DOCUMENT 15

Leaving the NDIS

Quick summary: There are different reasons you might leave the NDIS. For most participants, it’s a choice to leave. You might not want to be a participant anymore because you’ve met your goals. Or you might not meet the eligibility requirements anymore. There are Insurance different processes for leaving the NDIS depending on the reason you’re leaving. If you leave, you’re no longer a participant, and won’t be able to get NDIS supports. NDIS supports are the services, items and equipment that can be funded by the NDIS. If you leave, we can Disabilitystill help you connect to other government and community services and if things change, you can apply again.

NationalWhat’s on this page? TheThis page covers: by

What do we mean by leaving the NDIS? Act - What if you don’t want to be an NDIS participant anymore?
What if you start getting supports from aged care services?
Are you still eligible for the NDIS?
What happens if we check your NDIS eligibility? Information of Freedom under released was document14 October 2024 Leaving the NDIS Page 1 of 26 This document is correct at the date of publication. This Page 540 of 910

How You Can Leave The National Disability Insurance Scheme (NDIS)

Overview

You can choose to leave the NDIS any time.

You’ll also leave the NDIS if:

You’re no longer eligible or if your NDIS status is revoked
Learn more about when you can be revoked as a participant.

Some participants will stay with the NDIS for their lifetime. Other participants may need the NDIS for a shorter period. The length of time you stay eligible depends on your individual situation and supports needed due to disability.

There are several situations where you might leave the NDIS:

Leaving the NDIS

You can fill in the Leaving the NDIS form. You can also email or send a letter to let us know that you want to leave the NDIS. You can also contact us if you’d like some help.

AgencyThere are services in the community you can contact if you need supports after you leave. A local area coordinator or early childhood partner can help you find local supports that aren’t NDIS supports. This includes mainstream and community services available outside the NDIS. Learn more about mainstream and community supports.

Insurance If you choose to leave, remember:

Your plan ends on the day you let us know in writing that you wish to leave.8
You can’t use your NDIS funding once you let us know in writing that you wish to leave.9
You’ll no longer be an NDIS participant.10

National If you want to become a participant again, you’ll need to reapply. If you reapply, there’s no guarantee you’ll become a participant again. You’ll need to meet all the eligibility requirements. This includes the requirement that you must be younger than 65 on the day you apply.11 Learn more about the eligibility requirements.

If we stop your NDIS plan because you ask to leave, you can’t ask for an internal review. This is because when you write to us and ask to leave the NDIS, the law says we need to:

remove you from the NDIS12,
end your plan, without us needing to make a reviewable decision.13

Learn more about what decisions can be reviewed.

What if you start getting supports from aged care services?

Aged care services are funded by the Department of Health Aged Care system14 and include residential aged care services and home care services.

Home care services are supports you can get to help with your daily life. They include things like personal care for you in your home. When we say home care services, we mean services funded by the Department of Health Aged Care system.

What if you move into residential aged care?

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You’ll Leave The NDIS If You Move Into A Residential Aged Care Service Permanently For The First Time After You Turn 65

When we say residential aged care services, we mean services funded by the Department of Health and Aged Care system.

The supports you get in residential aged care can be different from NDIS supports outside aged care facilities. Find out more about residential aged care services on the Department of Health and Aged Care website.

If you leave the NDIS because you move into residential aged care permanently, you can’t ask for an internal review. This is because the law says we must remove you from the NDIS without us needing to make a reviewable decision. Learn more about what decisions can be reviewed.

Example

Vish is 66 and is an NDIS participant. Vish was living by himself but decides to permanently move into residential aged care for the first time. The law says Vish then stops being a participant and he leaves the NDIS. The aged care system is now responsible for all Vish’s support needs. Vish can’t ask for an internal review of this decision. Vish also can’t become a participant again as he is older than 65.

What if you were already in residential aged care before you turned 65?

If you were already living in residential aged care before you turn 65, you can still be an NDIS participant after you turn 65. Learn more about younger people in residential aged care.

Once you turn 65, you can also choose to leave and get support from the aged care system instead. If you want to leave the NDIS, you’ll need to let us know in writing.

If you choose to leave the NDIS, you can’t ask for an internal review. This is because if you ask in writing to leave the NDIS, then the law says we must remove you from the NDIS without us needing to make a reviewable decision. Learn more about what decisions can be reviewed.

Example

At age 50 Jane permanently moved into an aged care facility. She was found eligible for the NDIS when she was 64. Jane is now 66. She can choose to stay in residential aged care but she decides to move out and live with her children.

Jane’s Story

Jane is still an NDIS participant, so she talks to her planner about her goal of moving out of residential aged care. Jane gives assessments and reports from her treating healthprofessionals, so we understand her capabilities and support needs.

