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May be overly concerned with cleanliness.

May set unrealistic goals. | | Violence Potential Indicator | 1 | 46 | Average Score (Typical levels of concern) | May display, or may be at risk for, aggressive behaviour. | | Physical Symptoms | 0 | 40 | Average Score (Typical levels of concern) | May complain about aches, pains, or feeling sick. May have sleep, appetite, or weight issues. |

The following graph provides T-scores for each of the DSM-5 Symptom scales.

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ADHD Predominantly Inattentive | 55 ADHD Predominantly Hyperactive-Impulsive | 40 Conduct Disorder | 44 Oppositional Defiant Disorder | 39 Major Depressive Episode | 42 Manic Episode | 48 Generalized Anxiety Disorder | 46 Separation Anxiety Disorder | 39 Social Anxiety Disorder (Social Phobia) | 47 Obsessive-Compulsive Disorder | 44 Autism Spectrum Disorder | 42

<30 40 50 60 70 80 90+ T-scores

The following table summarizes the results of the parent’s assessment of Annie with respect to the DSM-5 Symptom scales, and provides general information about how she compares to the normative group.

The parent’s report of Annie’s level of impairment in academic, social, and home settings is presented below.

Not true at all/never | Just a little true/occasionally | Pretty much true/often | Very much true/very often

Academic

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Annie’s parent indicated that Annie’s problems seriously affect her schoolwork or grades very often or very frequently (score of 3).

Annie’s parent indicated that Annie’s problems seriously affect her friendships and relationships never (score of 0).

Home

Annie’s parent indicated that Annie’s problems seriously affect her home life occasionally (score of 1).

The following graph presents the Conners Clinical Index score that was calculated from the parent ratings of Annie. The Conners Clinical Index score is calculated from 24 items that were statistically selected as the best items for distinguishing youth with a clinical diagnosis (including Disruptive Behaviour Disorders, Learning and Language Disorders, Mood Disorders, Anxiety Disorders, and ADHD) from youth in the general population.

89

0 20 40 60 80 100 Probability (%)

Among clinical and general population cases, individuals with a clinical diagnosis obtained this score 89% of the time. Based on this metric, a clinical classification is strongly indicated, but other clinically relevant information should also be carefully considered in the assessment process.

Conners CBRS-Teacher Assessment Report

The following graph provides T-scores for each of the Conners CBRS-T Content scales and subscales.

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Emotional Distress (ED): Total | 53 Upsetting Thoughts/Physical Symptoms (ED subscale) | 50 Separation Fears (ED subscale) | 46 Social Anxiety (ED subscale) | 55 Defiant/Aggressive Behaviors | 44 Academic Difficulties (AD): Total | 68 Language (AD subscale) | 68 Math (AD subscale) | 69 Hyperactivity | 45 Social Problems | 45 Perfectionistic and Compulsive Behaviors | 52 Violence Potential Indicator | 48 Physical Symptoms | 46

<30 40 50 60 70 80 90+ T-scores

The following table summarizes the results of the teacher’s assessment of Annie and provides general information about how she compares to the normative group.

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The following graph provides T-scores for each of the DSM-5 Symptom scales.

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ADHD Predominantly Inattentive | 55 ADHD Predominantly Hyperactive-Impulsive | 45 Conduct Disorder | 46 Oppositional Defiant Disorder | 45 Major Depressive Episode | 45 Manic Episode | 43 Generalized Anxiety Disorder | 59 Separation Anxiety Disorder | 45 Social Anxiety Disorder (Social Phobia) | 52 Obsessive-Compulsive Disorder | 47 Autism Spectrum Disorder | 44

<30 40 50 60 70 80 90+ T-scores

The following table summarizes the results of the teacher’s assessment of Annie with respect to the DSM-5 Symptom scales, and provides general information about how she compares to the normative group.

The teacher’s report of Annie’s level of impairment in academic and social settings is presented below. Not true at all/never | Just a little true/occasionally | Pretty much true/often | Very much true/very often

Academic

Annie’s teacher indicated that Annie’s problems seriously affect her schoolwork or grades very often or very frequently (score of 3).

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Annie’s teacher indicated that Annie’s problems seriously affect her friendships and relationships never (score of 0).

The following graph presents the Conners Clinical Index score that was calculated from the teacher ratings of Annie. The Conners Clinical Index score is calculated from 24 items that were statistically selected as the best items for distinguishing youth with a clinical diagnosis (including Disruptive Behaviour Disorders, Learning and Language Disorders, Mood Disorders, Anxiety Disorders, and ADHD) from youth in the general population.

0 20 40 60 80 100 Probability (%)

Among clinical and general population cases, individuals with a clinical diagnosis obtained this score 68% of the time. Based on this metric, a clinical classification is indicated, but other clinically relevant information should also be carefully considered in the assessment process.

The following table displays the results from the teacher’s observations of Annie’s behaviour with regard to specific items that are related to other clinical concerns or diagnoses.

York Assessment of Reading for Comprehension (Primary) - Australian Edition

School: redacted | Year/Class: Year 3 Name: Annie redacted | Date of birth: redacted Assessed: redacted | Date of assessment: 12/07 Passage codes: Level 3 A, Level 2 A | Age at assessment: 8:04

Summary of scores

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| Comprehension | 50 | 89 | 23 | 7:03 |

Analysis of reading errors

Graph showing Standard Scores

Standard score 70 80 90 100 110 120 130

SWRT Accuracy Reading Rate Comprehension

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Individual Performance Summary Report

Examinee: Annie redacted | Date Tested: 27-Jun-redacted Year: 3 | Gender: Female | Ethnicity: | Date of Birth: redacted Examiner: Psychologist | Age: 8 years 3 months

Age Based Scores

Supplemental Scores

*Represents standard score.

