DOCUMENT 1 FOI 24/25-0113

Practice Guide – Review of Decisions

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Contents

Practice Guide – Review of Decisions …………………………………………………………………………. 1

1. Purpose ………………………………………………………………………………………………………. 3
2. To be used by ………………………………………………………………………………………………. 3
3. Scope ………………………………………………………………………………………………………….. 3
4. Review of a reviewable decision ……………………………………………………………………… 4

• Timeframe for requesting a review ……………………………………………………………….. 4
• Who can request an internal review?…………………………………………………………….. 4
• How does a person request an internal review? ……………………………………………… 5

5. The internal review process ……………………………………………………………………………. 6

• Who will conduct the internal review? ……………………………………………………………. 6
• How is the request for internal review prioritised? …………………………………………… 6
• How long does it take to get an internal review decision? ………………………………… 7
• How will the decision be communicated? ………………………………………………………. 7
• Automatic internal reviews …………………………………………………………………………… 8

6. How do internal reviews and participant requested plan reviews differ ………………….. 8

• Participant requested unscheduled plan reviews (s 48 (2)) ………………………………. 8
• How are internal reviews (statement of supports) and participant requested plan reviews different? ……………………………………………………………………………………………….. 9
• Review rights …………………………………………………………………………………….––––– 9
• Key points to consider about internal reviews ……………………………………………….. 10
• Key points to consider about participant requested plan reviews: ……………………. 10

7. Changes to plan management ………………………………………………………………………. 10
8. Supporting material ……………………………………………………………………………………… 11
9. Process owner and approver ………………………………………………………………………… 11
10. Feedback …………………………………………………………………………………………………… 11
11. Version change control ………………………………………………………………………………… 11

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1. Purpose

This Practice Guide will help you to understand the internal review process. This guide will explain:

• what a review of a reviewable decision is
• what types of decisions are reviewable
• who can request an internal review
• the differences between a request for a review of a reviewable decision, and a request for a plan review or other review type.

2. To be used by

• Plan Developers – Planners and Partners in the Community (LACs and Early Childhood Early Intervention [ECEI]).
• Business Support Officers (BSO’s).
• National Contact Centre (NCC).
• National Access Team (NAT).

3. Scope

Under the National Disability Scheme Act 2013 (the NDIS Act), certain decisions made by the National Disability Insurance Agency (NDIA) can be reviewed if requested by a person directly affected by the decision. These decisions are known as reviewable decisions and are listed in s 99 of the NDIS Act.

If a person directly affected by a reviewable decision is unhappy with the decision they can request the NDIA review it and make the decision again. This is called an internal review or s 100 review.

When an internal review is requested, a person not involved with making the original reviewable decision examines the evidence and information related to the decision, and makes a new decision to replace the original reviewable decision.

The most common decisions subject to review are:

• Access not met (s 99 (1) – 1) – A person requests access to the NDIS, and the NDIA decides they do not meet the access criteria to become a participant.
• Access revoked (s 99 (1) – 3) – A person was once a participant of the NDIS, but had an eligibility review and was found to not meet the access criteria, so their status as a participant was revoked.
• Statement of supports (s 99 (1) – 4) – The NDIA approves a participant’s NDIS plan, and the participant is unhappy with the supports/funding in that plan, the plan duration or the plan management decision.

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• Not to review a plan (s 99 (1) – 6) – The participant has requested a participant requested plan review under s 48(2) of the NDIS Act and the NDIA decided not to conduct that plan review.

A full list of reviewable decision types are listed in s 99 of the NDIS Act.

4. Review of a reviewable decision

Timeframe for requesting a review

A request for an internal review must be made within three months of receiving the original reviewable decision. The three month timeframe is set by s 100(2) of the NDIS Act. The NDIA calculates this by allowing 100 days from the date the original reviewable decision was made. This timeframe allows for postage time.

If a person requests an internal review more than three months from the date they receive the original reviewable decision, the NDIA cannot conduct an internal review. However, the person may initiate a participant requested plan review depending on their circumstances.

You should talk to the participant or their authorised representative about what a participant requested plan review involves. Tell them a delegate will look at if there is enough information to justify a plan review, not whether the supports in the plan are correct.

You should also tell the participant that a delegate may decide not to approve their request. If the participant understands this, and wants to proceed, lodge a participant requested plan review.

If they do not wish to proceed with lodging a plan review this information will be considered at the participant’s next scheduled review meeting.

For further guidance, refer to Practice Guide – Unscheduled Plan Reviews and Standard Operating Procedure – Plan review request.

Note: Only decisions listed in s 99 of the NDIS Act can be subject to internal review. If a participant’s plan was created as a result of a previous internal review decision or an Administrative Appeals Tribunal (AAT) decision, that plan cannot be subject to internal review.

Who can request an internal review?

A person directly affected by a reviewable decision can request the decision be reviewed by the NDIA. Who is considered to be a directly affected person will depend on the reviewable decision type and the individual circumstances of each request.

A directly affected person may include:

• a prospective participant (access not met decisions, access revoked decisions)
• a participant (plan related decisions)
• a person with parental responsibility for a child (decisions made relating to a child under 18 years of age, decisions to appoint, or not appoint a child’s representative)

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• a plan or correspondence nominee, or a person seeking to be appointed as a nominee (decisions to appoint, not appoint, suspend or revoke someone’s nominee status)
• a registered provider, or someone who applies to be a registered provider of supports (decisions related to providers)
• a person who owes a debt to the NDIA (decisions related to debts).

A person may also make a request on behalf of a directly affected person if they have authority or consent to do so. The NDIA needs consent, preferably in writing, from the directly affected person. This could include:

• a consent form signed by the directly affected person
• an email confirming the directly affected person gives their consent to lodge the review, or
• an interaction documenting a telephone conversation with the directly affected person where they provide their consent.

If you are unsure if a person requesting a review is able to do so, refer to Standard Operating Procedure – Consent and Authority.

How does a person request an internal review?

A person can request an internal review by:

• sending or delivering a written request (including by email) to the NDIA
• completing the Application for a review of decision from the NDIS website and lodging this form in person, by mail or email to NDIS enquiries.
• making a verbal request in person, by telephone or by other means at their local NDIS or partner office.