Agency

Jane and her planner create a plan. Jane’s plan includes the NDIS supports Jane needs. She uses her NDIS supports to work towards her goal of living with her children.

What if you start getting home care services from the aged care system?

Home care services are supports you can get to help with daily life. They include things like personal care for you in your home. When we say home care services, we mean services funded by the Department of Health and Aged Care system.

You must leave the NDIS if you start getting home care services permanently for the first time after you turn 65.20 You can’t ask for an internal review. This is because the law says you must leave the NDIS when this occurs, without us needing to make a reviewable decision.21

Learn more about what decisions can be reviewed.

Home care services can be different from NDS supports. Find out more about home care services on the Department of Health and Aged Care website.

Example

Kirsty just turned 65 and is an NDIS participant. She uses her NDIS supports to fund 10 hours a week of personal care.

Since she turned 65, she’s now eligible for home care services with aged care funding. She must decide if she’ll start using these aged care services.

If she starts getting home care services with aged care funding permanently, she must leavethe NDIS. She can keep getting NDIS supports until she permanently gets aged care home care services or moves into residential aged care permanently.22

Are you still eligible for the NDIS?

There are different reasons for leaving the NDIS. This might happen if you’re no longereligible.

You’re no longer eligible for the NDIS if you:

don’t live in Australia anymore23
are no longer an Australian citizen or permanent resident24

No longer meet the disability requirements or early intervention requirements.
If we have information that tells us you might not be eligible for the NDIS anymore, we Agency may check your eligibility.

Learn more about What happens if we check your NDIS eligibility? Do you still live in Australia? Insurance

You’ll need to live in Australia to stay an NDIS participant.26 If you leave Australia permanently, you won’t be eligible anymore, and we may decide to revoke your participant status.27 Learn more about when you can be revoked as a participant. Disability

You’ll probably still meet the residence requirements if you leave Australia for a short time. If you’re temporarily outside Australia for more than 6 weeks in a row, you’ll usually still be an NationalNDIS participant but may not be able to use your NDIS funding.28 Learn more about when we suspend your plan. the byAre you still an Australian citizen or permanent resident?

To remain a participant, you’ll need to either:29 1982

Be an Australian citizen. Act
Have a permanent residency visa
Have a protected special category visa – this is only for some New Zealand citizens.

For example, you may have to leave the NDIS if your permanent residency visa is cancelled. Information If you joined the NDIS from a New South Wales prescribed program and your residency or of citizenship status changes, you’ll remain eligible for the NDIS.

Do you still meet the early intervention requirements? Freedom If you’re eligible under the early intervention requirements, your support needs are more the likely to change. We’ll check each time we reassess your plan whether you still meet the early intervention requirements. under If you’ve benefitted from early intervention NDIS supports, you might have built your skills and increased your capacity. You may no longer need NDIS supports.If you no longer meet the early intervention requirements, we’ll check if you meet the released disability requirements. was What happens when a child with developmental delay turns 6 years old? document14 October 2024 Leaving the NDIS Page 6 of 26 This document is correct at the date of publication. This

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Early Intervention Requirements

If we decided a child met the early intervention requirements because of their developmental delay, they’re usually no longer eligible after they turn 6.

AgencyThis is because they will no longer meet the eligibility criteria under developmental delay. To remain a NDIS participant after they turn 6, the child will need to meet the requirements for disability, early intervention, or both. This requires the child to have an impairment that’s likely to be permanent.

InsuranceWe’ll talk to families or carers before a child turns 6. We’ll explain what information we need to decide if the child is still eligible.Learn more about the disability requirements and the early intervention requirements.

Disability

Example 1

Sarah is 6 years old. Sarah was eligible for the NDIS under the early intervention requirements for developmental delay and has been receiving NDIS supports since age 4. TheNationalAt age 4, Sarah had problems with her speech. Her parents and other children couldn’t understand her, and Sarah found it hard to manage her frustration. At age 5, Sarah’s early childhood partner explained to her parents that Sarah would most likely leave the NDIS after she turns 6.

theBy age 6, Sarah achieved many of the goals her parents set for her, including improved speech, communication, social and cognitive skills. Sarah’s therapy provider reports she no longer needs early intervention supports.

Sarah’s early childhood partner talks to her parents about the NDIS eligibility requirements and explains that Sarah no longer needs NDIS supports. Sarah let us know in writing they want Sarah to leave the NDIS.

Sarah leaves the NDIS, she continues to receive mainstream, and community supports. For example, her teacher can help set up the supports she needs at school. Sarah also joins a gymnastic and dancing class.

If Sarah’s situation changes and she needs NDIS supports in the future, her parents understand they apply for the NDIS again.