**Represents quartile scores using year based normative data.

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DOCUMENT 6 FOI 24/25-1470

redacted

Annie XXX 8 years old

ACCESS REQUEST FORM SUPPORT DOCUMENTATION

2 months prior to application

ATTENTION: National Disability Insurance Scheme

CONFIRMED DIAGNOSIS

• Specific Learning Disorder-Moderate meeting DSM-5 diagnostic criteria with symptoms characterised by persistent and impairing difficulties learning foundational academic skills in reading, writing and/or mathematics.

Annie meets the criteria under the National Disability Scheme Act 2013, requiring Early Intervention supports including:

(a) Annie has a disability that is attributable to cognitive and neurological impairments; and

(b) Annie’s impairments are, or are likely to be, permanent; and

(c) Annie’s impairments result in substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking, one or more of the following activities:

(i) communication;

(ii) social interaction;

(iii) learning;

(d) Impairments affect Annie’s capacity for social and economic participation; and

(e) Annie is likely to require support under the National Disability Insurance Scheme for a lifetime.

Early intervention supports are likely to benefit Annie by reducing Annie’s future needs for supports in relation to the confirmed disability. Provision of early intervention supports for Annie is likely to benefit Annie by:

(i) alleviating the impact of the Annie’s impairment upon the functional capacity of the Annie to undertake communication, social interaction, and learning, and

(ii) preventing the deterioration of such functional capacity.

Support for Annie through NDIS early intervention program would be considered the most appropriate option, with no other systems of service delivery or support services able to offer Annie the required interventions.

I support Annie Access Request application.

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I support Annie’s Access Request application for 20 x PSYCHOLOGY SESSIONS. Annie’s presentation in very complex and without Psychological support targeting the following areas, her potential to function in society will be hampered:

If you require any further information please contact me on XXXXXXXXXX

Yours Sincerely

MAPS

Practice Manager/Consultant Psychologist

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DOCUMENT 7

Access Request — Supporting Evidence Form

The National Disability Insurance Agency (NDIA) will use the information in this form to determine if a person meets the requirements to become a participant in the National Disability Insurance Scheme (NDIS). For children under 6 with a developmental delay, please use the Access Request — Supporting Evidence Form for Children Under 6 with Developmental Delay.

Instructions for the person applying to become a participant in the NDIS

You do not need to complete this form if you can provide recent existing information (letters, assessments or other reports) from a health or education professional which details:

• your impairment;
• how long it will last; and
• how it impacts on your daily life.

How to complete this form:

Section 1 can be completed by you, your parent, representative or your health or educational professional.

Sections 2 and 3 must be completed by a health or educational professional.

If you have questions about this form, are having difficulty completing it, or would like more information about the NDIS, please contact us:

Phone: 1800 800 110 | TTY: 1800 555 677 | Speak and Listen: 1800 555 727

Internet Relay: Visit http://relayservice.gov.au and ask for 1800 800 110

Email: nationalaccessteam@ndis.gov.au

Returning this form:

Please return the completed form to:

Mail: GPO Box 700, Canberra, ACT 2601 Email: NationalAccessTeam@ndis.gov.au Or take it to your local NDIA office.

Instructions for the health or educational Professional completing this form

Sections 2 and 3 of this form must be completed by a health or education professional.

You may provide the person applying to the NDIS with copies of letters, assessments or other reports in lieu of completing this form.

If you have any questions about this form please contact the NDIA on 1800 800 110 or go to ndis.gov.au

Personal-In-Confidence when complete

1 of 7

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SECTION 1: Details of the person applying to become a participant in the NDIS

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SECTION 2: Details of the person’s impairment/s

1. Details of the health professional completing Section 2

Personal-In-Confidence when complete

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2. Details of the person’s impairment/s

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NB: an impairment may be considered likely to be lifelong even if the impact on the functional capacity fluctuates or varies in intensity over time. | Yes | | 2.4. Please provide a brief description of any relevant treatment undertaken (current and/or past) | Medication Past CTO Psychologist | | 2.5. Does the person have another impairment that has a significant impact? If yes, please list | | | 2.6. How long has the person had this impairment? | | | 2.7. Is the impairment likely to be lifelong? | | | 2.8. Please provide a brief of any relevant treatment undertaken (current and/or past) | | | 2.9. Does the person have any other impairments? If yes, please list | |

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Personal-In-Confidence when complete

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3. Are there early intervention supports that are likely to benefit the person by reducing their future needs for supports?

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The provision of early supports will:

• Alleviate the impact on functional capacity
• Prevent deterioration of functional capacity
• Improve functional capacity
• Strengthen the sustainability of available or existing supports

Details of recommended early intervention supports:

Anything available

4. Have any assessments been undertaken of the person’s impairment(s)?

Please record assessment type, the date the assessment was undertaken and the assessment score or rating

Personal-In-Confidence when complete

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SECTION 3: Details of the functional impact of the impairment/s

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1. Mobility

Moving around the home, getting in and out of bed or a chair, mobilising in the community including using public transport or a motor vehicle.

• Assistance required does not include commonly used items such as glasses, walking sticks, non-slip bath mats, bathroom grab rails and hand rails installed at stairs.

Does the person require assistance to be mobile because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs home modifications [ ] Yes, needs assistance from other persons (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

2. Communication

Being understood in spoken, written or sign language and ability to understand language and express needs and wants by gesture, speech or context appropriate for age.

Does the person require assistance to communicate because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs home modifications [ ] Yes, needs assistance from other persons (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

Personal-In-Confidence when complete

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3. Social interaction

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Making and keeping friends and relationships, behaving within limits accepted by others, coping with feelings and emotions.

Does the person require assistance to interact socially because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs assistance from other persons: (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of social interaction assistance required:

Would benefit from transport to activities

4. Learning

Understanding and remembering information, learning new things, practicing and using new skills

Does the person require assistance to learn effectively because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs assistance from other persons: (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

Personal-In-Confidence when complete

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5. Self-Care

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Showering/ bathing, dressing, eating, toileting, caring for own health.

• Assistance required does not include commonly used items such as non-slip bath mats, bathroom grab rails and hand rails installed at stairs.

