DOCUMENT 31
Understanding an internal review
This article provides guidance for all NDIA staff and partners to understand:
- what is a request for an internal review
- who can submit a request for internal review
- when can an internal review request be submitted
- what happens once a request for internal review is submitted
- how internal review requests are prioritised.
Recent updates
3 April 2025
Minor update to reflect change to article title: Create an internal review (s100) for all PACE decisions and SAP CRM access not met and statement of support decisions excluding compensation to Submit a request for an internal review (s100).
What is a request for an internal review
If an applicant or participant is unhappy with an NDIA decision, they can sometimes ask us to review our decision. This is called an internal review. The Reviews branch manages internal reviews. A delegate who didn’t make the original decision will complete the internal review.
The Review Officer considers the evidence and information related to the decision, then decides to either:
- set aside the original decision (make a new decision)
- vary the original decision (make some changes)
- confirm the original decision (make no changes).
Not all NDIA decisions are reviewable. The list of reviewable decisions is under section 99 of the NDIS Act (external). The most common decisions that can be reviewed are:
- Access not met (s 99(1) - 1). A person requests access to the NDIS, but we decide they don’t meet the access criteria to become a participant.
- Access revoked (s 99(1) - 3). A person was once a participant of the NDIS, then had an eligibility review and was found not to meet the access criteria. So their status as a participant was revoked.
- Statement of supports (s 99(1) - 4). A participant is unhappy with the NDIS funded supports in the approved plan, the plan duration or the plan management decision.
- Not to review a plan (s 99(1) - 6). The participant has requested a variation to their plan under s47A of the NDIS Act and the NDIA decided not to vary that plan.
You can learn more in Our Guideline - Reviewing our decisions (external)
Who can submit a request for internal review
A directly affected person with authority can request an internal review. For most cases relating to a participant, a directly affected person can be:
- an applicant that had an access not met or access revoked decision
- a participant that doesn’t agree with a reviewable decision about their plan
- an appointed nominee or child representative of a participant that doesn’t agree with a reviewable decision about their plan
- a person affected by a decision to appoint, not appoint, suspend or revoke nominee or child representative status.
Other directly affected persons can include:
- providers affected by an NDIA decision specifically relating to a provider
- a person affected by an NDIA decision relating to debts.
A person with valid authority or consent may request an internal review on the behalf of a directly affected person. Authority can take the form of valid child representative, nominee or guardian permissions. Otherwise, we need consent from the directly affected person, preferably in writing. This can include:
- a consent form signed by the directly affected person
- an email confirming the directly affected person giving their consent to lodge the review
- an internal note documenting a telephone conversation with the directly affected person where they provided consent.
You can learn more in Our Guideline - Your privacy and information (external).
A directly affected person or their representative can submit a request for an internal review. Use the Request for a Review of a Decision form (external). They can also ask in person or on the phone, or by sending a request by letter or email.
When can an internal review request be submitted
A request for an internal review must be made within 3 months of receiving the original reviewable decision. We can’t conduct an internal review if a person requests one more than 3 months after the date of the original reviewable decision.
We may need more evidence or supporting documentation to consider a request for additional supports. Communicate this to the requestor when submitting an internal review request.
To create an internal review, refer to Submit a request for an internal review (s100).
What happens once a request for internal review is submitted
When an internal review request is submitted, PACE sends an automated acknowledgement letter using the preferred communication method to confirm we’ve received the request.
Note: if the participant has a statutory guardian and the relationship is established with an organisation account, you’ll need to manually send the auto-created Internal Review Acknowledgement letter to the statutory guardian. To do this, go to article Send a letter to a statutory guardian or trustee.
If the review request is not considered valid, the Reviews branch will discuss other
options and next steps with the person who requested the review. This may be because the request:
- was lodged by an unauthorised person
- doesn’t relate to a reviewable decision, or
- was submitted more than 3 months after the original decision.
If the request is valid, the request will be assigned to a Review Officer.
The Review Officer will contact the person who requested the review to acknowledge the request and to clarify aspects of the internal review.
The Review Officer will review the facts, laws and NDIA policies related to the original decision. They will determine what the correct or preferable decision is. The Review Officer will also consider any new information provided.
The Review Officer aims to complete the internal review within 60 days as outlined in the Participant Service Guarantee (external). The Review Officer will provide the outcome and reasons for the internal review decision in writing.
How internal review requests are prioritised
redacted: s47E(d) - certain operations of agencies
For more information, refer to article [Escalating a request for internal review (s100)](#).