Example 2

Ayesha was eligible for the NDIS under the early intervention requirements for developmental delay and has been receiving early intervention supports since she was 3. The releasedDuring check-ins, we have discussed Ayesha’s progress and reminded the family that Ayesha’s eligibility will be reassessed at age 6, this is because Ayesha will no longer meet the early intervention requirements under developmental delay once she turns 6. document14 October 2024 Leaving the NDIS Page 7 of 26 This document is correct at the date of publication. This

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For Ayesha to remain a NDIS participant after she turns 6

For Ayesha to remain a NDIS participant after she turns 6, she will need to meet the requirements for disability, early intervention, or both. This requires Ayesha to have an impairment that’s likely to be permanent.

Agency Ayesha is now 6 years old and has just started school. Ayesha’s parents are happy with her progress but would like her to be more confident when playing with her peers and interacting with adults. They think Ayesha needs ongoing support for her speech and communication.

Insurance At her plan reassessment, the evidence we have makes us think Ayesha is no longer eligible for the NDIS as there is no evidence to indicate that Ayesha has a condition that is likely to be permanent.

Disability We start an eligibility reassessment.

We send Ayesha’s family a letter. The letter explains that based on the information we have Ayesha may no longer meet the eligibility requirements. It explains, that if Ayesha’s family thinks she is still eligible, they need to provide us with evidence. The evidence needs to show that Ayesha meets the requirements for disability, early intervention, or both. Ayesha’s family is asked to respond within 28 days from the date of the letter.

Ayesha’s family send us a report from Ayesha’s therapy provider which confirms she has made progress towards her goals and Ayesha’s functional capacity has improved. It indicates that Ayesha still needs some help with her communication but that her school and parents can continue to support this. There are no other concerns with Ayesha’s development.

Based on the evidence we have we decided Ayesha no longer meets the requirements for disability, early intervention, or both. We talk to Ayesha’s parents about the NDIS eligibility requirements and explain that we have decided Ayesha is no longer eligible.

We send Ayesha’s family a letter explaining we have revoked Ayesha’s status as a participant. This means Ayesha will no longer be eligible and will leave the NDIS.

Ayesha is supported to leave the NDIS and gets ongoing support for her speech and communication from her school and her parents. They use the strategies Ayesha’s early childhood partner helped them put into place.

Do you still meet the disability requirements?

If you were eligible under the disability requirements, you’ll likely need NDIS supports for your lifetime. This means you won’t have to prove your NDIS support needs every time we change your plan.

If at any time your disability support needs or situation changes, we may need to check your NDIS supports or eligibility. We’ll contact you if this happens.

What happens if we check your NDIS eligibility?

We may check your eligibility if evidence suggests you may no longer be eligible. This could Agency mean you no longer meet one or more of the residence, disability, or early intervention requirements.

When you became a NDIS participant, you would have met the requirements for disability, Insurance early intervention, or from 3 October 2024, you may meet requirements for both disability and early intervention.

If you’re not sure which requirements you met, check the access decision letter we sent you Disability when we decided you were eligible. If you have been through an eligibility reassessment before and this was updated, you can find it in the eligibility reassessment outcome letter we sent you. You can also contact us.

National If we check, and it looks like you may no longer meet the eligibility requirements, we may thereassess your eligibility. We call this an eligibility reassessment. If we decide to start an byeligibility reassessment, we’ll let you know. We’ll give you the opportunity to give us more evidence about your NDIS eligibility. Learn more about How we let you know we’re doing an 1982eligibility reassessment.

ActAfter the eligibility reassessment process has finished, we’ll consider the information and decide if you’re still eligible. Learn more about How we decide if you’re still eligible for the NDIS.

You may have to leave the NDIS if you don’t provide us with the specific information, or the Information of evidence shows you don’t meet one or more of:  the residency requirements.

     the disability or early intervention requirements.30

Freedom the under releasedwas

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Eligibility Reassessment

If we start doing an eligibility reassessment, we’ll let you know that based on the evidence we have, we’re thinking about whether we should revoke your status as a participant. We’ll also let you know what eligibility requirements we don’t think you meet.

Will we ask you to provide evidence for an eligibility reassessment?

We’ll give you an opportunity to explain if you think you still meet these eligibility requirements. You can also give us any relevant information or evidence that shows this.

Sometimes if we don’t have enough evidence to make a decision, we will ask you for specific information or a report in a format that helps us to make a decision about your eligibility.31 We must tell you in writing when you need to provide this.32 We’ll only ask you to provide this specific information or report if we can’t reasonably get it in a different way33.

How much time will you have to give us more evidence?

The amount of time you will have to give us more information depends on the type of information we ask for. We will write to you to explain what we need and how much time you have.

Eligibility reassessment - 28 days

If we have evidence which indicates you’re no longer eligible, an eligibility reassessment will commence. We will send you a letter to explain why we think you are no longer eligible and give you 28 days to respond, if you think you still meet the NDIS eligibility requirements. If you don’t respond within 28 days, we’ll make the decision based on the evidence that we have.

