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OFFICIAL For Internal Use Only
Case Management Guide Supportable Impairments
Category Reference Documents Title Supportable Impairments Purpose This document is part of a suite of guidance
documents for Case Managers to use in formulating their approach to managing individual matters before the Administrative Review Tribunal (ART).
This Guide applies nationally to the conduct of all matters within the External Review Branch.
Scope A participant’s impairment and associated disability Section 24 of the can permanently and substantially reduce their National Disability functional capacity or their ability to undertake Insurance Scheme Act activities. 2013 For the purposes of this document, an impairment —_| Operational Guideline — can be: Applying for the NDIS e intellectual: Do you meet the disability requirements? e cognitive; ; Does your impairment
- neurological; substantially reduce your e sensory; functional capacity?
Do you have an extreme functional impairment or
e physical; or
e an impairment to which a psychosocial very high support disability is attributable. needs? NDIA policy The ART process is often seen as stressful and NDIA Dispute Resolution on this subject | adversarial by participants and prospective Policy participants of the Scheme. The NDIA will adopt a Appendix B to the Legal participant-focused approach to resolving disputes Services Directions 2017
before the ART, and will work directly with participants
and prospective participants to provide better and Section 24 of the . . National Disability earlier outcomes, where possible.
Insurance Scheme Act The role of the NDIA is to assist the ART in reaching | 2073
the correct and preferable decision, including by assisting participants and prospective participants in reaching the best possible resolution by agreement.
List B: Conditions that
are likely to result ina
permanent impairment Participants are generally ineligible to receive NDIS
funding if:
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FOI 24/25-1284 OFFICIAL For Internal Use Only
Case Management Guide
Supportable Impairments
Category
Reference Documents
e their impairment is temporary; or
e their impairment is treatable, whether treatment is ongoing or whether there are unexplored treatment options available to the participant.
The NDIA is also unable to fund supports which would more appropriately be funded by other mainstream service delivery systems.
NDIA posture | Whether the NDIA is able to offer support funding in Operational Guideline — in relation to relation to a particular impairment will typically hinge | Applying for the NDIS this subject on whether or not: Section 25 of the e the impairment is, or is likely to be, National Disabilit permanent; and Insurance Scheme Act e whether the support needed is most 2013 appropriately funded by the NDIA. Where the engagement with health is aimed at curing the impairment, the NDIS would not provide supports A person can have engagement with the health system and still require disability supports that work alongside the health system’s management of permanent impairments. Evidence The primary concern of the NDIA is the participant’s recommended | wellbeing. The NDIA will rely on the available to inform evidence and best practice when considering NDIA position | whether a participant is entitled to receive funding Providing evidence of in a matter from the NDIA for a particular impairment. your disability eer the _| The NDIA will refer to evidence from health and allied | Administrative Review health providers, expert evidence, opinion evidence Tribunal Guideline on and witness statements. The NDIA will also closely Persons Giving Expert consider a participant’s daily support needs as a and Opinion Evidence result of their impairment when considering the appropriate level of funding to provide, wherever possible. Other Some participants may have an impairment which will Do you need early considerations | improve over time, meaning that the participant will intervention? require progressively less disability support over time. NDIA-ERB-GDE-001-FINAL OFFICIAL Page 2 of 3
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Case Management Guide Supportable Impairments
Category Reference Documents
In those circumstances, participants may be eligible Sections 24, 25 and 27
to receive early intervention support funding. of the National Disability In those circumstances, the NDIA will consider: meance Scheme Act e whether the impairment is likely to be Rule 6.9 of the National
t: permanent, Disability Insurance
e whether early intervention supports are likely | Scheme (Becoming a to reduce the need for future supports; and Participant) Rules 2016
¢ whether the early intervention needed is an Case Management NDIS support Guide — Access to the NDIS Previous The question is not whether the impact of a matters that participant’s impairment is significant in general may inform terms, or whether a support js actually funded by the NDIA another mainstream service delivery system. Instead, position the test is whether or not the /egis/ative requirements are met; which is to say, whether a participant’s Allen and National
impairment is permanent and substantially reduces Disability Insurance their functional capacity, and whether or not support | Agency [2018] AATA funding in relation to that impairment is most 3851
appropriately provided by the NDIA, and not another | mainstream service delivery system.
The AAT affirmed a decision of the NDIA on the basis that it was not satisfied these legislative requirements were met, on the available evidence.
Document Control Responsible Person Date
Document author Continuous Improvement March 2025
Document approver | Assistant Director, Policy, 20 March 2025 Continuous Improvement
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