NDIA Accountability Project

This project is in DRAFT

IRT - Complete an internal review of a decision to vary impairments categories information

‹ PrevPage 1 of 12 · Source p. 179Next ›

DOCUMENT 10

IRT - Complete an internal review of a decision to vary impairments categories information.

This article provides guidance for an internal review officer to complete an internal review of a decision to vary Impairments categories information.

Recent updates

7 July 2025 Name change and language updates.

Before you start

You have:

  • read Our Guidelines - Applying to the NDIS (external), including sections:
  • What happens after we decide?
  • How do we weigh evidence of disability?
  • What happens after we decide?

Conduct a desktop review

An initial assessment of the internal review should be completed using the information available on the participant’s record in PACE.

Review the participant’s record

From the Person Account:

  1. Take note of any Alerts.
  2. Within the Details tab, confirm the Identity Confirmation Status. Refer to article Understand the identity confirmation status.
  3. Review the Disabilities tab in the Person Account to consider what disabilities met the requirements for disability, early intervention, or both.

Review the participant’s impairment categories

Review and take note of the participant’s current Impairment Categories. To review the participant’s Impairment Categories:

  1. Follow the steps in the article View Impairment Categories in the Person Account.
  2. Take note of the participant’s Approved Impairment Categories.

Review the request details

From the Internal Review Case:

  1. Review the Details tab.
  2. Review the Request tab.

Validate consent

From the Person Account:

  1. Select the Relationships tab.

  2. From the Authorised Reps tab, in Roles & Relationships, confirm the person who requested the review is listed as an Authorised Person with a Status of Active.

  3. Select Check Authorities to make sure the Submit request to review a decision made by the NDIA (S100) box is selected. If a person has the correct roles and authorities, you can continue to the heading Contact the participant. If the person does not have the correct authorities, continue to step 4.

    Note: Select the Relationships tab for relationship details and parental responsibility when completing an internal review for a child.

  4. Make one attempt to contact the participant, or their authorised representative to seek consent for the internal review to proceed. This attempt requires an SMS and either a phone call or email. If contact is successful and consent is not provided, or contact is unsuccessful and you are unable to obtain consent, proceed to step 6.

  5. Send the Internal Review Unauthorised Request Letter. Refer to the article IRT – Sending a manual letter.

  6. Cancel the Internal Review Case. Refer to the heading Cancel an Internal Review Case in the article IRT - Withdraw or cancel an internal review.

Contact the participant

You will need to contact the participant to clarify their request and gather additional details.

When completing an internal review, the participant must be part of the decision-making process.

When contacting a participant or authorised representative, you must first check their preferred communication method and authorisations. Refer to the article Check a person’s preferred contact method for further information.

When contacting a participant, or authorised representative, you must also log an Activity. Activity types include:

  • SMS messages
  • phone calls
  • emails
  • face-to-face meetings.

Refer to article [Log an activity or internal note](Log%20an%20activity%20or%20internal%20note) for guidance on creating case activities.

As the Reviews Branch is a virtual team with a limited footprint, we do not include face-to-face meetings as part of the standard service offering. If a face-to-face meeting is requested, the review officer must discuss and explore other options, such as engaging with advocates/authorised representatives, interpreting supports, and organising specific times to call. If it is determined that a face-to-face meeting may be necessary, seek assistance from your line manager to identify a pathway forward.

If during contact, there is a media threat, advise your line manager who will contact the Media Team and advise of any follow up action if required.

Phone

If the participant’s preferred contact method is by phone:

  1. Make one contact attempt. This attempt requires a pre-call SMS. Refer to Appendix 1 – SMS process. If contact is unsuccessful, leave a voicemail (if possible) and refer to the article IRT – Unable to contact process.

  2. If contact is successful begin by:

    • Stating your name, advising you are from the NDIA.
    • Verifying the identity of the person you are calling. Refer to the article Understand how to verify identity documents.
    • Acknowledging the type of internal review.
    • Listing the documents received that will be considered as part of the internal review.
    • Confirming whether the participant would like to supply further information, and if so, refer to the article IRT – Requests for further information. If they do not wish to provide further information, advise them the review will progress based on the available information.

  3. Confirm their preferred method of contact for the internal review outcome notification.

  4. Remind the participant of the support pathways available via their Local Area Coordinator, Early Childhood Partner and/or Support Coordinator, the contact centre, and local NDIS office. This will assist with connecting to mainstream supports and gathering and submitting information for their internal review.