Example: Eligibility reassessment – potential revocation of status as a participant

Pai is 6 years old. When she was 4 we decided she was eligible for the NDIS under the early intervention requirements for developmental delay. We developed a plan with Pai’s family with early intervention supports that are likely to benefit Pai. The early intervention supports Pai, and her family receive are NDIS supports. We have regular check ins with Pai and her family. This helps us understand Pai’s progress and the outcomes Pai has achieved. When Pai turns 5, we talk to Pai’s parents about the eligibility requirements. We remind them Pai’s eligibility will be reassessed once she turns 6. This is because Pai will no longer meet the eligibility requirements under developmental delay. To remain a NDIS participant after she turns 6, Pai will need to have an impairment that’s likely to be permanent. Pai will need to meet the requirements for disability, early intervention, or both. Because Pai is now 6 we start an eligibility reassessment.

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Eligibility reassessment – continuing to meet NDIS eligibility requirements

Example: Eligibility reassessments

Pai’s case:

We sent Pai’s parents a letter explaining that based on our information, Pai may no longer be eligible.
If they believe she still qualifies, they must provide proof showing her meeting criteria related to disabilities and/or early interventions within 28 days after receiving this notice.

The following day,

Her family contacted their paediatrician attempting to schedule an appointment but found out he wasn’t available until two months later due being away on holiday.
They provided confirmation details regarding said future consultation with him as requested documentation towards fulfilling these conditions.

Considering current circumstances we deemed it fair practice allowing additional time equaling those delays (i.e., also granting them another full month) before requiring further submissions from them concerning whether or not Paie continues satisfying necessary prerequisites under either category mentioned above during which period they eventually submitted relevant data confirming compliance status again thereby eliminating necessity for requesting anything else at present moment.

Eligibility reassessment - minimum 90-day window applies here too whereupon should specific types of verification materials become needed then appropriate requests shall follow suit accordingly while ensuring sufficient lead times afforded participants involved therein so long as such actions remain consistent throughout entire process without exception whatsoever.

Jo’s Case:

Jo is forty years old living with cognitive impairments resulting from stroke. Initially determined suitable candidate fitting into ‘early intervention’ bracket thus qualifying access NDIS benefits over past fourteen-month duration now seeking clarification about ongoing suitability thereof particularly focusing upon effectiveness achieved through utilization particular kind assistance programs designated specifically toward individuals experiencing similar challenges faced by her currently.

Initiating formal evaluation procedure,

Correspondence was dispatched informing Jo potentially facing loss eligibility standing unless she could demonstrate continued adherence standards outlined previously within twenty-eight calendar days post-receipt date specified thereon.

She replied submitting records obtained via consultation session held recently amongst medical personnel including input received directly from neurologist however insufficient detail contained inside those documents prevented definitive conclusion being drawn regarding actual level capability maintained nor potential future gains achievable solely relying upon existing support structures available today hence necessitating further investigation steps taken next stage forward involving resubmission request directed explicitly towards gathering additional information deemed essential making accurate determination possible going ahead thereafter.

To ensure proper judgment gets made we require confirmation coming straight out treating expert therefore another communication went back forth between parties concerned clarifying expectations placed onto recipient side ensuring clarity existed around what exactly needed done moving things along smoothly afterwards once all required components gathered successfully completed task assigned initially set forth earlier on schedule established beforehand.

evidence we need from their treating neurologist.
We only request reasonably necessary evidence from Jo. We don’t ask Jo to give us their whole medical record, or reports from every neurology appointment they’ve been to. Jo has at least 90 days from the date of the Agency letter to provide us with the report from their neurologist.
We support Jo to get the evidence we need in an approved form. We contact Jo to make sure they understand our letter and the evidence they need to provide. We also ask Jo to let Insurance us know if they need more time to send us the report. We may be able to give Jo more time if their request is reasonable. We won’t make a decision if Jo explains why, it is reasonable to not provide the report in 90 days.

Jo provides a neurology report within the 90 days. The report explains that while Jo has benefited from early intervention, they continue to have substantially reduced functional capacity and will require NDIS supports for their lifetime. We use this report to decide Jo is National now eligible for the NDIS under the disability requirements. We update Jo’s eligibility and help Jo build a new plan with NDIS supports for their current situation.

the by What if you need more time to give us evidence? If you think you need more time to provide the evidence or send us the report, let us know. 1982 We may be able to give you more time if your request is reasonable. You’ll need to tell us Act why you need more time, and how much time you need. For example, there could be a delay in getting information from your treating professional. If so, we could give you more time so you can get the information and send it to us.