The person may provide any new evidence they would like the NDIA to consider as part of their internal review.

The NDIA or partner staff member who receives the internal review request must enter the details on the s 100 request form or in Feedback in the System. Refer to the Standard Operating Procedure – Documenting review of decisions – s 100.

The original reviewable decision will remain in place while the internal review is undertaken.

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5. The internal review process

Who will conduct the internal review?

When an internal review request is lodged, a member of the Internal Review Team (IRT) will determine if the request is valid. If the request is considered valid, an internal review officer will contact the requestor to acknowledge, and clarify the request. The request will then be allocated to an internal review delegate to complete the review.

The delegate will reconsider the facts, laws and NDIA policies related to the original decision and determine what the correct or preferable decision is. The delegate will also consider any new information provided. If needed they will consult with NDIA Subject Matter Experts and consider if any additional evidence is required.

The power to review a reviewable decision is detailed in the NDIS Operations Delegations – Instrument of Delegation.

If the review request is not considered valid a member of the IRT will discuss other options and next steps with the participant or their authorised representative.

How is the request for internal review prioritised?

Priority will be considered if there is evidence of:

• risk of harm to the health or well-being of a person
• risk to stability in the accommodation arrangements of the participant, including the risk of homelessness
• risk to stability in the care arrangements of the participant, including the risk of a primary carer not being able to provide care
• risk associated with the nature of the person’s disability, including the risk of rapid deterioration or progression
• the participant is hospitalised and is awaiting discharge
• the participant has an active request for Assistive Technology, Home Modifications or Supported Independent Living.

If the IRT determine the person is at high or extreme risk based on the NDIA’s Escalation and Prioritisation Matrix, the internal review will be assigned to a case officer or delegate as a priority. The IRT will prioritise requests based on the highest category of risk that applies based on the participant’s circumstances.

An IRT case officer or delegate will make contact with the person who requested the review within 48 hours of receiving escalation notification and tell them they will be completing the review as a priority. They will also gather any relevant information needed to complete the review.

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The IRT case officer or delegate will then complete the internal review as soon as reasonably practical. Case officers or delegates will also prioritise reviews based on the end date of NDIS plans to ensure participants receive continuity of supports.

Note: If there is an imminent risk of harm to the participant or someone else, refer to the NDIA’s Participant Critical Incident Framework.

How long does it take to get an internal review decision?

The NDIA has committed under the Participant Service Guarantee to completing all internal reviews within 90 days from 1 July 2020. By June 2021, the NDIA aims to have all internal reviews completed within 60 days from the date of the request. If this is not possible, the reviewer will contact the person who requested the review, explain the reason for the delay, and provide an estimated timeframe for completion.

How will the decision be communicated?

An IRT case officer or delegate has three options available to them when completing an internal review:

• Confirm the original decision – if they agree the original reviewable decision was correct. This means there is no change to the original reviewable decision.
• Vary the original decision – if they change the original reviewable decision.
• Set aside the original decision – if they set aside the original reviewable decision and make a new decision in its place.

The IRT case officer or delegate will contact the person who requested the internal review by phone (or their preferred contact method) when they have reached a decision. They will explain the outcome of the review and the reasons for their decision.

The IRT case officer or delegate will send a decision letter clearly setting out the decision and the reasons for the decision on the same day as or within one business day of this phone call. If the decision results in a new plan being made for a participant a copy of that plan will be sent with the letter. Decision letters are located on the Letters and Forms Intranet page.

The decision letter also sets out the person’s right to request a review of the decision by the Administrative Appeals Tribunal (AAT). The letter includes a link to the AAT’s website and their phone number to enable the person to seek further information.

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Automatic internal reviews

Internal reviews are automatically initiated by the NDIA when:

• s 21(3)(a) – The NDIA has decided a person does not meet the access criteria because an access decision was not made within 21 days of receiving the request. For example, if a request is made on 2 August, the 21 days will begin on 2 August.
• s 21(3)(b) – The NDIA has decided a person does not meet the access criteria because a formal request for information was made (under s 26 of the NDIS Act) and the access decision was not made within 14 days after receiving the last piece of information or report. For example, if the last information or report is received on 2 August, the 14 days will begin on 3 August.
• s 48(2) – The participant has requested a plan review, the NDIA must decide whether or not to conduct the plan review within 14 days after receiving the request. For example, if the request was received on 2 August, the 14 days will begin on 3 August. If a decision is not made within 14 days, the NDIA is deemed to have made a decision not to conduct a plan review. This decision will be internally reviewed automatically.

In the above situations the person or persons directly affected by the decision do not need to request the internal review – this will occur automatically.

If a person contacts the NDIA requesting an internal review in these circumstances you should not lodge a s 100 request form in the System.

6. How do internal reviews and participant requested plan reviews differ

Participant requested unscheduled plan reviews (s 48 (2))

A request for plan review under s 48(2) of the NDIS Act, also known as a participant requested unscheduled plan review or s 48, is a request for the NDIA to initiate the plan review process outside of the scheduled plan review. A participant or their representative can make a request for participant requested plan review at any time.

A participant requested plan review requires a delegate to consider if the participant’s circumstances have changed sufficiently since their plan was approved, to require a plan review before the scheduled review date.

If a participant requested plan review is declined, the person may request an internal review of that decision.

Participant requested plan review decisions are made by the National Review Team (NRT). For further information, refer to the Practice Guide – Unscheduled Plan Reviews and Standard Operating Procedure – Plan review request.

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How are internal reviews (statement of supports) and participant requested plan reviews different?

In some cases it can be difficult to distinguish between an internal review related to a participant’s plan and a participant requested plan review. You should consider the participant’s circumstances and needs when determining which review type is best for them. You should also talk with the person requesting the review about what option/s are available to them.

The main difference between an internal review and a participant requested plan review is the reason the person requests the review. For example, a request for an internal review of a statement of participant supports is a request to have a delegate reconsider the decision. This is because the participant believes the original planner made the wrong decision. A participant requested plan review is a request to have their plan reviewed, because the participant’s circumstances or needs have changed since the plan was approved.