Email

If a participant’s preferred contact method is email:

  1. Send an email. Refer to Appendix 2 – Email process.
  2. The next business day after the introduction email timeframe has lapsed, if there has been no response, proceed with the review based on the information available.

Mail

If a participant’s preferred contact method is mail:

  1. If appropriate send the Internal Review Request for Information Letter to the participant’s listed address and request a reply within 14 days. Refer to the article IRT – Sending a manual letter.

  2. The next business day after the request for further information letter timeframe has lapsed, if there has been no response, proceed with the review based on the information available.

Review the application

Review the evidence

  1. From the Person Account, select the Documents tab.
  2. From the Internal Review Case, select the Evidence tab.

Note: make sure you review all evidence in the Internal Review Case and Person Account.

Make a decision

  1. Using the available evidence, decide what impairments meet the requirements for disability, early intervention or both.

    Note:

    • you will also need to consider if there are any other impairments that meet the requirements for disability or early intervention, including developmental delay (under early intervention) for a child younger than 6.
    • if you need to add or remove any impairments from the Disabilities tab, this will be completed in a later step.
    • if you decide that the participant no longer meets the access requirements for disability, early intervention, or both, continue to the heading Record your decision and make a decision to not vary the categories of impairments. You must also refer the participant for an eligibility reassessment by following the steps in the article Complete an eligibility reassessment referral, making sure you only use sections Create the Eligibility Reassessment case and Complete the eligibility reassessment referral. If the participant has been on the scheme for less than 12 months, you can create the eligibility reassessment referral, however an eligibility reassessment can’t

commence until 14 months after the initial access decision.

  1. Use the article Impairment categories guide to help you decide which categories apply for all eligible impairments that meet the requirements for disability, early intervention, or both.

  2. Search the ICD Code or Condition name for all eligible impairments.

  3. Note the impairment listed in the Required impairment category column and consider if any of the Optional impairment categories meet the requirements for disability, early intervention, or both.

Record your decision

From the Internal Review Case:

  1. Select the Decision tab.
  2. From Request for PACE Decisions, select Pending Decision. The RORD Request will open on a new screen.
  3. Select Make a Decision.
  4. From the Decision view, complete the mandatory fields.
  5. Select Next – Justification.
  6. From the Justification view, select relevant Justification and Sub-Justification.
  7. Select Next – Evidence.
  8. From the Evidence view, complete mandatory fields for evidence.
  9. Select Next.
  10. From the Confirmation view, select Done.
  11. Return to the Internal Review Case and from the Decisions tab select Submit Decisions.
  12. From the Confirmation view, select Next.
  13. From the Summary view, select Done.
  14. From the Decision tab, select Confirm manual letter has been sent.
  15. From the Confirmation view, select the appropriate option.
  16. Select Next.

  1. From the Decision Letter Sent view, select Next. You will now be returned to the Internal Review Case.

  2. Send the decision outcome letter, refer to the article IRT – sending a manual letter.

  3. The participant or their authorised representative who requested the review will need to be informed of the outcome. Refer to Appendix 3 – Communicate an outcome for guidance on communicating the decision outcome.

Complete closure tasks

From the Internal Review Case:

  1. From the Log Activity view, create an Internal Communication to note the decision has been made using the correct template from. Refer to article [Log an activity or internal note](Log%20an%20activity%20or%20internal%20note) for guidance on creating case activities.

  2. From the Details view, in the banner, select the Complete Case button.

  3. At Closure Reasons options, from the drop down menu, select Completed.

  4. Closure comments can be added to advise of the decision

  5. Select Confirm and then select Done.

  6. From the Person Account navigate to the Cases tab and check Open Cases to see if any other cases relevant to the internal review have a status of New or In Progress. These cases can be Closed or marked Completed if there is no further action required.

Check the Disabilities tab

The Disabilities tab in the Person Account must include all disabilities that meet the requirements for disability, early intervention, or both, as this supports planning.

There may be disabilities that you need to add or remove.

  1. From the Person Account, select My Profile.
  2. Select the Disabilities tab.
  3. Review Active status to see what disabilities are current.

  1. If required, use articles Update a person account to:

    • add disabilities that meet the eligibility requirements
    • remove any disabilities that don’t meet the eligibility requirements by adding an End Date.