Generally, we’ll only give you one extension of time each time we ask you for more Information information. This is because the first extension should give you reasonable opportunity to of give us the information. If you need another extension, you’ll need to explain why you need more time again and how much extra time you need.If you give us the information we have asked for, we’ll consider it and decide if you’re still Freedom eligible. We will ask you for more information if we need more to make a decision about your the eligibility.

35 How do we decide if you’re still eligible for the NDIS? under We’ll look at all relevant information against the eligibility requirements to decide if you’re still eligible for the NDIS. We’ll do this after: released  we let you know we’re reassessing your eligibility, and what specific eligibility requirements we’re looking at was document14 October 2024 Leaving the NDIS Page 12 of 26 This document is correct at the date of publication. This Page 551 of 910

we let you know what information we need to make our decision. We’ll only ask you to provide this specific information or report if we can’t reasonably get it in a different way.

you’ve had a reasonable opportunity to give us the information we asked for

we look at the information you give us.

Insurance The person who reassesses your eligibility and decides if you’re still eligible will be one of our staff. They will be different from the people who first decided that you’re eligible, and the people who approved your plans. They will also be someone who doesn’t have a personal interest in whether you’re a participant or know you, other than through the NDS.

Disability If there’s information and evidence that shows us you’re still eligible, you’ll remain a participant. You can keep using your NDIS supports.

National You may have been eligible under the early intervention requirements but give us evidence thethat shows you now meet the disability requirements. If so, we’ll change our records to show byyou now meet the disability requirements. This means we won’t revoke your status as a participant, and you will remain an NDIS participant.

1982 Act When can you be revoked as a participant?

After we have assessed your eligibility, there are some situations where you can be revoked as a participant, this includes where you have not provided the information we need.36 This means you won’t be a participant anymore and you’ll leave the NDIS.

We won’t make a decision to revoke your status as a participant if it was reasonable for you not to have provided the information in the agreed timeframe.37 We’ll consider:

The timeframe we gave you38 - The timeframe since we were last given relevant information about your eligibility39 Freedom of Information released document14 October 2024 Leaving the NDS Page 13 of 26 This document is correct at the date of publication. This Page 552 of 910

Eligibility Reassessment

If we check your eligibility, and evidence suggests that you may no longer meet the eligibility requirements, we will start an eligibility reassessment. We’ll let you know and give you the opportunity to provide us with more evidence about your NDIS eligibility. You’ll have an opportunity to respond in 28 days with the necessary information or request an extension of time to obtain the evidence.

We will look at the evidence you provide us44. If, based on the evidence we believe you’re not eligible, we will revoke your status as a participant.45

Example

Johan is 7 years old. When he was 3, we decided he was eligible under the early intervention requirements for developmental delay. Marita is Johan’s mother and child representative. We haven’t completed a check-in or plan reassessment in two years. This is because Marita won’t respond to us.

Marita self-manages Johan’s plan and can see the NDIS funding in Johan’s plan is being utilised. Because Johan is now older than 6 his eligibility needs to be reassessed. To remain a NDIS participant after he turns 6, we need to have evidence that Johan has an impairment that’s likely to be permanent, and he meets the requirements for disability, early intervention, or both.

We send Marita a letter. The letter explains that based on the information we have Johan may no longer meet the eligibility requirements. If Marita thinks Johan is still eligible for the NDIS, they need to provide us with evidence. The evidence needs to show that Johan meets the requirements for disability, early intervention, or both. Marita is asked to respond within 28 days from the date of the letter. We try to contact Marita using her preferred contact details several times. We don’t hear back within the 28 days. Marita hasn’t asked for more time to provide the evidence we need.

We make the decision based on the evidence already available and decide to revoke Johan’s status as a participant. We send Marita a letter explaining we have revoked Johan’s status as a participant. This means Johan will no longer be eligible and will leave the NDIS.

Revoking - when we’ve asked for specific information or a report

When we ask you for specific information or a report within 90 days, we will consider whether the information or report was sent to us on time, or within an agreed timeframe. If you don’t send us any information within 90 days, or within an agreed timeframe, we will revoke your access to the Scheme46.

We will also look at whether the information is in an approved format and an appropriately qualified person completed the assessment or examination.47

If you send us the information or report on time and in the correct format, we will use it to decide:

If we think you’re still eligible
If we need more information to make a decision. Agency What if you don’t agree with our decision? If you don’t agree with our decision to revoke your status as an NDIS participant, you should talk to us. Your planner, local area coordinator or early childhood partner can help explain our decision, answer any questions and explore next steps. You can also ask for an internal review of our decision to revoke your status as a participant. This means one of our staff, who wasn’t involved in the original decision, will decide if we made the correct decision. You’ll need to ask for an internal review within 3 months after we tell you in writing that we revoked your status as a participant. You can ask us to stop our internal review at any time. If you don’t agree with the internal review decision, you can then ask for an external review. This means the Administrative Review Tribunal will decide if we made the right decision. Learn more on the Administrative Review Tribunal website. If we decide you’re not eligible, you can apply again, unless you have requested a review of that decision and are waiting for a decision to be made. Learn more about internal and external reviews. What if you become a participant again because of an internal or external review? If an internal or external reviewer decides you’re eligible for the NDIS, you’ll become a participant again. You’ll become a participant again from the date you stopped being a participant. This means we’ll identify the plan you had when you stopped being a participant and put that plan back in place. This plan will continue until we reassess your next plan. In some situations, you can claim the cost of the NDIS supports you purchased during the period your participant status was revoked. This is the period between the day:
you stopped being an NDIS participant
you became a participant again because of the internal or external review decision. You can only claim funding for NDIS supports purchased when you stopped being an NDIS participant if:
they were in your plan – the plan that was in place when we revoked your status as a participant

there is enough funding remaining in that plan
you have proof of buying and using the supports, such as a receipt Agency
you claim them within 60 days after you become a participant again.

If your NDIS supports are self-managed or plan-managed, you or your plan manager can claim the funding for NDIS supports as usual. If your NDIS supports are agency-managed, contact us so we can help you claim the funding for NDIS supports. Learn more about ways to manage your funding.

Example

Charlie is a participant and was eligible for the NDIS under the early intervention requirements.On 1 July, we decide Charlie isn’t eligible for the NDIS anymore and revoke their status as a participant. We have information that shows Charlie no longer meets requirements for the disability or early intervention. Once Charlie’s status as a participant ends they can no longer use their NDIS supports.

Charlie asks for an internal review of this decision. They also give us new evidence from their doctor and specialists about their impairments, functional capacity and support needs. On 1 September, the internal reviewer decides to set aside the decision to revoke Charlie from the NDIS. This means Charlie is eligible for the NDIS and becomes a participant again.

We treat Charlie as if they were a participant the whole time. This means we put back the plan that existed when their status as a participant was revoked. Charlie’s reinstated plan will remain until it’s replaced by a new plan at their next plan reassessment.

Charlie kept using their supports in July and August after their participant status had been revoked. Charlie paid for these supports with their own money and kept the receipts. Charlie can’t claim every support but can claim NDIS supports that were in the NDIS plan before their participant status was revoked.

Charlie self-manages their funding, so they claim the amount they paid for NDIS supports included in their plan on the my place portal.

What happens after you leave the NDIS? When you leave the NDIS, you’re no longer a participant and your plan will stop.55 We can’t fund any NDIS supports after you leave.56

We can help you sort out your final payment requests. If you want help, talk to your local area coordinator, early childhood partner or planner. You can also contact us.

What happens when a participant dies?

We recognise the importance of supporting family, carers and support networks when a participant dies.

To give the best support we can during this difficult time, we have specialist staff who can help you work through any remaining NDIS matters. Learn more about how we can help after a participant dies.

When we say ‘you’ in this section, we mean someone who is a verified contact of the participant in our system and is looking after the participant’s matters after they’ve died.

You might be a:

spouse
nominee
parent or child representative
court appointed trustee or guardian.

It’s important you tell us when a person dies, as they’re no longer an NDIS participant, and we’ll need to finalise their NDIS record.57

You can contact us in person, or by phone, email or letter when the participant dies. Or you can fill in the Leaving the NDIS form.

We’ll ask for the participant’s date of death. We’ll also ask who the executor of the estate is if you have this information. This is the person who will be managing the participant’s estate. We use this information to help us finalise the participant’s NDIS record. This means we’ll end the plan and stop their NDIS supports.

We know this is a difficult time. Where appropriate, we’ll offer support to help you work outwhat you need to do to finalise matters relating to the participant’s plan after they die. You can reach out to a local area coordinator, early childhood partner or planner. You can also contact us.

Learn more about what to do when someone dies.

What happens to a participant’s NDIS funded supports when they die?

The participant’s plan ends the day they die. We can’t fund any NDIS supports purchased or Agency supplied after this date. If the participant’s plan manager uses NDIS funds to purchase supports after this date, the plan manager will need to repay us.

Also, an NDIS provider will need to repay us if they receive a payment they are not entitled to after the participant’s death.

For example, the participant may have funding for cleaning services in their NDIS plan. A provider can’t claim this funding to purchase cleaning services after the participant dies. Ifthe provider claims the funding, it will need to be repaid to the NDIS.

Sometimes we can pay for NDIS supports that were arranged or ordered in writing before the participant died that haven’t been paid yet. For example:

return and payment for rented assistive technology, where the costs are covered by a service agreement entered before the participant died.

assistive technology that has been purchased by the participant but not paid for or delivered – when it fits with the pre-payments guidance of the Pricing Arrangements and Price Limits

home or vehicle modifications that were started but haven’t been finished.
services that were purchased and provided before the participant died.
cancellation fees covered by a service agreement.