Does the person require assistance with self-care because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, need special equipment [ ] Yes, needs assistive technology [ ] Yes, needs home modification [ ] Yes, needs assistance from other persons in the areas of:

[ ] showering/bathing [ ] eating/drinking [ ] overnight care (e.g. turning)

[ ] toileting [ ] dressing

If yes, please describe the type of assistance required:

6. Self-Management

Doing daily jobs, making decisions and handling problems and money (not applicable for children under 8 years of age)

Does the person require assistance with self-management because of their disability?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs assistance from other persons: (physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

Would benefit from someone to mow his lawn on a regular basis

Personal-In-Confidence when complete

7 of 7

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DOCUMENT 8

Access Request — Supporting Evidence Form

The National Disability Insurance Agency (NDIA) will use the information in this form to determine if a person meets the requirements to become a participant in the National Disability Insurance Scheme (NDIS). For children under 6 with a developmental delay, please use the Access Request — Supporting Evidence Form for Children Under 6 with Developmental Delay.

Instructions for the person applying to become a participant in the NDIS

You do not need to complete this form if you can provide recent existing information (letters, assessments or other reports) from a health or education professional which details:

• your impairment;
• how long it will last; and
• how it impacts on your daily life.

How to complete this form:

Section 1 can be completed by you, your parent, representative or your health or educational professional.

Sections 2 and 3 must be completed by a health or educational professional.

If you have questions about this form, are having difficulty completing it, or would like more information about the NDIS, please contact us:

Phone: 1800 800 110 | TTY: 1800 555 677 | Speak and Listen: 1800 555 727

Internet Relay: Visit http://relayservice.gov.au and ask for 1800 800 110

Email: nationalaccessteam@ndis.gov.au

Returning this form:

Please return the completed form to:

Mail: GPO Box 700, Canberra, ACT 2601 Email: NationalAccessTeam@ndis.gov.au Or take it to your local NDIA office.

Instructions for the health or educational Professional completing this form

Sections 2 and 3 of this form must be completed by a health or education professional.

You may provide the person applying to the NDIS with copies of letters, assessments or other reports in lieu of completing this form.

If you have any questions about this form please contact the NDIA on 1800 800 110 or go to ndis.gov.au

Personal-In-Confidence when complete

1 of 7

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SECTION 1: Details of the person applying to become a participant in the NDIS

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SECTION 2: Details of the person’s impairment/s

1. Details of the health professional completing Section 2

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Personal-In-Confidence when complete

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2. Details of the person’s impairment/s

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NB: an impairment may be considered likely to be lifelong even if the impact on the functional capacity fluctuates or varies in intensity over time. | Yes | | 2.4. Please provide a brief description of any relevant treatment undertaken (current and/or past) | | | 2.5. Does the person have another impairment that has a significant impact? If yes, please list | | | 2.6. How long has the person had this impairment? | | | 2.7. Is the impairment likely to be lifelong? | | | 2.8. Please provide a brief of any relevant treatment undertaken (current and/or past) | | | 2.9. Does the person have any other impairments? If yes, please list | |

3 of 7

Personal-In-Confidence when complete

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3. Are there early intervention supports that are likely to benefit the person by reducing their future needs for supports?

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The provision of early supports will:

• Alleviate the impact on functional capacity
• Prevent deterioration of functional capacity
• Improve functional capacity
• Strengthen the sustainability of available or existing supports

Details of recommended early intervention supports:

4. Have any assessments been undertaken of the person’s impairment(s)?

Please record assessment type, the date the assessment was undertaken and the assessment score or rating

Personal-In-Confidence when complete

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SECTION 3: Details of the functional impact of the impairment/s

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1. Mobility

Moving around the home, getting in and out of bed or a chair, mobilising in the community including using public transport or a motor vehicle.

• Assistance required does not include commonly used items such as glasses, walking sticks, non-slip bath mats, bathroom grab rails and hand rails installed at stairs.

Does the person require assistance to be mobile because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs home modifications [ ] Yes, needs assistance from other persons (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

2. Communication

Being understood in spoken, written or sign language and ability to understand language and express needs and wants by gesture, speech or context appropriate for age.

Does the person require assistance to communicate because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs home modifications [ ] Yes, needs assistance from other persons (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

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Personal-In-Confidence when complete

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3. Social interaction

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Making and keeping friends and relationships, behaving within limits accepted by others, coping with feelings and emotions.

Does the person require assistance to interact socially because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs assistance from other persons: (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of social interaction assistance required:

4. Learning

Understanding and remembering information, learning new things, practicing and using new skills

Does the person require assistance to learn effectively because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs assistance from other persons: (including physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

Personal-In-Confidence when complete

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5. Self-Care

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Showering/ bathing, dressing, eating, toileting, caring for own health.

• Assistance required does not include commonly used items such as non-slip bath mats, bathroom grab rails and hand rails installed at stairs.

Does the person require assistance with self-care because of their impairment/s?

[X] No, does not need assistance

[ ] Yes, need special equipment [ ] Yes, needs assistive technology [ ] Yes, needs home modification [ ] Yes, needs assistance from other persons in the areas of:

[ ] showering/bathing [ ] eating/drinking [ ] overnight care (e.g. turning)

[ ] toileting [ ] dressing

If yes, please describe the type of assistance required:

6. Self-Management

Doing daily jobs, making decisions and handling problems and money (not applicable for children under 8 years of age)

Does the person require assistance with self-management because of their disability?

[X] No, does not need assistance

[ ] Yes, needs special equipment [ ] Yes, needs assistive technology [ ] Yes, needs assistance from other persons: (physical assistance, guidance, supervision or prompting)

If yes, please describe the type of assistance required:

Personal-In-Confidence when complete

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DOCUMENT 9 FOI 24/25-1470

ndis

Overview of Access decision making

Scheme Eligibility Branch

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Acknowledgement of Country

Before we begin, | would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. | pay my respects to their Elders, past and present.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today.