Review rights

6.3.1 Participant requested plan review

If the participant is unhappy with a participant requested plan review decision they can apply for an internal review of the decision. If the participant receives an internal review decision about their participant requested plan review and they are still unhappy, they can apply for external review to the AAT within 28 days of receiving that decision. Participants cannot apply to the AAT without first having the NDIA complete an internal review of the original reviewable decision.

IRT staff may contact the person who requested the review to clarify their request if it is not immediately clear what the request is, or if it may be for the ‘wrong’ review type. IRT staff will ensure the participant receives the review type that best meets their needs.

6.3.2 Internal review

Once an internal review decision is made, the NDIA cannot complete additional internal reviews of the same reviewable decision, or re-make the internal review decision. If a person is unsatisfied with the decision and would like it reviewed, they must apply to the AAT. This is known as an external review or merits review.

The request for an external review must be made within 28 days of receiving written notice of the NDIA internal review decision. If the timeframe has passed the person can apply directly to the AAT for an extension of time by filling out an application for extension form on the AAT website, or by writing to the AAT directly.

Once the AAT makes a decision about the review, the NDIA will implement the decision.

Note: The internal review decision remains in place while the external review is undertaken. A request for external review does not prevent the NDIA from implementing the participant’s plan.

Further information is available on the AAT website or in the NDIA Operational Guideline - Review of Decisions – External Review.

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Key points to consider about internal reviews

To help identify if a person is requesting an internal review, you should consider the following:

• Is the request related to a reviewable decision?
  • If related to a plan, was the plan created as a result of a plan review? If a participant’s plan was created as a result of a previous internal review decision, or an Administrative Appeals Tribunal (AAT) decision, that plan cannot be subject to internal review.
• Is the request made within three months of receiving the decision?
• For planning/statement of supports internal reviews - is the request being made because the person was dissatisfied with the plan decision and believes the plan decision was wrong from the outset? For example, the participant is not satisfied with the supports included in their recently approved plan because they asked for $50,000 in their core supports budget but only received $20,000.

Key points to consider about participant requested plan reviews:

• Is the request being made because of changed circumstances, or the plan no longer meets the participant’s needs? For example, the participant’s primary informal carer is no longer able to care for them and extra supports are required to compensate for that loss.
• Has the person provided new information, or are they requesting something new that they didn’t request at their last planning meeting?

7. Changes to plan management

When the participant requests a review or change to their plan management, it is important to check what type of review to progress. This is to make sure you use the correct review tool in the NDIS Business System and the request goes to the right team so they respond in a timely manner.

Below are two review types with examples to help you identify what type of review request to progress:

• Reviewable decisions (s 100) - When the delegate makes a decision not to approve the plan management type the participant requested and the participant disagrees with this decision. For example, the participant requested to self-manage and the plan delegate determined self-management would present an unreasonable risk to the participant and made the decision to have funded supports Agency managed. This must occur within three months of the participant being notified of the decision.

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• Unscheduled plan review (s 48) - When the participant wants to change their plan management type. For example, the participant is now able to self-manage with the help of informal supports and wishes to change their plan management to self-management. This can be requested any time after the plan has been approved.

8. Supporting material

• NDIS Act 2013 (s 100)

9. Process owner and approver

General Manager Participant Experience and Design.

10. Feedback

If you have any feedback about this Practice Guide please email Service Guidance and Practice In your email, remember to include the title of the resource you are referring to and to describe your suggestion or issue concisely.

11. Version change control

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Standard Operating Procedure

For Internal Use Only

The contents of this document are OFFICIAL.

Complete a Verbal Access Request (VAR)

This Standard Operating Procedure (SOP) will help you complete a verbal access request with an applicant (or their representative).

1. Recent updates

2. Checklist

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Standard Operating Procedure

For Internal Use Only

3. Procedure

Note: If the applicant has an internal review or Administrative Appeals Tribunal (AAT) case in progress, they cannot re-apply to the NDIS until the review decision has been finalised (S19(2) of the NDIS Act).

3.1 Verify defined program status

1. In the NDIS Account screen: Select Internal Use.
2. Select > next to State and Territory Load Data.
3. If Yes next to Defined in Program: The applicant is from a Defined program.
4. If No next to Defined in Program: The applicant is from a Non-Defined program or has a ‘New’ access request.

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Standard Operating Procedure

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Phase in Date: 01.01.2016 Phase in Quarter: New Defined in Program: No Classification:

3.1.1 If Non-Defined or New

1. Go to Step 3.2: Identify contact person and make outbound call.
2. Note: Defined programs in WA are still transitioning to the NDIS (until 30 June 2023). All other applicants are ‘New’ as the state and Commonwealth funding has ceased.

3.1.2 If Defined

1. Refer to Standard Operating Procedure – Complete a verbal access request (VAR) – defined – WA.

3.2 Identify contact person and make outbound call

1. If you have existing information about an authorised representative or parent, check their details before calling to streamline the VAR process. Refer to Our Guideline – Your privacy and information and Our Guideline – Child representatives for support with decision making about the authority of an applicant’s representatives. Refer to Standard Operating Procedure – Identify authorised representatives at access for work instructions.

3.2.1 Contact the person

1. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send ‘Contact attempt SMS template’ to advise you will be calling.

   Note: Only send this SMS before your first attempt to call the person.

2. Do not contact the person by SMS if the person has told the agency that they do not consent to this form of communication.

3. Make 3 telephone contact attempts (a maximum of 2 calls per day, at different times of day) to the applicant or their representative. If you reach their voicemail and the person identifies themselves, leave a brief message requesting they contact the NDIA on 1800 800 110.

3.2.2 If all 3 contact attempts are unsuccessful

1. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send ‘Unsuccessful contact attempt’ SMS to advise you tried to call.

   Note: Only send this SMS after you make all required call attempts.

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Standard Operating Procedure

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Do not contact the person by SMS if the person has told the agency that they do not consent to this form of communication.

3.2.3 If the call is answered

1. Identify if you are speaking with the applicant or their representative:

• Hello, my name is ___________. Is <Applicant / Representative> available?
• Advise that you are calling from the NDIA.