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What Happens When A Participant Dies

Ownership Of Assistive Technology Items

If The Participant Owns An Item

If the participant owns an item, then when they die, it becomes part of their estate and the person who manages this estate will decide what happens next.

If The Participant Rents Or Leases From An Ndis Provider

In cases where a rental or leasing arrangement exists between the participant and an NDIs provider:

You must return any rented assistive technology equipment to that same provider because ownership remains with them even after death.
This rule applies whether one single piece of assistance tech was leased out individually or multiple items were obtained via shared resources like loan pools or libraries.

Insurance And Early Return Costs Covered By Us

When there’s been agreement regarding early returns within service contracts we’ll help cover associated expenses including but not limited too:

Fees incurred due to returning things ahead schedule;
Shipment/delivery charges related backtracking process.

Handling Undelivered Orders After Death

Should someone pass away prior receiving ordered goods which had already been scheduled under their plan, we’d still honor initial payments made towards those purchases provided two conditions hold true simultaneously:

Those costs align closely enough against guidelines set forth by our pricing arrangements & limits policy document;
Ordering occurred definitively before passing event took place. Once full payment has cleared through system verification, then said technologies become assets belonging solely unto deceased individual’s inheritors now.

Assistance Animals/Dog Guides Considerations

Those managing estates might want consult directly about handling matters concerning companion animals trained specifically for support roles (like guide dogs). They should review existing agreements carefully and possibly reach direct contact points established earlier during care planning phases involving these specialized pets’ ongoing management posthumously.

Home/vehicle Modifications Post Mortem Management

Managing modifications done previously on behalf of departed individuals requires coordination efforts between current estate administrators alongside original contractors who performed such works initially. Generally speaking though, claims relating home or vehicle alterations can continue being submitted toward NDIS funding sources assuming all necessary steps were completed successfully beforehand - especially when final installments haven’t yet reached completion stage at time death occurs unexpectedly. In situations where approvals weren’t fully realized due to untimely demise happening mid-project phase discussions around alternative resolutions must occur promptly amongst involved parties following parameters outlined within active service contracts currently governing respective modification projects.

What happens after someone dies

This may mean completing modifications to make the building or vehicle safe and suitable for more general use. But if the modifications continue, they shouldn’t include specific features required by the participant who died.

Agency

Remember, we can help you work out what to do about the participant’s plan after they die. You can reach out to a local area coordinator, early childhood partner or planner. You can also contact us.

Insurance

What can service providers claim?

Service providers can claim for NDIS supports purchased before the participant’s death under a service agreement. They have 90 days from the participant’s date of death to make a claim.

If the funding was plan managed, the plan manager will need to claim any funding for NDIS supports purchased before the participant’s death. Plan managers can claim the plan management fee for the month of the participant’s death for this purpose, if this forms part of their service agreement.

When can providers claim cancellation fees? In some situations, providers can claim a cancellation fee if they had short notice of the participant’s death. Providers can claim the fee according to the conditions in the service agreement and the Pricing Arrangements and Price Limits.

If the participant lived in Specialist Disability Accommodation, the Specialist Disability Accommodation provider can claim vacancy costs in some situations. We have more information in the SDA Pricing Arrangements and Price Limits.

Information of Do we disclose information about a participant’s death?There are some situations where we may disclose information about the participant’s death. For example, we may need to disclose this information to:

finalise outstanding service bookings.
help arrange removal or disposal of assistive technology.
stop delivery services.

We can only disclose information about the deceased participant in certain situations, where it’s in the public interest to do so.60

We may disclose information when:

there is no reason to think the deceased participant wouldn’t want their information disclosed.
the information is needed for a genuine reason, such as to help administer the deceased participant’s estate.
the information isn’t available from another source.

The people we may talk to include:

a family member, guardian or support person. - a correspondence nominee, plan nominee or child representative.
a service provider that was providing NDIS supports to the participant – they will need to know as soon as possible since they can’t claim funding after the participant dies.
an executor administering the estate.
a Commonwealth, State or Territory department or authority.
a lawyer or legal representative that was supporting the participant.

If you have any questions about why we’ve disclosed details about the participant’s death, you can always contact us.

