Process access decision overturn by AAT order

OFFICIAL DOCUMENT 22 FOI 24/25-0830 Standard Operating Procedure For Internal Use Only

The contents of this document are OFFICIAL.

Process access decision overturn by AAT order

This Standard Operating Procedure (SOP) will help Quality Development Officers to overturn an Access not met decision by Administrative Appeals Tribunal (AAT) order.

1. Recent updates

Date What’s changed

April 2022  New SOP format to align with Our Guidelines refresh. SOPs include process information only. Use Our Guidelines to help you make decisions and refer to Related procedures or resources.

 Guidance updated to align with Our Guideline – Applying to the NDIS.

 Step 3.6.1 – Complete participant streaming task: updated work instructions to make it easier to understand the next steps.

2. Checklist

Topic Checklist

Pre-requisites You have: Quality Development Officer (QDO) delegation with the National Access and Reviews Branch (NARB). received an AAT order from the Administrative Appeals Branch or received an AAT order from an applicant and you have approval from the Administrative Appeals Branch l to overturn the decision.

Actions 3.1 Check AAT order is attached to inbound documents 3.2 Identify which eligibility requirements are met 3.3 Add the interaction 3.4 Generate/select the access application 3.5 Complete pathway tasks 3.6 Complete participant streaming task 3.7 Suppress letters 3.8 Communicate decision to the Administrative Appeals Branch 3.9 Add workflow identifier: priority (High)

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FOIOFFICIAL24/25-0830 Standard Operating Procedure For Internal Use Only 3. Procedure

You must receive the AAT order from the Administrative Appeals Branch. If you receive documents from an external source, email s22(1)(a)(ii) - irrelevant material @ndis.gov.au to confirm the decision and for approval to overturn the decision.

3.1 Check AAT order is attached to inbound documents

1. In the NDIS Account screen: Select Documents.

2. Select Inbound Documents.

3. Has the AAT order been attached to Inbound Documents?

 If Yes: Go to Step 3.1.1: Update status of inbound document to completed.  If No: Go to Step 3.1.2: Attach AAT order to inbound documents.

3.1.1 Update status of inbound document to completed

1. If there is an open Inbound Document, make sure the Status is Completed.

2. In the NDIS Account screen: Select Internal Use.

3. In Internal Use: Select Open Activities.

4. In the Open Activities list: Select the Transaction Id associated with the inbound correspondence.

5. Select Edit.

6. In Status: Select Completed.

7. Select Save.

3.1.2 Attach AAT order to inbound documents

1. In the NDIS Account screen: Select Documents.

2. Select Add Items and then select Inbound Document.

3. In Description: Enter AAT Order – Access.

4. In Document Type: Select Others.

5. In Manual Document Type: Enter AAT Order – Access.

6. In Site Location: Select National Access Team.

7. In Status: Select Completed.

8. In Category 1: Select NDIA Service.

9. In Category 2: Select Other Correspondence.

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10. In Re: Business Process: Do not select any option (leave blank).

11. In Employee Responsible: Enter your details.

12. In Note: Record the specific document attached, how and when it was received.

13. Select Upload File.

14. In the File Explorer window: Open the relevant document.

15. Select Save.

3.2 Identify which eligibility requirements are met

1. Review the AAT order.

2. Identify whether the applicant met:

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 Section 21(2) – residence requirements under the NSW Prescribed Program Rules  Section 24 – disability requirements  Section 25 – early intervention requirements.

Note: If the order indicates that Section 21 (NSW Prescribed Program Rules) is met, refer to the Interactions screen. This should contain an Interaction from the AAT Team detailing the requirements that are met.

If you cannot determine which requirements are met, email the AAB team member and cc s22(1)(a)(ii) - irrelevant material @ndis.gov.au to seek clarification.

Note: The AAB team member is the person that either sent the email or attached the AAT order to Inbound Documents.

3.3 Add the interaction

1. In the Participant Lifecycle Management screen: Select Interactions.

2. Select the Arrow and then select Add Interaction.

3. In Category 1: Select Pathway.

4. In Category 2: Select Internal Review.

5. In Category 3: Select AAT Overturn – Access met.

6. In Channel: Select Internal Notes.

7. In Status: Select Completed.

8. In Notes:

As per AAT order attached in Inbound Documents, <Applicant’s name> meets access

meets the Age, Residence and <Disability / Early Intervention> requirements. I have

added a priority workflow identifier in the NDIS Business System.

Please consider for priority planning.

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9. Select Submit.

3.4 Generate/select the access application

3.4.1 If there is an existing open access application, select the application

1. In the NDIS Account screen: Select Pathway.

2. Select the open application.

3. Go to Step 3.5: Complete pathway tasks.

3.4.2 If there is no existing open application, generate a new access application

1. In the NDIS Account screen: Select Pathway.

2. Select Add Items and then select Access to create an application.

3. Go to Step 3.5: Complete pathway tasks.

3.5 Complete pathway tasks

Use the pre-populated information to complete the Pathway tasks and finalise the decision.