Check the participant’s Approved Impairment Categories

To check that the participant’s Impairment Categories have updated correctly in line with your decision:

  1. Follow the steps in the article View Impairment Categories in the Person Account.
  2. Review the participant’s Approved Impairment Categories. Make sure that these have updated correctly.

Note: if the Approved Impairment Categories do not match your intended decision outcome, please speak to your team leader.

Appendix

Appendix 1 – SMS Process

All contact methods and attempts require internal review officers to send a text message to the participant.

When sending an SMS:

  • Make sure the SMS is sent one hour before contact is made.
  • Consider appropriate contact times based on varying time zones, gazetted public holidays, and other relevant factors such as school drop off and pick up times.

For every SMS sent, make sure you log an activity to record your SMS contact and include the following:

  • which SMS template was sent
  • why the SMS was sent
  • details of who the NCC need to direct the call to if the SMS sent asks the person to call us.

Refer to article [Log an activity or internal note](Log%20an%20activity%20or%20internal%20note) for guidance on creating case activities.

Send an SMS

In PACE:

  1. From Open Cases, select the case you want to send an SMS from.

  2. From the Activity panel, select Send SMS. The Mobile Number will populate from the Person Account.

    Note: If you’re sending an SMS from the case you’re working in, it will use the mobile number on the person account linked to that case. If the person has an authorised representative, the mobile number won’t populate from the authorised representative’s account. For more information regarding this, refer to the heading Understand who an SMS will send to in the article Send an SMS in PACE.

  3. At Select an SMS Template, select the type of SMS you want to send from the drop down list.

    • Unable to contact
    • We are going to call you.

    Note: You have an appointment and You have missed an appointment SMS templates are not used in the internal review process.

  4. Select Next.

  5. Review the message in Preview of SMS. If the message:

  • Is correct, select Send SMS. Progress to step 6.
  • Needs to be changed, select Select another template. Go back to step 3.
  1. Once the SMS has successfully been sent, select Finish.

Appendix 2 – Email

To send an email in PACE, navigate to the Activity window:

  1. Select the Email tab.
  2. In From, select the account you would like to send your email from. Note: participant contact must be sent from enquiries@ndis.gov.au.
  3. In To, enter the email address, or addresses, you would like to send your email to. You may select the Cc button if you would like to add the Cc field.
  4. In Sensitivity Label Category, select the appropriate classification.
  5. In Subject, enter the subject of your email.
  6. Complete body of the email, using the IRT – Internal review email templates as required.
  7. Select Send.
  8. Document the email contact as an Internal Communication. Refer to article [[Log an activity or internal note](/foi-library/releases/23fb25e35a95-foi-24-25-0519-decison-document/document-001__log-an-activity-or-internal-note/)](Log%20an%20activity%20or%20internal%20note).

Appendix 3 – Communicate an outcome

The participant, or their authorised representative who requested the review will need to be informed of the outcome. This includes information about how and why the decision was made, where to seek further assistance if required and their review rights. You must document this contact as an Internal Communication. Refer to the article Log an activity or internal note.

When contacting a participant, or authorised representative, you must first check their preferred communication method. Refer to article Check a person’s preferred contact method.

If making phone contact, refer to article Guide - Conversation style guide for guidance on how to have authentic and engaging conversations.

Phone

  1. Make one attempt to contact the participant. This attempt requires a pre-call SMS. Refer Appendix 1 – SMS process. If contact is unsuccessful, and if the internal review is a priority or escalation, further outcome contact attempts may be required.

  2. If contact is successful begin by:

  3. Communicate the outcome of the decision by explaining:

    • what evidence was reviewed
    • the reasons for the decision, referencing the appropriate legislation and guidelines.

  4. Explain that there is no change to the participant’s eligibility for the scheme, and if the participant feels their funded supports no longer meet their supports needs, they can contact their my NDIS contact to discuss their plan.

  5. Advise the participant of their Administration Review Tribunal (ART) rights. Explain that ART applications must be lodged within 28 days of the internal review decision date. A Disability Advocate may also be able to help them with lodging an external review. Refer them to the ART website or provide the ART phone number if required (1800 228 333).

  6. Advise a written notice of the decision will be issued by mail or email. Refer to article IRT – Sending a manual letter.

Email

Send an email with the outcome internal review letter attached. Refer to Appendix 2 – Email process and article IRT – Sending a manual letter.

Mail

Send the outcome internal review letter to the participant’s mailing address. Refer to article IRT – Sending a manual letter.