Appendix A: New South Wales prescribed programs

We may have decided you were eligible because you had support from one of the following Agency programs in New South Wales. If so, you will remain eligible for the NDIS even if your residency or citizenship status changes. This also includes if you were eligible under one of these programs, but now live in a different state or territory. Insurance These programs were provided to residents of New South Wales and were administered by the New South Wales Department of Family and Community Services for people younger than 65. Disability New South Wales programs:

Large Residential Centres

Large Residential Centre/Institution. The Group Home by
Small Residential Centre/Institution.
Group Homes. Community High
Hostels.
Attendant Care.
In-home Accommodation Support. of
Alternative Family Placement. Other Accommodation Support. Information The
Therapy Services for Individuals.
Early Childhood Intervention. under
Behaviour/Specialist Intervention.
Counselling. Freedom Regional Resource and Support Teams. The
Case Management, Local Coordination and Development. released
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Community Access
Learning and Life Skills Development.
Recreation/Holiday Programs.
Other Community Access.Respite
Own Home Respite.
Centre-based Respite/Respite Homes.
Host Family Respite/Peer Support Respire.
Flexible/Combination Respite.
Other Respite.

Community Care by

Domestic assistance.

Act

Social support.
Nursing care received at home or at centre/other.
Allied health care received at home or at centre/other by intervention type.
Personal care.

Information of

Other food services.
Respite care.

Freedom
the

Assessment including screening (client).
Assessment including screening (carer).
Case management.
Client care coordination (client).
Client care coordination (carer).

under

Home maintenance.

was

Counselling/support, information and advocacy (client).
Counelling/support, information and advocacy (carer).

Meals received at home or at centre/other.
Goods and equipment (self-care aids, support and mobility aids, communication aids, Agency aids for reading, medical care aids, car modifications, other goods/equipment).
Formal linen services.
Transport - Client – number of one-way individual or group trips by purpose. Insurance
Home modification.

Commonwealth programs Disability

Better Start for Children with Disability.
Disability Employment Assistance: Australian Disability Enterprises. National
Helping Children with Autism. the Younger Onset Dementia Key Worker Program. on to by 1982 Act Information of Freedom the under released document14 October 2024 Leaving the NDIS Page 24 of 26 This document is correct at the date of publication. This Page 563 of 910

Reference list

Agency11

2 NDIS Act s 29(1)(d). 3 NDIS Act s 29(1)(b). 4 NDIS Act s 29(1)(b). 5 NDIS Act ss 29(1)(c), 30, 30A6 Insurance NDIS Act s 29(1)(a). 7 NDIS Act s 29(1)(d). 8 NDIS Act ss 29(1)(d), 37(3)(c). 9 NDIS Act ss 29(1)(d), (2). 10 NDIS Act s 29(1)(d).11 Disability NDIS Act s 22. 12 NDIS Act s29(1)(d). 13 NDIS Act ss 99, 100. 14 NDIS Act s 29(1)(b); Residential care service has the same meaning as in the Aged Care Act 1997.15 NDIS Act s 29(1)(b). National 16 NDIS Act s 29(1)(b); Residential care service has the same meaning as in the Aged Care Act 1997. 17 NDIS Act ss 29(1)(b), 99, 100. The 18 NDIS Act s 29(1)(b). By 19 NDIS Act ss 29(1)(d), 99, 100. 20 NDIS Act s 29(1)(b).21 NDIS Act ss 29(1)(b), 99, 100. 1982 22 NDIS Act s 29(1)(b). 23 NDIS Act ss 23(1)(a), 30(1)(a). Act 24 NDIS Act ss 23(1)(b), 30(1)(a). 25 NDIS Act ss 24, 25, 27, 30(1)(b)(i)-(ii). 26 NDIS Act ss 23(1)(a), 23(2), 30(1)(a). 27 NDIS Act ss 23(1)(a), 23(2), 30(1)(a). 28 NDIS Act s 40.29 NDIS Act s 23(1)(b). Information 30 NDIS Act ss 30(1)(b), 30A(1)(a)(b). 31 of NDIS Act s 30(3)(b) 32 NDIS Act ss 30(3AA), 30A(5AA) 33 NDIS Act ss 30(3A), 30A(5A) 34 NDIS Act ss 30(4)(b), 30A(6)(b)35 NDIS Act s30(4)(c) Freedom 36 NDIS Act s 29(1)(c) 37 NDIS Act s 30(6) The 38 NDIS Act ss 30(6A)(a), 30A(7A)(a) 39 NDIS Act ss 30(6A)(d), 30A(7A)(d) 40 NDIS Act ss 30(6A)(b)(c), 30A(7A)(b)(c) Under 41 NDIS Act ss 30(6A)(e), 30A(7A)(e) 42 NDIS Act ss 30(6A)(f)(g), 30A(7A)(f)(g) 43 NDIS Act ss 30(7)(8), 30A(8)(9) 44 NDIS Act s 30(3)(a)45 NDIS Act ss 30(1), 30A(1) Released 46 NDIS Act ss 30(5), 30A(7) 47 NDIS ss 30(3)(b)(i)(ii) Was 48 NDIS Act ss 30(4)(a)(b) 49 NDIS Act s 30(4)(d) 50 NDIS Act s 100.

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