3.2.4 If person needs an interpreter

1. If needed, call back via an interpreter following the instructions in Standard Operating Procedure — Assist the participant with their preferred method of communication.

3.2.5 If person is the applicant

1. Go to Step 3.5: Explain collection, use and disclosure of personal information.

3.2.6 If person is someone other than the applicant

1. In the NDIS Account screen: Select Details.
2. Select Consent.
3. View the Details of the Authorised Representative field to determine:

• If the person’s name is listed as a legally authorised or an authorised representative
• The nature of the relationship
• The scope of the legal authority to act or the consent to act as an authorised representative
• How the evidence of legal authority or the consent to act was provided.

Overview Contacts Details Interactions Appointments Feedback My Requests Payment En… Pathway

∨ Consent

Consent to use: [ ] CRN:

3.2.6.1 If listed as an authorised representative

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Standard Operating Procedure

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1. Go to Step 3.5: Explain collection, use and disclosure of personal information.

Note: You do not need to take further steps to confirm the representative’s authority, as this has already been done.

If not listed as an authorised representative and the applicant is a child

1. Go to Step 3.3: Check authority to make an access request for a child.

If not listed as an authorised representative and the applicant is an adult

1. Go to Step 3.4: Check authority to make an access request for an adult.

3.3 Check authority to make an access request for a child

Note: You must confirm the representative’s authority to act on behalf of the child before starting a VAR.

For children aged 0–17:

Make sure you are speaking with the person who has parental responsibility for an applicant aged under 18. This usually means:

• the child’s parent (as long as they have not ceased to have parental responsibility for the child because of a court order or under a State or Territory law), or
• the child’s legal guardian, or
• the person identified in a parenting order.

A step-parent does not have legal authority to act on behalf of the child unless they have legally adopted the child.

You can find more information to decide who has legal authority to act on behalf of a child in Our Guideline – Child representatives, including the documents you may need to confirm their authority. Refer to Standard Operating Procedure – Identify authorised representatives at access for work instructions.

3.3.1 Consider person’s relationship to the child

If the person is the child’s parent

1. Go to Step 3.3.2: Consider if the person is a parent, but another guardian has been formally appointed in their place.

If the person is someone other than the child’s parent

1. Go to Step 3.3.4: Consider nature of authority to act when the person is not a parent.

3.3.2 Consider if the person is a parent, but another guardian has been formally appointed in their place

1. Ask the person:

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Standard Operating Procedure

For Internal Use Only

• Has any other person been formally appointed as <Child’s> legal guardian? For example, are there any guardianship in place for ?

• Yes: Another legal guardian has been appointed (collapsible heading)
• No: Another legal guardian has not been appointed (collapsible heading)

3.3.3 Consider if person is a parent, but parental responsibility has ceased under a court order

1. Ask the person:

• Have you ceased to have parental responsibility for under any orders of the court?

• Yes: Parental responsibility has ceased under a court order (collapsible heading)
• No: Parental responsibility has not ceased under a court order (collapsible heading)

3.3.4 Consider nature of authority to act when the person is not a parent

1. Ask the person:

• What is the nature of your authority to act on <Child’s> behalf?

• If person is not a parent, but states they are the child’s legal guardian (collapsible heading)
• If person is not the child’s legal guardian (collapsible heading)

3.4 Check authority to make an access request for an adult

Note: You must confirm the representative’s authority to act on behalf of the applicant before starting a VAR.

For adults (aged 18 and over)

If the applicant is aged 18 or over, make sure you are speaking with them directly, or with someone who has legal authority to act on their behalf. This includes:

• a guardian
• a public guardian
• an enduring guardian
• an enduring power of attorney (personal/medical/health)
• an advance care directive or appointment (if their power covers such a decision).

Before starting a VAR, you must ask a representative to provide written evidence of their legal authority. For example, a copy of the guardianship order or enduring power of attorney.

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Standard Operating Procedure

For Internal Use Only

You can find more information about who has authority to act on behalf of an applicant in Our Guideline – Your privacy and information, and the documents they need to provide, in the Standard Operating Procedure – Identify authorised representatives at access.

3.4.1 Consider the nature of authority to act

1. Ask the person:

• Can you please confirm your full name and your relationship to ?
• What is the nature of your authority to act on <Applicant’s> behalf?

• If the person advises they are a legal representative (collapsible heading)
• If person advises they have no legal authority (e.g. they are not a guardian) (collapsible heading)
• If the applicant’s consent is confirmed (collapsible heading)
• If the applicant is not available (collapsible heading)
• If person advises they have no legal authority and there is no consent (collapsible heading) from the applicant for the person to act on their behalf.

3.5 Explain collection, use and disclosure of personal information

Note: We collect consent to contact other people who can provide personal and health information about the applicant. This is called third party consent. Third parties can help to determine whether the applicant meets the eligibility requirements and, if they become a participant, to develop and implement their NDIS plan. Third parties may include health and medical practitioners, service providers, group home personnel, or other government agencies.

1. Advise the person:

• During this call, I will ask some questions about <you / Applicant> to start an access request for the NDIS.
• As part of this process, I will explain why I am collecting <your / Applicant’s> information and how it will be used.
• We collect <your / Applicant’s> personal and sensitive information to decide if <you / they> are eligible for the NDIS. If <you are / Applicant is> eligible, we will use this information to help develop, implement and review <your / their> NDIS plan and do other things related to the NDIS.