3.5.1 Complete enter the Access Request Form task

1. In Input Channel Manual Method: Select method access request was received.

2. Next to Are you living in Australia permanently?: Select Yes.

3. Next to Are you an Australian Citizen?: Select Yes or No.

4. Next to If NO, what type of visa do you have?: Select relevant visa.

5. Select Submit.

3.5.2 Complete validate request as complete task

You do not need to verify age and residence as the AAB team member is the delegate and the information is verified in accordance with the AAT order.

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1. Select Validate Access Request as Complete task.

2. In the Age and Residence sections: Select the appropriate Evidence Type, then select the Verified tick boxes.

3. In Access Request Complete Date: Enter the date of the AAT order.

4. Select Submit.

5. Once complete, re-assign the application to yourself.

3.5.3 Complete impairment assessment task

1. Select Impairment Assessment task.

2. In Impairment or Developmental Delay: Do not amend pre-populated primary impairment.

3. In What evidence was used to confirm the diagnosis?: Select the relevant evidence type.

4. Select the Verified checkbox.

5. Select Submit.

3.5.4 Complete determine the access decision task

1. Update all radio buttons to N/A.

2. In Override Access Decision: Select Yes.

3. In The Override Decision: Select Access Met.

4. In Reason Code: Select Disability Met or Benefit from Early Intervention.

5. Select Approve.

6. In the free text box:

As per AAT order attached in Inbound Documents, <Applicant’s name> meets the

Age, Residence and <Disability / Early Intervention> requirements.

7. If the decision is sent for quality checking, seek Team Leader approval to add it to the priority quality check spreadsheet.

3.6 Complete participant streaming task

It is important to complete this task correctly, as it is used to determine what support a participant requires to engage with the NDIS. The participant record will not progress to planning if you do not complete the participant streaming task.

3.6.1 Complete participant streaming task

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1. Select Participant Streaming task.

2. Refer to Step 3.3.1: Table One in SOP – Update Participant Streaming.

3. Under Record Additional Streaming Factors: Select Yes next to the relevant streaming factors.

4. Select Calculate Stream.

Note: The new stream will be displayed under Recommended Streaming in the Streaming Decision.

 If the recommended stream aligns with Table One streaming factors: Select Submit, go to Step 3.7 – Suppress letters.

 If the Table One streaming factors indicate a higher stream is required, go to step 5 to override the streaming decision.

5. Next to Override Streaming Decision?: Select Yes.

6. Select the appropriate stream.

7. In Justification for over-ride: Copy and paste relevant streaming factor from Table One.

8. Note: Do not select ‘yes’ for Self-Plan. This will make pre-planning tasks visible on the myPlace participant portal.

9. Select Submit.

Note: The application status will now display as On Hold-Contact Participant.

10. If you need to change streaming, you can adjust it by clicking on the Streaming tab, then More Items, then Restream.

3.7 Suppress letters

3.7.1 Suppress the ARF receipt letter and Kick Off letter

1. In the NDIS Account screen: Select Documents.

2. Select Outbound Documents.

3. Select ARF Receipt letter / Kick Off Letter.

4. Select Admin.

5. Select Suppress Document.

6. In Reason for suppression: Enter Letter not required.

7. Select Suppress.

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3.8 Communicate decision to the Administrative Appeals Branch

1. Email the AAB team member and cc s22(1)(a)(ii) - irrelevant material @ndis.gov.au to notify them that you have finalised the access decision.

Note: The AAB team member is the person that either sent the email or attached the AAT order to Inbound Documents.

2. If there is an AAT alert is on the record, do not update the end date. The alert should remain active and will be closed by the AAB team member.

3. You do not need to contact the participant to notify them that the decision has been processed. The appropriate AAB team member will notify them of the outcome.

3.9 Add workflow identifier: priority (High)

3.9.1 Add workflow identifier for priority (High)

1. In the NDIS Account screen: Select Details.

2. Select > next to Workflow Identifier.

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3. Select Edit.

4. Select +.

5. In Workflow Identifier: Select High.

6. In Valid From: Enter today’s date.

7. In Valid To: Leave as 31.12.9999.

8. Select Submit.

9. Related procedures or resources

 Our Guideline – Applying to the NDIS

5. Feedback

If you have any feedback about this SOP, please complete our Feedback Form.

6. Version control

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Version Amended by Brief Description of Change Status Date

1.0 TS0036 Class 2: NAR BM approval APPROVED 2021-09-08

MB0056 Class 2: SGP BM approval

New SOP including instructions to process an access decision overturned by an AAT order.

2.0 CH0026 Class 2: NARB BM approval APPROVED 2022-03-27

CW0032 Class 2: SGPB BM approval

Updates to align with new Our Guideline – Applying to the NDIS.

Step 3.6.1 – Complete participant streaming task: updated work instructions to make it easier to understand the next steps.

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