Facilitator notes:

[Show or hide this slide as needed.]

Say

Before we begin, | would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea, and community. | pay my respects to their Elders, past and present.

I acknowledge that | am facilitating this training from the lands of the [insert name] people.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples

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here today. Click [to go to next slide]

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Click [to go to next slide]

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OFFICIAL

Learning outcomes

This session has been designed to help you:

• develop a broad understanding of the access eligibility requirements for accessing the NDIS
• build confidence in navigating the Intranet and sourcing information in Our Guidelines
• enhance your critical thinking skills while reviewing evidence
• develop an understanding of streamlined access processes
• understand the final tasks involved in making and communicating your decision.

Facilitator notes:

Say

Let’s look at our learning outcomes for today’s session.

This session has been designed to help you:

• develop a broad understanding of the access eligibility requirements for accessing the NDIS
• build confidence in navigating the Intranet and sourcing information in Our Guidelines
• enhance your critical thinking skills while reviewing evidence
• develop an understanding of streamlined access processes
• understand the final tasks involved in making and communicating your decision.

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Click [to go to next slide]

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Part one —

The access eligibility requirements

Facilitator notes:

[The purpose of this section is for new starters to gain an introduction to the Disability and Early Intervention requirements, and to build their confidence navigating the Intranet and sourcing information in Our Guidelines. Section 24 and Section 25 will be explored in more depth in later weeks.]

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Click [to go to next slide]

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Eligibility requirements

An applicant will meet the access requirements if, at the time of considering the access request, they meet the:

• Age requirements (section 22) and;
• Residence requirements (section 23) and;
• Disability requirements (section 24); and/or
• Early intervention requirements (section 25)

Facilitator notes:

Say

For us to begin to assess a request, we need to have a solid understanding of the eligibility requirements. Let’s recap what they are.

An applicant will meet the access requirements if, at the time of considering the access request they meet the following requirements as outlined in the NDIS Act:

• Age requirements (section 22) and;
• Residence requirements (section 23) and;
• Disability requirements (section 24); and/or
• Early intervention requirements (section 25)

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You will get more familiar with these requirements as we move through today’s training. Let’s start with age and residency requirements on the next slide.

Click [to go to next slide]

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redacted: s22(1)(a)(ii) - irrelevant material

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Section 24 - Disability requirements

OFFICIAL

Facilitator notes:

[The purpose of this section is for new starters to gain an introduction to the Disability requirements, and to build their confidence navigating the Intranet and sourcing information in Our Guidelines. Section 24 and Section 25 will be explored in more depth in later weeks.]

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OFFICIAL

Disability requirements (s24)

(1) A person meets the disability requirements if:

(a) The person has a disability due to intellectual, cognitive, neurological, sensory, physical, or psychosocial impairments; and

(b) The impairment is, or is likely to be, permanent; and

(c) The impairment results in substantially reduced functional capacity;

(d) The impairment affects the person’s capacity for social or economic participation; and

(e) The person is likely to require NDIS supports for their lifetime.

Facilitator notes:

Say

In this part, we’ll explore the disability requirements for accessing the NDIS, as outlined in Section 24 of the NDIS Act. You can see the relevant subsections on the slide.

In summary, Section 24 of the NDIS Act specifies that to access the NDIS, a person must have a permanent impairment that significantly reduces their ability to perform daily activities such as communication, social interaction, learning, mobility, self-care, or self-management. Additionally, they must require lifelong support under the NDIS.

We’ll do a range of activities aimed at building your knowledge on these requirements and your confidence in navigating the Intranet and sourcing information in Our Guidelines.

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Click [to go to next slide]

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redacted: s22(1)(a)(ii) - irrelevant material

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redacted: s22(1)(a)(ii) - irrelevant material

Say Let’s begin with the Disability Requirements. For this activity, navigate to the sub-heading ‘Do you meet the disability requirements?’

Paste in chat [Question 1: How would you explain ‘impairment’ in plain English? Question 2: What does the Agency think about when considering an applicant’s disability?

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Question 3: Define the following impairments: intellectual, cognitive, neurological, sensory, physical. Question 4: True or False? Diagnostic evidence will generally be required to determine whether a person has a disability caused by an impairment. Question 5: How important is the cause of an applicant’s impairment?

[Give learners 10 mins to complete activity. Answers on next slide.]

Click [to go to next slide]

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Activity One - Answers

Facilitator notes:

[Bring the group back and go through their responses using the answers and additional debrief points below.]

Say

Section 24(1)(a) : The person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or to one or more impairments attributable to a psychiatric condition.

Question 1: How would you explain ‘impairment’ in plain English?

Pause [for answers]

Loss of, or damage to, a physical, sensory or mental function.

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Question 2: What does the Agency think about when considering an applicant’s disability?

Pause [for answers]

When considering an applicant’s disability, we think about whether any reduction or loss of ability to do things, across all life domains, is because of an impairment.

Pause [for answers]

Question 3: Define the following impairments: intellectual, cognitive, neurological, sensory, physical.

Answer:

• intellectual – how a person speaks and listens, reads and writes, solves problems, and processes and remembers information
• cognitive – how a person thinks, learns new things, uses judgment to make decisions, and pays attention
• neurological – how the body functions
• sensory – how a person sees or hears
• physical – the ability to move parts of the body

Question 4

True or False?

Diagnostic information will generally be required to determine whether a person has a disability attributable to an impairment.

Answer: True. Whilst the NDIA is not diagnostically driven, an Access Delegate requires evidence from a relevant Treating Health Professional to make the access decision. It is important to note that we cannot request that an applicant undergoes an assessment to determine a diagnosis.

Question 5

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How important is the cause of an applicant’s impairment?

Answer:

It doesn’t matter what caused the applicant’s impairment, for example if they’ve had it from birth, or acquired it from an injury, an accident or a health condition.