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Standard Operating Procedure

For Internal Use Only

• We will collect information directly from <you / Applicant> unless it is not practical to do so. We can also collect <your / their> information from others when it is allowed under a law. Sometimes we may need to:
  • collect <your / their> personal and sensitive information from other people, and
  • disclose <your / their> personal information to other people.
• We need your consent to share this information with other people to help us to decide whether <you are / Applicant is> eligible for the NDIS and, if so, to help make <your / their> NDIS plan. These other people are called third parties, and they may be a family member, representative, nominee, treating professional, support worker, community partner or other state, territory or Commonwealth Government agencies.
• <Do you / Does Applicant> live in Shared Supported Accommodation? For example, a home shared with other people with disabilities that includes shared support from paid staff.
• Yes: As <you live / Applicant lives> in a group home, we may also disclose <your / their> personal information to personnel employed within the group home. This enables us to collect further personal information about <you / Applicant> to support the development of <your / their> NDIS plan if <you / they> become a participant.
• If <you have / Applicant has> received any compensation payments because of <your / their> disability, we need consent to collect and disclose personal and sensitive information from <your / their> legal representative about the compensation matter. This will help us develop an NDIS plan if <you / they> become a participant.
• If we do not collect <your / Applicant’s> personal and sensitive information, we may not be able to decide <your / their> eligibility for the NDIS or assist <you / them> with preparing and implementing an NDIS plan.
• You can find out more about how we collect, use and disclose personal and sensitive information by visiting our online Privacy Notice and Privacy Policy. You can also contact our Privacy Officer on privacy@ndis.gov.au. You can ask for help to access <your / Applicant’s> personal and sensitive information, or make a

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Standard Operating Procedure

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complaint about the handling of this information by visiting our online Feedback and Complaints page.

3.6 Obtain consent for the collection of information from third parties

1. In the NDIS Account screen: Select Details.
2. Select Consent.

3.6.1 Request consent to contact third parties to collect information

1. Ask the person:

• I will now ask you to confirm that you consent to us collecting <your / Applicant’s> information including from third parties, for the purposes of determining whether <you / Applicant> meet/s the eligibility requirements for the NDIS and to help develop or implement <your / their> NDIS plan if <you / they> become a participant.
• Do you give your consent for us to contact <your / Applicant’s> health professionals, service providers and schools where relevant, to collect information about <you / them>?

If the person provides consent to collect information

1. In Contact health professionals, service providers and schools where relevant, to collect information about you: Select Yes.

If the person does not provide consent to collect information

1. In Contact health professionals, service providers and schools where relevant, to collect information about you: Leave radio button as No.

3.6.2 Request consent to share information with third parties

1. Ask the person:

• Do you give your consent for us to share information about <you / Applicant> with identified third parties to help with developing and implementing <your / their> plan?

If the person provides consent to share information

1. In Share information about you with identified third parties to help with developing and implementing your plan: Select Yes.

If the person does not provide consent to share information

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1. In Share information about you with identified third parties to help with developing and implementing your plan: Leave radio button as No.
2. Select Submit.

3.7 Obtain Centrelink consent

1. Advise the person:

• We will also need to confirm <your / Applicant’s> age and residence information.
• The easiest way to do this is by you providing consent for us to access <your / Applicant’s> Centrelink record.

If applicant is an adult:

• Do you consent to us using <your / Applicant’s> Centrelink record to obtain information about <your / their> age and residence for NDIA purposes?

If applicant is a child:

• As is a child, I will also need to access your Centrelink record for the purposes of confirming <Applicant’s> age and residence. This is because your Centrelink record and <Applicant’s> record are linked. Do you consent to us accessing your Centrelink record to confirm <Applicant’s> age and residence?

3.7.1 Yes: Consent given

• Thank you. Are you please able to tell me the CRN number?

1. In the NDIS Account screen: Select Details.
2. Select Edit.
3. Select Consent.
4. In Consent to Use: Select Centrelink.
5. In CRN: Enter the CRN (if available).

∨ Consent

6. Select Submit.

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Note: If the applicant provided consent to use Centrelink but did not provide their CRN, you will search for this information later.

3.8 Enter/update personal details

1. Advise the person:

• Thank you. I am now going to confirm some further details with you.

3.8.1 Ask for the applicant’s information, and update as required:

1. In the NDIS Account screen: Select Details.
2. Select Edit.
3. Select Personal Details.
4. Ask for information to complete the relevant fields in:

• Name: Confirm spelling is correct
• Preferred Name
• Gender: Confirm person’s gender using the drop-down options Note: Someone’s preferred name and gender identity may differ from their identity documentation. It is important to be aware of this and to be respectful during your conversation with them. You should also check their pronouns to make sure you refer to them in the correct way. You can find more information in Fact sheet — Updating your name, pronouns, and information about your gender.
• Date of Birth
• Indigenous Origin: Ask if the person is of Aboriginal or Torres Islander origin and select the appropriate response
• Australian South Sea Islander: Ask if the person is of Australian South Sea Islander origin and select the appropriate response

∨ Personal Details

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3.8.2 Confirm/update Residence Details

1. Select Residence Details.
2. Ask for information to complete the relevant fields in:

• Country of Birth
• Living in Australia permanently
• Australian Citizen
• Visa Subclass: Select from the drop-down menu if not Australian citizen

∨ Residence Details

3.8.3 Confirm/update addresses

1. Ask for the applicant’s current residential address.

3.8.3.1 If the applicant’s home address is incorrect

1. Select Addresses: Select +.
2. In Address Type: Select Home Address.
3. Note: If unable to provide current home address (for example, if the applicant is in the process of moving home or in temporary accommodation): Select Alternate Home Address.
4. In Search Address: Start typing the applicant’s residential address.
5. Select applicant’s residential address when displayed.

Add New Address / Move to New Address

6. Confirm or update Postal Address following the steps above.

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Note: If the applicant is a child you must confirm and update the address within the parent’s record as letters are automatically sent to the parent’s address, not the child’s.

3.8.4 Confirm/update Communication Details

1. Select Communication Details.

2. Ask for information to complete the relevant fields in:

   • Preferred Contact Method
   • Preferred Language Used at Home
   • Interpreter Required
   • Interpreter Language
   • Home Number
   • Work Number
   • Mobile
   • Email

3.8.5 If person selects email as their preference

1. Advise the person:

   As you have chosen email as your preferred method of contact, I need to let you know that we may email you sensitive or confidential information, and we cannot guarantee the security of the email once it leaves our system. Do you still wish to use email as your preferred method of contact?

   Yes: email is the preferred correspondence method

3.8.5.1 Advise the person:

Thank you. Just a note that although your preference is email, many formal letters from the NDIA are system generated. This means they may be posted to you instead of emailed.

Add interaction: email is the preferred correspondence method

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1. In the NDIS Account screen: Select Interactions.

