29 May 2026
Joint Committee of Public Accounts and Audit Parliament House CANBERRA ACT 2600 By email: jcpaa@aph.gov.au
Dear Committee,
Please find our responses to questions on notice below.
Question raised at hearing
Chair: Yes, annually, for how many cases would you be appearing before the tribunal?
Our capacity to represent people at the tribunal has fallen from an average of 35 matters a year due to delays from both the Tribunal and the National Disability Insurance Agency. The data below covers the last three financial years.
| 2025-26 (to date) | 2024-25 | 2023-24 | |
|---|---|---|---|
| Enquiries (contacts from the public seeking assistance) | 647 | 696 | 337 |
| Advices (a half-hour advice call with a lawyer for people who have an appeal underway) | 119 | 232 | 166 |
| Legal representation | 28 | 29 | 35 |
Questions received 18 May 2026
- Transparency over compliance requirements:
Your submission mentions reports of the difficulties participants experience when a payment lock is applied, including that no information is provided as to the reason for the rejection of the claim, and how to resolve the matter.
(a) To what extent is this issue occurring?
We cannot quantify this issue because we only have full visibility when we act for a client. Given the volume of enquiries compared with the number of clients we can represent, our detailed knowledge is limited. Although we hear reports of this issue through enquiries, we cannot assess the reasonableness of the Agency’s actions without the underlying material.
(b) In your experience, can you elaborate on the impact that a lack of transparency over compliance actions has on claimant and provider compliance with NDIS claim requirements.
The matter in which we have the most detailed records demonstrates that the Agency:
- Withheld payments over five months due to questions about twenty nine invoices, some of which dating back 12-15 months; and
Phone: 1800 014 111 | Web: villamanta.org.au Email: legal@villamanta.org.au
Address: 244 Latrobe Terrace, Geelong West VIC 3218 Mail: PO Box 7328, Geelong West VIC 3218
- Requested copies of those invoices, despite those having already been provided at the time of the claim for payment; and
- Never gave a reason why this particular participant was being audited; and
- Gave different information about what was required at different stages of the process; and
- Required the participant to follow up repeatedly to get responses to queries.
This left the participant with significant debt to providers and unable to engage further supports. They went without supports for five months while the matter was resolved, for claims totalling just under $10,000. Although 80 percent was eventually paid, the relationship with providers had been damaged beyond repair.
The participant was given no support or guidance. Instead, they received emails with attachments requesting different types of information. Those requests used NDIA identifiers such as posting dates and payment numbers, which mean little to participants, and did not identify the provider or claim category, making the information harder to locate.
The first of these requests demonstrates that the Agency was likely using a checklist they have developed for providers rather than participants, requesting information such as:
- Support notes regarding services
- Pay slips of support workers
- Rosters and timesheets
- Contact details of support workers
A month later the participant was told the claims were still rejected because “the agency cannot confirm supports are delivered as claimed. No invoices are provided, no progress or shift notes, or any other detailed information to substantiate the claim.”
Invoices had been provided and they did include notes about what had been delivered, and most importantly the participant was there at the time when supports were delivered.
The language used in this “integrity and compliance” process is received by participants as an accusation of wrongdoing by the NDIA. Given that they then withhold all payments until the matter is resolved, participants state they feel like they are being punished for something without being told what the allegations are.
The next correspondence gave a different list of requirements:
- Date and time the support was provided
- Description of how the support was provided
- Support worker/participant ratio
- Price charged for the support
- Name and contact details of the support worker; and
- Name, contact details and professional certification or Services Australia Provider Number of the Allied Health professional who delivered the support (if applicable).
The relevant information from the above list had already been provided, twice, on the invoices sent with the claim for payment.
This lack of transparency had a significant impact on compliance. When requirements are unclear, participants and providers are more likely to make mistakes despite acting in good faith. Here, providers issued invoices later deemed insufficient, and the participant had to seek retrospective corrections to
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documents prepared without knowledge of the Agency’s expectations. This points to unclear standards, not deliberate misuse.
The lack of clear requirements also prevented proactive compliance. The participant repeatedly sought guidance, including whether anything beyond invoices was required and whether there were specific formatting or content expectations, but received no clear, practical direction. Compliance therefore became reactive, with issues identified only after claims were rejected or reviewed.
The administrative burden was substantial. The participant needed legal help, support coordination and input from multiple providers to revise invoices and gather further material. Emails show providers were asked to retrospectively add line items, rates and service descriptions, and justify pricing against the NDIS Price Guide. That rework flowed directly from the lack of clear guidance at the outset.
The financial impact was also significant. Payments for several claims were withheld or rejected, including for supports that had already been delivered. The outcome confirms that claims were initially rejected due to an alleged lack of substantiation. Delays in payment, combined with uncertainty about what was required to resolve the issues, created ongoing financial instability.
(c) How can administration be improved
It is difficult to make recommendations when it is unclear why:
- The Agency kept asking for copies of documents it already had been provided with; and
- The information requirements kept changing and are not consistent with any materials provided to participants; and
- The participant was never provided with information as to why any of this was happening.