Click [to go to next slide]

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Activity Two — Disability requirements

Section 24(1)(b)

The impairment or impairments are, or are likely to be, permanent

Facilitator notes:

[This slide contains an activity where learners will navigate to Our Guidelines. You will need to paste questions into the chat.]

Say To complete this next activity, you need to refer to the sub-heading ‘Is your impairment likely to be permanent?’

Section 24(1)(b): the impairment or impairments are, or are likely to be, permanent.

Paste in chat

[Question 1: True or False? A disability is, or is likely to be, permanent only if there are no known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy the

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impairment.

Question 2: If a disability varies in intensity, could it still meet permanence criteria despite the variation? For example – impairments that are of a chronic episodic nature.

Question 3: What evidence would you need to sight to be satisfied that the disability is permanent, or likely to be permanent?]

[Allow learners 10 minutes to complete the activity. Answers on next slide.]

Click [to go to next slide]

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Activity Two - Answers

Facilitator notes:

[Bring the group back and go through their responses using the answers and additional debrief points below.]

Say Section 24(1)(b): the impairment or impairments are, or are likely to be, permanent.

Question 1: True or False?

An impairment is, or is likely to be, permanent only after all available and appropriate treatment options have been pursued.

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Pause [for answers]

True. If there is a potential treatment which may reduce, or eliminate, disability related functional impacts this must be explored before the impacts are considered permanent.

However, if treatment has been explored or is in progress, and a relevant Treating Health Professional verifies the impairment will remain irrespective of the treatment outcome, permanence would be met.

This is particularly relevant for a person with a psychosocial disability who may still be receiving clinical treatment.

Question 2: If a disability varies in intensity, could it still meet permanence criteria despite the variation? For example – impairments that are of a chronic episodic nature.

Pause [for answers]

Yes. An impairment may also be permanent even if the severity of its impact on the functional capacity of the person, may fluctuate or improve.

An impairment might still be considered permanent due to the overall impact on a person’s life, and the likelihood of lifetime impact.

Impairments of a degenerative nature are also permanent, or likely to be, if medical / other treatments haven’t, or are unlikely to improve it.

Question 3: What evidence would you need to sight to be satisfied that the disability is permanent, or likely to be permanent?

Pause [for answers]

That:

• There are no known, available, appropriate and evidence-based treatments likely to remedy the impairment

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• An impairment that varies in intensity is permanent despite the variation
• The impairment is permanent despite the fact that its functional impacts may fluctuate or improve
• Further treating or medical review is not required to demonstrate that the impairment is permanent
• No further medical or other treatment would be likely to improve an impairment that is degenerative in nature

This is matter of judgment but what the Becoming a Participant Rules are trying to do is rule out cases where the permanency or likely permanency has not been established because the person requires further medical treatment or review before the permanency or likely permanency can be demonstrated.

This does not mean that an impairment will not be permanent or likely to be permanent if it requires further medical treatment or review.

In some cases, an impairment may continue to be treated and reviewed after it has been demonstrated that is permanent or likely to be permanent.

If a relevant Treating Health Professional verifies disability related functional impacts will remain irrespective of the treatment outcome, permanence would be met.

Click [to go to next slide]

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Activity Three — Disability requirements

Section 24(1)(c) The impairment or impairments result in substantially reduced functional capacity to undertake, or

psychosocial functioning in undertaking, one or more of the following activities:

(i) communication;

(ii) social interaction;

(iii) learning;

(iv) mobility;

(v) self-care;

(vi) self-management

OFFICIAL

Facilitator notes:

[This slide contains an activity where learners will navigate to Our Guidelines. You will need to paste questions into the chat.]

Say To answer these questions, you need to refer to the sub-heading ‘Does your impairment substantially reduce your functional capacity?’

Section 24(1)(c): the impairment or impairments, result in substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking, one or more of the following activities:

• Communication
• Social interaction

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• Learning
• Mobility
• Self-care and
• Self-management

Paste in chat

[Question 1: A person’s impairment is considered to result in substantially reduced functional capacity if they usually need disability specific supports to undertake activities in the areas of communication, social interaction, learning, mobility, self-care and self-management (if older than 6). What are some examples of disability specific supports? Question 2: Which factors does the Agency consider when deciding if an applicant’s impairment substantially reduces their functional capacity? Question 3: How would an Access Delegate determine if an applicant’s hearing impairment leads to a substantially reduced functional capacity?]

[Allow 5 minutes for learners to answer the questions. Answers on next slide.]

Click [to go to next slide]

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Activity Three - Answers

Facilitator notes: [Bring the group back and go through their responses using the answers and additional debrief points below.]

Say Section 24(1)(c): the impairment or impairments, result in substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking, one or more of the following activities:

• Communication
• Social interaction
• Learning
• Mobility
• Self-care and
• Self-management

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Question 1: A person’s impairment is considered to result in substantially reduced functional capacity if they usually need disability specific supports to undertake activities in the areas of communication, social interaction, learning, mobility, self-care and self-management (if older than 6).

What are some examples of disability specific supports?

Pause [for answers]

• a high level of support from other people, such as physical assistance, guidance, supervision or prompting
• assistive technology, equipment or home modifications that are prescribed by your doctor, allied health professional or other medical professional.

Question 2: Which factors does the Agency consider when deciding if an applicant’s impairment substantially reduces their functional capacity?

Pause [for answers]

The Agency considers how the applicant might be involved in different areas of life, like home, school, work and the community, and how tasks and actions are carried out in those contexts.

Question 3: How would an Access Delegate determine if an applicant’s hearing impairment leads to a substantially reduced functional capacity?

Pause [for answers]

Generally, hearing loss would be considered substantial if the loss is at least 65 decibels in the better ear based on a pure tone average of 500Hz, 1000Hz, 2000Hz and 4000Hz.

Pause

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It is important to note that the guideline requires us to consider substantially reduced functional capacity in relation to impairments that are permanent.

This means we need to consider whether any substantial reduction is attributable to an impairment that meets the permanency criteria.