2. Select Add Items and then select Interaction.

3. In Category 1: Select Pathway.

4. In Category 2: Select General.

5. In Category 3: Select Verbal consent obtained.

6. In Channel: Select Phone.

7. In Status: Select Completed.

8. In Notes:

   Email preferred contact – risk accepted. Staff read email disclaimer to during VAR. They agreed to accept email security risk.

9. Select Submit.

3.8.6 Enter/update Correspondence Details

1. Select Correspondence Details.

2. Ask for information to complete the relevant fields in:

   • Preferred Correspondence Method
   • Preferred Format
   • Formatting Option

3. Select Submit.

3.8.7 If the person needs an interpreter: Add alert

1. In the NDIS Account screen: Select Add Items and then select Alert.

   Note: Do not select the Primary checkbox.

2. In Alert: Select Interpreter Required.

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3. In Additional Information:

Do not contact without a interpreter for .

4. Select Submit.

3.9 Add contacts

Note: If you do not add a parent or guardian to a child’s record, no correspondence will be sent. Add any additional people with parental responsibility here.

1. In the NDIS Account screen: Select Contacts.

2. Select Add Items and then select Contact.

3. Complete fields in:

   • Relationship
   • First Name
   • Last Name

   Name: redacted: s47F - personal privacyAredacted Relationship: redacted: s47F - personal privacy

   Valid From: 23.07.2019 Valid To: 31.12.9999

   Parenting Order in Effect: ( ) NO

   • First Name: Bredacted
   • Last Name: Tredacted

4. Select Check Matches.

Note: If there are multiple matches, check the date of birth (if known) and city to ensure that you select the right person.

3.9.1 If there is not a match

1. Select < Back Arrow.
2. Select Create.
3. Enter information in additional fields (if known).
4. Select Submit.

3.9.2 If there is a match and the person already has a record

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1. Select Radio Button next to correct record.
2. Select < Back Arrow.
3. Select Submit.

3.10 Verify age and residence details

Note: This information is not sufficient to confirm Evidence of Identify (EOI). EOI will be verified during the planning stage if the person is eligible for the NDIS.

3.10.1 If consent to access Centrelink was given

Note: If the applicant is a child, you will need to verify their age and residence information using a parent’s record. You must ask the child’s parent if you can access their record to verify their child’s age and residence.

1. Advise the person:

   I am now going to confirm the information in <your / Applicant’s> Centrelink record. Do you mind if I place you on hold for a moment while I do this?

3.10.2 Check Centrelink record in the business system

Note: You can only use the Business System to search for adult applicants. If the applicant is a child, go to Step 3.10.3: Check Centrelink record in mainframe.

Check Centrelink by name and date of birth

1. In the NDIS Account screen: Select Centrelink Search.

2. In Search Type: Select Name and Date of Birth.

3. Enter the mandatory fields.

   • If you are unsure how to spell a person’s name, do a ‘wildcard’ search using their date of birth and at least two letters of their last name.

   Note: Make sure you use the person’s legal name for this search function. The system can only search for a legal name, and not someone’s preferred name.

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Search Criteria

Search Type: Name and Date of Birth

Name Search

Required fields are marked with an asterisk (*)

First Name: redacted

• Last Name: Predacted
• Date of Birth: redacted: s47F - personal privacy

4. Select person from search results.

Note: A message indicating ‘100% match’ confirms that the search details are a match for the person’s Centrelink record. It does not indicate that the person meets the age and residence requirements.

5. View Record Details to confirm:

   • CRN
   • Name
   • Date of Birth
   • Current Address
   • Citizenship / Visa status

Record Details

Identification

CRN: redacted: s47F - personal privacy First Name: Predacted Last Name: Credacted Date of Birth: redacted: s47F - personal privacy

Address

Street: redacted: s47F - personal privacy City: redacted: s47F - personal privacy Region: redacted Post Code: redacted Country: redacted

Show Historical Addresses

Visa

Visa Subclass: redacted: s47F - personal privacy Visa Grant Status: redacted Visa Grant Date: redacted Visa Expiry Date: redacted

Citizenship

Citizenship Country: redacted: s47F - personal privacy Citizenship Start Date: redacted Citizenship End Date: redacted NZ Residence Status: redacted NZ Residence Code: redacted

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Enter/update Consent

1. In the NDIS Account screen: Select Details.
2. Select Consent.
3. Select Edit.
4. In Consent to Use: Select Centrelink.
5. In CRN: Enter CRN.
6. Select Submit.

Check Centrelink with CRN

Note: If you cannot locate the Centrelink record by searching the person’s name and date of birth, search for the record using their CRN.

1. In the NDIS Account screen: Select Centrelink Search.

2. In Search Type: Select CRN.

3. Enter CRN.

4. Select Search.

5. Select person from search results.

6. View Record Details to confirm:

   • Name
   • Date of Birth
   • Current Address
   • Citizenship / Visa status

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Record Details

Identification

CRN: redacted: s47F - personal privacy First Name: Predacted Last Name: Credacted Date of Birth: redacted: s47F - personal privacy

Address

Street: redacted: s47F - personal privacy City: redacted: s47F - personal privacy Region: redacted Post Code: redacted Country: redacted

Visa

Visa Subclass: redacted: s47F - personal privacy Visa Grant Status: redacted Visa Grant Date: redacted Visa Expiry Date: redacted

Citizenship

Citizenship Country: redacted: s47F - personal privacy Citizenship Start Date: redacted Citizenship End Date: redacted NZ Residence Status: redacted NZ Residence Code: redacted

Show Historical Addresses

3.10.3 Check Centrelink record in mainframe

Note: Follow this step if the Centrelink Search function in the Business System does not work, or if the applicant is a child.

1. View Record Details to confirm:

   • Name
   • Date of Birth
   • Current Address
   • Citizenship / Visa status

3.10.3.1 Check Centrelink — Adult

1. In the PED screen: Enter the following codes into NXT.
2. For Home Address: Enter ADH.
3. For Country of Residence: Enter CRES.
4. For Citizenship Status: Enter RSLEG.

Note: Refer to Standard Operating Procedure — Verify age and residence details using Centrelink mainframe for detailed instructions, navigation tips and list of approved screen codes.

