NDIA Accountability Project

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Notify the participant about an eligibility reassessment

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FOI 24/25-0830 DOCUMENT 13

Notify the participant about an eligibility reassessment SGP KP Publishing

Exported on 2025-02-28 01:08:45

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SGP KP Publishing – Notify the participant about an eligibility reassessment

Table of Contents

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

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

3 Create the Call task ……………………………………………………………………………………………….. 6

4 Contact the participant to notify them of the eligibility reassessment …………………….. 7 4.1 If the participant requests more time to provide evidence ………………………………………….. 8 4.2 Log the contact attempt ………………………………………………………………………………………… 8 4.3 Send eligibility check evidence request letter …………………………………………………………… 9

5 Next steps …………………………………………………………………………………………………………… 10

Table of Contents – 2 Page 118 of 271

SGP KP Publishing – Notify the participant about an eligibility reassessment

This article provides guidance for an access delegate to:

  • create the Call task
  • contact the participant to notify them of the eligibility reassessment
  • log the contact attempt
  • send letter - Eligibility reassessment evidence request.

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SGP KP Publishing – Notify the participant about an eligibility reassessment

1 Recent updates

16 September 2024

  • Guidance updated to include information about auto reply email changes in the Enquiry case.
  • Letter name updated to Eligibility reassessment opportunity to respond.

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SGP KP Publishing – Notify the participant about an eligibility reassessment

2 Before you start

During the eligibility reassessment eligibility check, there was an outcome to commence an eligibility reassessment using article:

You have read:

You have completed steps in article:

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SGP KP Publishing – Notify the participant about an eligibility reassessment

3 Create the Call task

Before you contact the participant, you must create a Call task. This is to log you’re going to contact the participant to notify them of the eligibility reassessment. This task won’t automatically generate in PACE.

  1. In the Person Account, select the Cases tab.
  2. Select All Cases.
  3. Select the Eligibility Reassessment case from the list of cases.
  4. Select the Case Activity tab.
  5. In Open Activities, select New Task.
  6. Select General Task, then Next.
  7. In Activity Type select Internal Note.
  8. In Subject select Call.
  9. Select Save.

Note: You must contact the participant using their preferred contact method, which can include calling.

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SGP KP Publishing – Notify the participant about an eligibility reassessment

4 Contact the participant to notify them of the eligibility reassessment

When contacting the participant, their nominee or child representative, make sure you follow the guidelines in article Guide - Conversation style guide.

  1. Check the person’s preferred communication method and authorisations.

  2. Contact the participant, their nominee or child representative using article [Contact attempts and unable to contact in an eligibility reassessment case](/foi-library/releases/d12c3f3ba399-foi-24-25-0830-documents-documents/document-011__contact-attempts-and-unable-to-contact-in-an-eligibility-reassessment-case/). Your actions will be different depending upon if the person answers. If:

    • Successful: introduce yourself and confirm if this is a suitable time for the call. Then go to step 2.

    • Unsuccessful: follow guidance in article Contact attempts and unable to contact in an eligibility reassessment case. You must also record all the contact attempts, go to section Log the contact attempt.

  3. Complete a security check to verify you’re speaking to the correct person. Use article Consider a request for personal information, section How to complete a security check.

  4. Help the person understand why the NDIS is checking their eligibility. Explain to the person that:

    • you’re calling from the NDIA about the participant’s NDIS eligibility
    • the NDIS invests in people with disability to build capacity based on their individual goals. Some people achieve their goals and leave the NDIS with our support
    • we check eligibility at plan reassessments and at other times, like when a person’s situation changes
    • a person must continue to meet the residence and disability or early intervention requirements to remain an NDIS participant. If there’s information that a person may no longer meet the eligibility requirements, or if there’s not enough information to determine their ongoing eligibility, we need to do an Eligibility Reassessment.
    • you’ve reviewed all information on their record, and we need more evidence to determine whether the participant continues to be eligible.
    • a decision has not yet been made. They have an opportunity to explain why they think the participant continues to meet the eligibility requirements and provide any further supporting information.

  5. Help the person understand what happens next. Explain that:

    • they’ll have 28 days to submit more evidence
    • after 28 days, we’ll use the evidence we have and decide if the participant is still eligible for the NDIS
    • It’s your responsibility to help them understand what evidence we need, and who to get evidence from
    • If we don’t have evidence that they meet the eligibility requirements, we may decide they’re no longer eligible. This means they’ll no longer be an NDIS participant
    • they’ll receive a letter which also explains what evidence they need to give us
    • if we don’t receive any information, we’ll use the evidence we have to make the decision
    • if they need more time to give evidence, they can request an extension by providing evidence of why they need an extension via email to

SGP KP Publishing – Notify the participant about an eligibility reassessment

enquiries@ndis.gov.au or phone 1800 800 110. For more information, read article Contact the participant about their request for more time to provide evidence. If they request an extension, go to section If the participant requests more time to provide evidence.

  • Note: If they send an email, you can find their email responses in PACE. To find an email response in PACE, go to article Send and receive an email in PACE.

  • the participant can continue to use their plan while the eligibility reassessment is happening

  • if they have any questions about or need support using the participant’s plan, encourage them to contact the participant’s my NDIS contact, which is likely to be either a local area coordinator or early childhood partner.

  • the participant will be supported by their my NDIS contact throughout the eligibility reassessment process.

  1. Explain that if the outcome of the eligibility reassessment is that the participant is no longer eligible for the NDIS. This means the participant will:

    • no longer be a participant, from 28 days after the decision is made
    • no longer have access to NDIS funds to purchase NDIS supports
    • be supported by their my NDIS contact with their community connections as they prepare to leave the NDIS.

4.1 If the participant requests more time to provide evidence

If the participant requests more time to give evidence, and further evidence to approve the extension:

  • is required: Let them know they’ll need to submit further evidence and that they should request an extension once this has been provided
  • isn’t required: Explain that you’ll record their request and you’ll contact them with the outcome.

For more information, read article Contact the participant about their request for more time to provide evidence

4.2 Log the contact attempt

  1. Log the details of your contact attempt with the participant using article Log an activity or internal note.

  2. In the Comments section record the details of a successful or unsuccessful contact attempt.

  3. If the contact attempt was successful use this template:

    Eligibility Reassessment Commenced on . Phone call made to <Person/Authorised Representative> to advise that they may no longer be eligible and are being provided with an opportunity to respond.

    .

    • Go to section Send eligibility check evidence request letter.

  4. If the contact attempt was unsuccessful use this template:

    Eligibility Reassessment commenced on .

SGP KP Publishing – Notify the participant about an eligibility reassessment

<First/Second/Third> phone call attempt made to <Person/Authorised Representative> on all available numbers to advise that the participant may no longer be eligible and we are providing an opportunity to respond.

Call not answered.

4.3 Send eligibility check evidence request letter

  1. Manually prepare and send the letter Eligibility reassessment opportunity to respond, using article Send a manual letter.

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SGP KP Publishing – Notify the participant about an eligibility reassessment

5 Next steps

  1. No further action is needed. The Eligibility Reassessment case will move to the Requested Further Info status and go on hold for 6 weeks. The 6 weeks include:

    • 4 weeks allocated time for the participant to give evidence
    • 2 weeks for evidence processing.

    During this time, the case will reassign to the Eligibility Reassessment Hold Queue. For more information read article Understand the Eligibility Reassessment Hold Queue.

  2. If the participant has requested an extension, read article Contact the participant about their request for more time to provide evidence.

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