The most important improvement would be to stop withholding payment on future claims while this process is underway. Denying a participant access to supports for four months is punitive and unreasonable.
The Agency should also pick up the phone and explain what is happening and why, rather than relying on formal documents with accusatory language while withholding payment.
Up to date and reliable online materials explaining what is required in relation to payment claims would remove the mystery from this process and allow participants to push back on providers who do not invoice accordingly.
There needs to be an understanding of the difference between an invoice submitted by a provider, and one submitted by a participant. While it may be appropriate to seek evidence that the shift took place when a provider is claiming, the participant will have direct personal knowledge of the shifts which have occurred, and will not be comfortable providing personal details about their support staff to the Agency.
Procedural fairness would also expect that the basis for any compliance action is clearly explained.
Accessibility is also critical. The material shows the participant could not reconcile NDIA records with their own because of how the information was presented. Correspondence should therefore be in plain language and structured to align with the way participants and providers keep records.
A further improvement would be a proportionate, graduated approach to compliance. Issues such as missing invoice details or categorisation inconsistencies are administrative and should be addressed through guidance and correction, not immediate claim rejection.
The NDIA’s own policy framework recognises that participants may make mistakes and should be supported to correct them. Administrative processes should reflect this by providing opportunities to
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rectify deficiencies before adverse decisions are made, particularly where there is no indication of misuse.
Questions received 29 May 2026
- How accessible and timely is the Administrative Review process for participants?
Participants tell us the ART process is highly inaccessible for a range of reasons, which is especially concerning given the current number of unrepresented participants.
Communication
We work in courts and tribunals and understand their specialised language. Participants generally do not. ART correspondence is formal and technical, and often does not explain the process, the steps involved, or what participants can expect at each stage.
Format
The first step in most matters is conferencing, usually two to five times. The default is telephone conferencing, which is the least accessible option.
In our experience there are at least two other people on the call, aside from the participant and ourselves, and there could be more. Accessibility issues include:
- Not being able to tell who is speaking and what their role is
- Not clearly understanding what is a comment to the Tribunal and what is directed at the participant
- People speaking over each other
- Poor sound quality due to the background noise from multiple calls
- No visual cues from the person speaking
Video conferencing gives a far better experience in relation to all of these aspects:
- Having seen the registrar when they introduce themselves, participants more readily understand that they are facilitating the discussion
- Having seen the various individuals in attendance, and seeing their name on the screen, the participant can better understand who is being addressed
- All attendees have visual cues that someone is about to speak
- The sound is better due to all callers logging into the videoconference
- Participants can see the body language and facial expressions of the person speaking and have a better understanding of where they are coming from
Even so, we must ask for videoconferencing every time. Even where every earlier conference in a matter has been by video, we still have to contact the ART repeatedly to change future events from telephone to video.
Perceived bias
Those of us who work in courts and tribunals know they are slow and not equipped to deal with crises. Participants often do not, and are frequently already in crisis because they lack funding and supports while their matter proceeds.
When the Agency responds slowly, uses corporate lawyers who add delay, fails to comply with directions, and seeks long periods to complete simple steps, the ART rarely pushes back. Both institutions have heavy caseloads and limited resources, but participants may perceive this as bias in the Agency’s favour.
A further issue is the different reference points for delay. The ART and the Agency focus on the time since the ART application was filed; the participant focuses on the time since they first sought access or funding, which may be 18 months earlier.
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- Do participants have adequate access to legal support when disputing NDIS decisions?
See the statistics above. We have received 647 requests for assistance this financial year to date and have been able to represent only 28 people. There is plainly not enough advocacy or legal assistance for participants.
- Have you observed a change of behaviour from the NDIA in recent years? Is the NDIA forcing more participants towards legal avenues?
This is difficult to assess because the key stage is internal review, and we do not see the reviews that do not lead to appeal. Some may be careful, thoughtful and effective for the participant.
The ones we do see, with which the participant is not satisfied, have certainly been of poorer quality, rely on copy and paste (as evidenced by incorrect details being imported), and do not engage with the evidence provided by the participant.
As mentioned in our submission, we have seen appeals become necessary simply because an impairment has been “end-dated” in the NDIA’s system. This kind of issue should be resolvable at internal review stage, but clearly is not.
In our view, this data should be visible to participants who use the NDIS portal or app, so they can see what information the NDIA is relying on and correct errors before reaching the ART.
It is also difficult to tell whether NDIA behaviour has changed or whether the increase reflects the pace of recent change. Where the Agency fails to conduct a thorough internal review and instead pushes participants to appeal, that may be driven by KPIs rather than any improper motive.
- Do you feel that the NDIA is meeting its obligations to be a model litigant?
No, I don’t. Model litigant complaints are completely ineffective at changing this. Conduct that is plainly inappropriate—such as refusing to provide supports that the Agency has deemed to be reasonable and necessary unless the applicant withdraws their appeal in its entirety—has been treated as acceptable behaviour. The failure to move matters efficiently through the Tribunal and to treat participants with respect is too often baseline behaviour from the Agency.
I trust this information assists the Committee.
Yours sincerely
Naomi Anderson Legal Practice Manager
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