5. Go to Step 3.11: Generate/select access application.

3.10.3.2 Check Centrelink — Child

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Note: If the applicant is a child, you will need to verify their age and residence information using a parent’s record. You must ask the child’s parent if you can access their record to verify their child’s age and residence.

1. In the PED screen: Enter the following details into NXT.

2. Enter CHS: Press Hard Enter.

3. Locate the child’s name: Type S next to it and press Enter.

4. For child’s Home Address: Enter ADH.

5. For child’s Country of Residence: Enter CHRES.

6. For child’s Citizenship Status: Enter CHRSLEG.

   Note: Refer to Standard Operating Procedure – Verify age and residence details using Centrelink mainframe for detailed instructions, navigation tips and list of approved screen codes.

7. Go to Step 3.11: Generate/select access application.

3.10.4 If person does not consent, or details do not match the business system

1. Advise the person:

   Okay, that’s fine. You will need to provide documents to us that verify <your / Applicant’s> age and residence. You can provide these documents by post or email, and we will need them within 28 days to process the access request.

   I will send you a letter with information about the required documents.

   Note: Refer to the Standard Operating Procedure – Verify age and residence using documentary evidence to provide information about the documents required.

2. Go to Step 3.11: Generate/select access application.

3.11 Generate/select access application

3.11.1 If there is not an existing open application, generate access application

1. In the NDIS Account screen: Select Pathway.
2. Select the Add Items and then select Access to create an application.
3. Go to Step 3.12: Complete enter the Access Request Form task.

3.11.2 If there is an existing open access application, select the application

1. In the NDIS Account screen: Select Pathway.
2. Select the relevant application.

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3. In the Participant Lifecycle Management screen: Select Access.
4. Select Enter the Access Request Form task.
5. Go to Step 3.12: Complete enter the Access Request Form task.

3.12 Complete enter the Access Request Form task

1. Select Enter the Access Request Form task.

2. Update the fields where incorrect or not populated:

   • Access Request Channel: Select Phone

   • Assistance Required: Do not use this feature — this will place the application on hold

   • Your Details: Information entered within the Details tab should pre-populate here

   • Title: redacted: s47F - personal privacy

   • First Name: Aredacted

   • Middle Name:

   • Last Name: Tredacted

   • Preferred Name:

   • Date Of Birth: redacted: s47F - personal privacy

   • DOB Estimated: ( ) NO

   • Gender:

     • Female
     • Male
     • (•) Unspecified

   • Consent: Information entered within the Details tab should pre-populate here

   • Contact Details: Select if person does not want to be contacted directly and enter the details of preferred direct contact

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Email Address: redacted Phone No.: redacted Mobile No.: redacted TTY: How would you like NDIA to contact you?: Email How would you like to receive letters?: Post/Letter Do you need an interpreter to help us talk with you?: No Interpreter Language: Do not contact me directly: (•) YES

• Who should we contact instead?: redacted: s47F - personal privacy

• Extra Details: Re-enter any missing information so that all fields are populated

• Are you of Aboriginal or Torres Strait Islander origin?: Neither Aboriginal nor Torres Strait Islander

• Are you South Sea Islander?: ( ) No

• • Country of Birth: Australia
• • Language spoken at home: English

Are you living in Australia permanently?: (•) YES Are you an Australian Citizen?: (•) YES

• Carers and Family Info: Ask the person:
  • Enter the information provided into the Business System

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• Are any immediate family members NDIS participants or seeking to become NDIS participants?
• Enter the information provided into the Business System
• Your Disability: Ask the person:
  • What is <your / Applicant’s> primary disability? This is the disability that has the most impact on <your / their> daily life.
  • When was this first identified?
  • Enter primary disability only, and the date identified (if known)
• Compensation: Ask the person:
  • Was <your / Applicant’s> disability caused by an accident or event?
  • Have <you / they> sought compensation for that accident or event?
  • If yes (they are seeking compensation): Thank you. I’ll ask a few more questions about <your / Applicant’s> compensation claim in a moment.
  • Enter the information provided into the Business System

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3. Select Submit.

3.13 Record compensation details (if required)

Note: Only complete this step if the person confirmed that they are seeking (or have sought) compensation for their disability. They would have answered Yes to this question in the Enter the Access Request Form task.

1. Tell the person that you are now going to ask them some questions about their compensation claim. Ask them to wait while you create a new interaction.

2. In the NDIS Account screen: Select Interactions.

3. Select Add Items and then select Interaction.

4. In Category 1: Select Pathway.

5. In Category 2: Select Access.

6. In Category 3: Select Access Request.

7. In Channel: Select Phone.

8. In Status: Select Completed.

9. Prepare this template in the Notes field:

   Compensation claim not finalised OR Compensation claim finalised: . Payment amount: . Legal advice received: <Yes / No>.

10. Recording their responses in this template, ask the person:

    • What date was the compensation claim finalised?
    • How much was the compensation payment?
    • <Have you / Has Applicant> received legal advice about the compensation matter?

11. Select Submit.

3.14 Complete request evidence documents task

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Note: You need to request evidence of disability for all Non-Defined and New applications. You only need to request evidence of age and residence if you have not verified these details through Centrelink.

1. Advise the person:

   I will now send you a letter and a form by mail explaining the information we need about <your / Applicant’s> <age/residence and> disability. This information will help us determine whether <you / Applicant> meet/s the disability or early intervention requirements to become an NDIS participant.

   You can either organise for a health professional to complete the form, or you can provide existing information you have from a health professional, such as letters, assessments or reports.

   You will need to provide this information within 28 days. We will send you a reminder letter if we have not received it within this timeframe. If you do not provide this information, we will take <your / Applicant’s> access request to be withdrawn.

   You can provide the information to us by post or email. The letter will explain how to do this.

2. In the NDIS Account screen: Select Pathway.

3. Click on the relevant application.

4. Select the Request Evidence Documents task.

5. Next to Do you want to request any evidence from this participant?: Select Yes.

6. Select the box/boxes next to the type of evidence that you wish to request:

7. Select Submit.

Note: The application status will now display as 1st Wait for Evidence.

