 Before you start

You have read and understood Our Guideline — Applying to the NDIS (external) including sections Do you meet the disability requirements? and Do you need early intervention?

Before you start — 5

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3 Who can provide evidence of disability?

A person’s treating professional must provide disability evidence.

Evidence provided by treating professionals — such as medical reports — needs to consist of genuine, original documents. The information must also be specific to the person applying or the participant updating their categories of impairments.

Before accepting evidence from a treating professional, you should read the article Check treating professional details.

Who can provide evidence of disability? — 6

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4 What evidence does the NDIA require?

Anyone applying for the NDIS needs to have evidence of disability, regardless of what NDIS support they are asking for. A person’s evidence needs to show they meet all of the disability requirements.

We ask for this evidence from the person:

• when they first apply to the NDIS
• when making an access decision
• if they apply to vary their categories of impairments in their Notice of impairments
• during an eligibility reassessment.

You can’t submit the access request case until you have evidence of disability from the person.

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5 How to check evidence

Before you make a decision about the person’s NDIS eligibility, you need to check the person’s disability evidence:

• is from a treating professional registered with AHPRA (the Australian Health Practitioner Regulation Agency). Use article Check treating professional details.
• provides enough information to show if the person is eligible for priority application decision. Use article Request priority eligibility decision.
• demonstrates that the person has a condition from List A (external), List B (external) or List D (external).
• shows if the person meets the requirements for disability, early intervention or both. Use article Understand disability requirements and Understand early intervention requirements.

If the evidence does not show each of the above, the person may need to provide additional evidence.

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6 What if the person lives in a remote region?

The NDIA makes some exceptions to the evidence requirements for people living in remote regions of Australia. People living in these regions may find it difficult to provide or obtain evidence.

When you support people who live in very remote communities, you must record information about their:

• local health service
• consent for the NDIA to talk to the local health service
• local community connection contact
• Council and/or Department of Social Services contact in the area.

The person lives in a remote region if they live in a MM6 or MM7 region, under the Modified Monash Model (external).

If this is the case, you should talk with your team leader. They can help you consider options and alternatives for the person’s circumstances.

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7 Next steps

1. If you are completing an:

   • Access Request case: continue with article Complete form in the access request case
   • Access Decision case: continue with article Make an access decision - post legislation changes
   • Update Impairment (category) case: continue with articles Submit an application to vary the participant’s Notice of impairments or Decide whether to vary the participant’s Notice of impairments
   • Eligibility Reassessment case: continue with articles Complete an eligibility reassessment referral, Review the referral information and complete the eligibility reassessment check or Finalise eligibility reassessment decision.

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