The General issues around the implementation and performance of the NDIS

My name is James Wood, I’m a 54 year old adult who has lived with a spinal cord injury since 1985 after a workplace injury.

For the last 30 years I have been self funded, I was able to find employment and basically get on with life after the injury.

The roll out of the NDIS has been an incredibly positive experience for me. I have received funding for some equipment and allied health support that previously I have had to budget and save for and in some cases put off or not even consider due to cost factors.

However I feel that the system still needs some fine tuning for participants such as myself who choose to self manage.

My biggest concern is the justification of “Reasonable and Necessary” when it comes to the approval of funding for equipment.

My example on this is that I maintain a reasonable level of fitness, I value my independence and to help me with this I force myself to exercise as often as possible. I use a hand powered 3 wheeled bike (Handcycle) on a set of rollers for 30-90 minutes each day.

This promotes good cardio fitness and maintains shoulder and arm strength.

My current bike is 17 years old and in constant need of repair and maintenance.

I would like to purchase a new bike and have asked NDIS for funding now on two separate planning meetings. It has been denied on the basis of not being reasonable and necessary.

I disagree with this as it is something that I use on an almost daily basis, and it adds to my health and fitness more than any other activity or piece of equipment that I currently use.

I have been told to make a new submission supported by OT and other allied health professionals recommendations. My OT has advised that this will take 15 hours of time (Billed to me)

I guess the point I’m trying to make is that for some NDIS participants that know what works for them and have investigated the options for replacement or upgrading this equipment without having to “Prove” that it is reasonable and necessary.

I know that each request can be taken in different ways by the assessing officer, but is there any opportunity for funding to be approved in an easier manner.

My suggestion would be for a participant to request funding for the particular piece of equipment, then for the planner to meet the participant at their home or where the equipment is and actually see how it is used. (possibly with a health professional present)

Then do the same thing with the planner at a supplier’s premise and see the benefit of the upgraded piece of equipment?

Then the planner would have specific knowledge of the request and be able to decide if the benefits justify the funding.

I’d be ok if the planner said no to me and gave me a valid reason, but it seems it is just easy for them to knock back something that they don’t understand or is maybe not explained properly in the first place.

Please feel free to contact me if you require any further information

James Wood