Click [to go to next slide]

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OFFICIAL

Activity Four — Disability requirements

Section 24(1)(d)

The impairment or impairments affect the person’s capacity for social or economic participation

Section 24(1)(e) The person is likely to require NDIS supports under the National Disability Insurance Scheme for the person’s lifetime

Facilitator notes: [This slide contains an activity where learners will navigate to Our Guidelines. You will need to paste questions into the chat.]

Say To answer these questions, you need to refer to the sub-headings: ‘Does your impairment affect your social, work or study life?’ and ‘Will you likely need support under the NDIS for your whole life?’

We will now look at:

Section 24(1)(d): the impairment or impairments affect the person’s capacity for social or economic participation and; Section 24(1)(e): the person is likely to require NDIS support under the National Disability Insurance Scheme for the person’s lifetime

Paste in chat

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[Question 1: Give an example of how a person’s capacity for social and economic participation may be affected? Question 2: True or False? If an impairment varies in intensity (for example, because the impairment is of a chronic episodic nature) the person is unlikely to meet Section 24(1)(e).]

[Allow 5 minutes for learners to answer the questions. Answers on next slide.]

Click [to go to next slide]

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OFFICIAL

Activity Four - Answers

Facilitator notes:

[Bring the group back and go through their responses using the answers and additional debrief points below.] Say

Question 1: Give an example of how a person’s capacity for social and economic participation might be affected?

Pause [for answers]

• Barriers to joining sporting activities or accessing movie theatres
• Difficulties in finding and keeping a job
• Challenges with spending and saving money

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Question 2: True or False? If an impairment varies in intensity (for example, because the impairment is of a chronic episodic nature) the person is unlikely to meet Section 24(1)(e).

Pause [for answers]

False. Even if a person’s needs go up and down over time, or happen episodically, we may still consider it’s likely they’ll need lifetime support under the NDIS.

Click [to go to next slide]

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Early intervention (El) requirements (s25)

Section 25(1): A person meets the early intervention requirements if:

(a) The person has one or more identified impairments that are permanent.

(b) Early intervention supports are likely to reduce future need for supports. (c) Early intervention supports are likely to benefit the person (d) Early intervention supports are NDIS supports as defined in the legislation.

Facilitator notes: Say

As you will now know, to determine if an applicant is eligible to become an NDIS participant, you will assess the legislative requirements outlined in Section 24 and 25 of the NDIS Act.

In the last section, we covered Section 24 Disability requirements. redacted: s22(1)(a)(ii) - irrelevant material

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OFFICIAL

Early Intervention activity - Answers

Facilitator notes:

[Bring the group back and go through their responses using the answers and additional debrief points below.]

Say Question 1: What do you notice about the early intervention requirements that is similar to the disability requirements?

Pause [for answers]

• A person must have an intellectual, cognitive, neurological, sensory, or physical impairment, or an impairment attributable to a psychiatric condition, that is likely to be permanent.
• Early intervention must be most appropriately funded by the NDIS.

You will notice that the early interventions only consider the impairment, compared to the disability requirements which

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consider both the impairment and the disability in Section 24(1)(a).

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Part two —

Making your decision

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What evidence should be provided?

Disability Requirements:

• Confirm permanent impairment
• Impact on functional capacity

Early Intervention Requirements:

• Confirm permanent impairment
• Need for early intervention

OFFICIAL

Facilitator notes: Say What type of evidence do you need to see as an assessor to determine eligibility?

For the disability requirements, we need evidence to confirm a person’s permanent impairment and evidence about how this impacts their functional capacity.

For the early intervention requirements, we need evidence to confirm a person’s permanent impairment and evidence that confirms their need for early intervention.

Click [to go to next slide]

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How old should evidence be?

Permanent impairment confirmation: Evidence from any age is acceptable.

Functional capacity impact: Evidence should be from the last 12 months.

Current circumstances: Recent evidence ensures understanding of current support needs.

Weighing evidence: Newer evidence is generally given more weight. Lack of updated evidence may affect eligibility.

Facilitator notes:

Say

How old should evidence be?

When assessing evidence for NDIS eligibility, it’s important to understand a few key points.

First, evidence from a person’s doctor or specialist to confirm their permanent impairment can be from any age. However, when it comes to how their impairment impacts their functional capacity, the evidence should be from the last 12 months.

This is because a person’s functional capacity can change over time, even if their impairment does not. Having up-to-date evidence helps us understand their current support needs accurately.

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OFFICIAL

Streamlined access requirements

OFFICIAL

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OFFICIAL

Streamlined requirements

Lists designed to streamline the access process:

• List A — conditions which are likely to meet the disability requirements of s24
• List B — permanent conditions for which functional capacity is variable
• List D — permanent impairment/early intervention, under 7

Other streamlined processes:

• Hearing 0-25

OFFICIAL

Facilitator notes:

Say

The NDIA has developed lists of conditions which are designed to streamline the access process in certain cases. There is also a streamlined process for people aged 0-25 with hearing impairments.

We won’t go into detail about the streamlined hearing requirements now, but it is important to be aware of this approach. You can find more information about these requirements in Our Guidelines — Applying to the NDIS, under the heading ‘How will early intervention help you?’

Click [to go to next slide]

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List A, B, and D

Lists designed to streamline the access process:

• List A — conditions which are likely to meet the disability requirements of s24
• List B — permanent conditions for which functional capacity is variable
• List D — permanent impairment/early intervention, under 7

Facilitator notes:

Say

We are now going to look at the other streamlined lists; List A, B and D.

[Refer learners to locate List A on the NDIS website.]

List A describes conditions which are likely to meet the disability requirements in section 24 of the NDIS act.

This means that conditions on this list will generally meet the disability requirements without any further assessment.

What are some examples of conditions on List A?

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Pause [for answers]

[Any conditions listed on List A are acceptable.]

[Refer learners to locate List B.]

List B describes permanent conditions for which functional capacity is variable.

This means conditions on this List likely meet the requirements of Section 24 (1)(a) and (b) but further assessment of the remaining disability requirements is required.

What are some examples of conditions on List B?

Pause [for answers]

[Any conditions listed on List B are acceptable.]

List D describes permanent impairments that likely meet the early intervention requirements without any further assessment. List D only applies to children under the age of 7.

[Refer learners to locate List D.]

What are some examples of condition on List D?

Pause [for answers]

[Any conditions on List D are acceptable.]

For List A and List D, no further evidence is required to satisfy the DIS and EI criteria respectively for conditions on these lists.

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For List B, impairment and permanency are satisfied but further evidence of functional capacity is required to determine if the disability or early intervention requirements are met.

After verifying age and residency, you will then consider whether the applicant has an impairment on one of these Lists before proceeding to assessing the remaining access requirements.

Click [to go to next slide]

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Hidden Slide — Version Control

Recap of Legislative Criteria

redacted: s47E(d) - certain operations of agencies @NDIS.GOV.AU

Acknowledgement of Country

I would like to acknowledge the Traditional Owners and Custodians of the Country on which we meet today, and their continuing connection to land, sea and community.

I pay my respects to their Elders, past, present and emerging.

I would like to extend that acknowledgement and respect to any Aboriginal and Torres Strait Islander peoples here today

Overview

• Relevant Sections of the National Disability Insurance Scheme (NDIS) Act 2013 for Access Decisions
• Disability Criteria — Section 24
• Early Intervention Criteria — Section 25
• Questions

NDIS Act 2013

The National Disability Insurance Scheme Act 2013 (NDIS Act) is the legislation which establishes The National Disability Insurance Scheme.

The NDIS Act sets out:

• The objects and principles under which the NDIS operates
• How a person can become a participant in the NDIS
• A process for internal and external review of certain decisions made under the NDIS Act

To access the NDIS, a person must meet specific access requirements outlined in the relevant legislation.

NDIS Act 2013 — Relevant Sections

The NDIS Act is the primary consideration when determining access for persons applying to become a Participant of the Scheme.

The most relevant sections for Access are:

• s 21: When a person meets the access criteria
• s 22: Age requirements
• s 23: Residence requirements
• s 24: Disability requirements
• s 25: Early Intervention Requirements
• s 26: Requests that the CEO may make

Disability Criteria - Activity

• Section 24(1)(a): Disability attributable to an impairment
• Section 24(1)(b): Permanent, or likely to be permanent, impairment
• Section 24(1)(c): Substantial Reduction in Functional Capacity
• Section 24(1)(d): Impairment affects social and/or economic participation
• Section 24(1)(e): Requiring lifetime support under the NDIS

Section 24(1)(a)

The person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or to one or more impairments attributable to a psychiatric condition

What does this mean?

• Disability: Reduction or loss of an ability to do things, across all life domains, because of an impairment.
• Impairment: Loss of, or significant change in, your body’s functions, structure or how you think and learn.

The evidence needs to show that the person has a reduction or loss in ability to do things, across all life domains, because of an impairment.

Body Scan Analogy: If you take a full body scan of someone with Multiple Sclerosis you will see brain lesions (impairment — significant change to a mental function) that is causing (for example) the person to use a 4 Wheel Walker (disability — reduction in their ability to walk)

Section 24(1)(b)

The impairment or impairments are, or are likely to be, permanent

What does this mean?

• If the person has a condition on List B then it is considered the impairment is likely to be permanent and 24(1)(b) is met
• You are assessing the permanency of the impairment — not the condition and not the disability
• The evidence needs to demonstrate at least one of the below:
  • There are no known, available and appropriate evidence-based clinical, medical or other treatments that would be likely to remedy the impairment
  • The impairment fluctuates, but there is always an underlying impairment
  • No further medical treatment or review is required for the impairment. However, the person can still receive management intervention (i.e. the treatment is so they don’t deteriorate, but they will still have an impairment)
  • The impairment is degenerative in nature and no medical intervention will stop the deterioration

Section 24(1)(c)

The impairment or impairments result in substantially reduced functional capacity to undertake, or psychosocial functioning in undertaking, one or more of the following activities: communication, social interaction, learning, mobility, self-care, self-management

What does this mean?

• You only assess the substantial reduction in functional capacity for permanent impairments
• The person must usually require the assistance of another person or specially prescribed equipment to complete tasks and activities
• Completing a task at a slower rate, over an extended duration and/or by using commonly used items does not result in a substantial reduction in functional capacity

Section 24(1)(c) — Yes or No

You are assessing a case where the applicant is living with Fibromyalgia and unilateral Sensorineural Hearing Loss. You have determined that the impairment resulting from Fibromyalgia is not permanent. Sensorineural Hearing Loss is a List B condition. The evidence demonstrates that the Fibromyalgia is resulting in a substantial reduction in functional capacity in mobility. The hearing loss does not result in substantial reduction.

Is section 24(1)(c) met?

No — as it has been determined that the impairment resulting from Fibromyalgia is not permanent you do not assess 24(1)(c). However as Sensorineural Hearing Loss is permanent you assess the functional impacts from this which are not substantial and therefore 24(1)(c) is not met.

You are assessing a case where the applicant is living with a right above knee amputation and is fitted with a prosthetic. The General Practitioner (GP) has completed the Access Request Form (ARF) and ticked “no assistance required” for all domains.

Is section 24(1)(c) not met?

No — 24(1)(c) is likely met as the person is fitted with a prosthetic. As the GP has advised no assistance is required a clarification call is needed purely to confirm that the applicant requires the prosthetic to mobilise.

Section 24(1)(d)

The impairment or impairments affect the person’s capacity for social or economic participation

What does this mean?

• Similar to 24(1)(c) you only assess whether the permanent impairments affect the person’s capacity for social or economic participation
• The person’s capacity for social or economic participation only needs to be affected — there is no threshold
• Therefore if 24(1)(c) is met then 24(1)(d) will generally always be met

Section 24(1)(e)

The person is likely to require support under the National Disability Insurance Scheme for the person’s lifetime

What does this mean?

• The support that the person requires is the responsibility of the NDIS
• Use the COAG to assist in determining this
• Take into consideration if it is a new diagnosis, the person’s age and if capacity building supports are recommended (and are likely to make an improvement to the point there is no longer a substantial reduction in functional capacity)

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Questions?

Thank you

National Access — Quality Development Officer Team

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DOCUMENT 11 FOI 24/25-1470

Descriptions of impairment categories

SGP KP Publishing

Exported on 2025-04-02 22:27:37

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SGP KP Publishing – Descriptions of impairment categories

Table of Contents

1. Recent updates ……………………………………………………………………………………………………..
2. Impairment categories ……………………………………………………………………………………………
3. References …………………………………………………………………………………………………………….

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SGP KP Publishing – Descriptions of impairment categories

This article provides guidance for an access delegate to understand the impairment categories when deciding what categories to select for a person that meets the eligibility requirements.

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SGP KP Publishing – Descriptions of impairment categories

1 Recent updates

14 October 2024 New guidance to:

• reflect legislation changes from 3 October 2024
• understand the impairment categories when deciding what categories to select for a person that meets the eligibility requirements.

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SGP KP Publishing – Descriptions of impairment categories

2 Impairment categories

1. Intellectual — Such as how you speak and listen, read and write, solve problems, and process and remember information.

   An intellectual impairment may be considered a developmental disorder as it becomes apparent at an early age1. Without these skills, a person needs additional supports to succeed at school, work, or independent life. Conditions such as down’s syndrome and cerebral palsy may be associated with intellectual impairments.

2. Cognitive — Such as how you think, learn new things, use judgment to make decisions, and pay attention.

   Cognitive impairment involves various aspects of high-level mental functions and processes such as attention, memory, knowledge, decision-making, planning, reasoning, judgment, perception, comprehension, language, and visuospatial function . There are some similarities with intellectual impairments however, cognitive impairments generally become apparent at a later stage in life and are associated with brain injury or pathology1. Conditions such as dementia and traumatic brain injury may cause cognitive impairments.

3. Neurological — Such as how your body functions.

   Neurological impairments happen when there’s a change in function of the nervous system, which includes the brain and spinal cord2. Damage to either or both areas can affect the way the nervous system processes information. Parkinsons disease, epilepsy and multiple sclerosis3 are conditions which have a neurological basis.

4. Sensory — Such as how you see or hear.

   Sensory impairment most commonly relates to hearing or visual loss but can include all senses2.

5. Physical — Such as the ability to move parts of your body.

   Physical impairment may cause limitations in posture control, moving and coordinating parts of the body or in stamina2. There are many conditions which can cause a physical impairment including amputation of a limb, arthritis, multiple sclerosis, heart disease.

6. Psychosocial — This means you have reduced capacity to do daily life activities and tasks due to your mental health.

   Participants with a psychosocial impairment may find it hard to engage in education, training and employment or engage with the community. Mental health conditions such as bipolar affective disorder and schizophrenia are commonly associated with psychosocial impairments1 but other conditions such as autism could also have associated psychosocial impairments.

To learn more about impairment categories, go to article [Impairment categories guide].

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SGP KP Publishing – Descriptions of impairment categories

3 References

1. The Diagnostic and Statistical Manual of Mental Disorders (5th edition. DSM-5, American Psychiatric Association, 2013).
2. International Classification of Functioning, Disability, and Health: ICF. Geneva. World Health Organisation, 2001.
3. World Health Organisation (WHO), (1983). The ICD-10 classification of mental and behavioural disorders. World Health Organisation.

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DOCUMENT 12 OFFICIAL For Internal Use Only

Description of Impairment Categories

1. Intellectual – such as how you speak and listen, read and write, solve problems, and process and remember information.

   An intellectual impairment may be considered a developmental disorder as it becomes apparent at an early age1. Without these skills, a person needs additional supports to succeed at school, work, or independent life. Conditions such as Down’s syndrome and cerebral palsy may be associated with intellectual impairments.

2. Cognitive – such as how you think, learn new things, use judgment to make decisions, and pay attention.

   Cognitive impairment involves various aspects of high-level mental functions and processes such as attention, memory, knowledge, decision-making, planning, reasoning, judgment, perception, comprehension, language, and visuospatial function2. There are some similarities with intellectual impairments however, cognitive impairments generally become apparent at a later stage in life and are associated with brain injury or pathology1. Conditions such as dementia and traumatic brain injury may cause cognitive impairments.

3. Neurological – such as how your body functions.

   Neurological Impairments occurs when there is a change in function of the nervous system, which includes the brain and spinal cord2. Damage to either or both areas can affect the way the nervous system processes information. Parkinsons disease, epilepsy and multiple sclerosis3 are conditions which have a neurological basis.

4. Sensory – such as how you see or hear

   Sensory impairment most commonly relates to hearing or visual loss but can include all senses2.

5. Physical – such as the ability to move parts of your body

   Physical impairment may cause limitations in posture control, moving and coordinating parts of the body or in stamina2. There are many conditions which can cause a physical impairment including amputation of a limb, arthritis, multiple sclerosis, heart disease.

6. Psychosocial - This means you have reduced capacity to do daily life activities and tasks due to your mental health.

   Participants with a psychosocial impairment may find it hard to engage in education, training and employment or engage with the community. Mental health conditions such as bipolar affective disorder and schizophrenia are commonly associated with psychosocial impairments1 but other conditions such as autism could also have associated psychosocial impairments.

7. The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013)

8. International Classification of Functioning, Disability, and Health: ICF. Geneva: World Health Organization, 2001.

9. World Health Organization(WHO). (1993). The ICD-10 classification of mental and behavioural disorders. World Health Organization.

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Impairments Categories Guide

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Legend

• Mandatory TAPIB
• Does NOT require TAPIB

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