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Application: redacted: s47F - personal privacy Created on: redacted: s47F - personal privacy Status: 1st wait for evidence Employee Responsible: redacted: s47F - personal privacy Assigned To Team: Sub-Status:

3.15 Read verbal declaration

1. Read the following declaration word for word:

   I am now going to read you a verbal declaration, which I need you to confirm you understand and agree to before I can submit <your / Applicant’s> access request.

   You certify that all the information you have provided today is true and correct. You understand that providing false or misleading information is a serious offence.

   You confirm that you are authorised to provide the personal details presented. If you provide any identity documents, such as a copy of a birth certificate, you consent to this information being checked with the document issuer or official record holder via third party systems.

   You consent to us collecting, using and disclosing <your / Applicant’s> information as discussed earlier in this phone call.

   You understand that you can withdraw consent for the NDIA to do things with <your / Applicant’s> information at any time by letting us know.

   You understand that you can access our Privacy Notice and Privacy Policy on the NDIA website or by contacting us.

   You understand that you must inform us as soon as possible about any changes in circumstance (or likely changes in circumstance) that may affect <your / Applicant’s> access request, status as an NDIS participant, or the implementation of <your / their> NDIS plan.

   For example, you must tell us if <your / Applicant’s> disability support needs change, <you / they> move house or overseas, or <you / they> get or may get compensation relating to an injury.

   You understand that if you selected email as your preferred means of communication, we may email you sensitive or confidential information, the security of which cannot be guaranteed once it leaves our system.

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• You understand that if we request further evidence or information and you do not comply with this request within the specified timeframe, <your / Applicant’s> access request may be taken to be withdrawn.
• You understand that, if applicable, access to the Commonwealth programs, Helping Children with Autism, Better Start and Mobility Allowance, will cease if <you become / Applicant becomes> a participant in the NDIS.
• Do you confirm you understand and agree to the statements I have read?

3.15.1 If the person agrees and understands

1. In the NDIS Account screen: Select Interactions.

2. Select the Arrow and then select Add Interaction.

3. In Category 1: Select Pathway.

4. In Category 2: Select Access.

5. In Category 3: Select Verbal Access Request.

6. In Channel: Select Phone.

7. In Status: Select Completed.

8. In Notes:

   VAR completed with <Applicant/Authorised Representative> on .

   <Applicant/Authorised Representative> agreed to verbal declaration read from VAR script.

   Consent to access Centrelink record <provided/not provided>. (If a child: provided consent to access their Centrelink record.)

   Consent for Third parties <provided/not provided>.

   (Delete if not applicable) <Verbal/signed consent> provided by on for to act as their authorised representative for access purposes.

   If provided and age and residence verified: Name, DOB, Australian Citizenship/Visa Subclass and current residential address verified through Centrelink record with consent by on .

   Information requested for (select all relevant) <Age / Citizenship/Visa status / Residential address / Disability>.

   Letter <emailed/mailed> to on .

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Application status: ‘1st wait for evidence’.

9. Select Submit.

3.16 End call

1. Advise the person:

   Do you have any questions for me at this point in time? That brings us to the end of our call. Thank you so much for your time today. Once we receive the information, we will make a decision about <your / Applicant’s> access request and send you a letter with the decision and information about the next steps.

2. End the call.

3. Check that the application status is 1st Wait for Evidence.

4. Check that the Employee Responsible status is blank on the application. If not, un-assign the application.

Note: The application status will display as 1st Wait for Evidence.

Application: redacted: s47F - personal privacy Created on: redacted: s47F - personal privacy Employee Responsible: Assigned To Team:

4. Related procedures or resources

• Our Guideline — Applying to the NDIS
• Our Guideline — Your privacy and information
• Our Guideline — Child representatives
• Standard Operating Procedure — Send SMS using Whispir messenger
• Standard Operating Procedure — Complete a Verbal Access Request (VAR) — Defined — WA
• Standard Operating Procedure — Complete NDIS application tasks
• Standard Operating Procedure — Identify authorised representatives at access

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• Standard Operating Procedure – Assist the participant with their preferred method of communication
• Standard Operating Procedure – Verify age and residence using documentary evidence
• Standard Operating Procedure – Verify age and residence details using Centrelink Mainframe
• NDIS Website: Offices and contacts in your area
• Fact sheet – Updating your name, pronouns or information about your gender

5. Feedback

If you would like to provide feedback about this SOP, please complete our Feedback form.

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6. Version control

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Attach evidence — validate access request

This Standard Operating Procedure (SOP) will help you process evidence received to support an applicant’s access request, like evidence of age, residence, disability or for an authorised representative to act on their behalf.

1. Recent updates

What’s changed

2. Checklist

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3. Procedure

Note: If the applicant resides in an area that is classified as Remote or Very Remote (MMM6 or MMM7 under the Modified Monash Model):

• If the work item is allocated to you through the business system, assign it to Danika redacted: s22(1)(a)(ii) - irrelevant (JS497).
• If the evidence is sent to the NAT inbox, place the email in the Remote sub-folder.

3.1 Check application status is Draft, 1st or 2nd wait for evidence

1. In the NDIS Account screen: Select Pathway.
2. View application status.

Application: redacted: s47F - personal privacy Created on: redacted: s47F - personal privacy

3.1.1 If application status is Further Information Requested

1. Do not proceed — refer to Standard Operating Procedure — Attach evidence — further information requested (s26).

3.1.2 If application status is Access Not Met

1. Do not proceed — refer to Standard Operating Procedure — Attach evidence after Access not met decision.

3.1.3 If application status is Planning (Approved)

1. Check for Eligibility Re-Assessment Request in Open Activities.

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2. If Yes, do not proceed – refer to Standard Operating Procedure – Attach evidence – Eligibility Reassessment.

3.2 Attach evidence

Note: If a work item is allocated via the Business System, this step will already be completed.

1. Save each document as a PDF and update the file name using the following convention:

   Access – – , DOB <DD.MM.YYYY>.

   For example: Access – ARF 04.08.2021 – redacted: s47F - personal privacy DOB redacted: s47F - personal privacy

3.2.1 Attach evidence to Inbound Documents

1. In the NDIS Account screen: Select Documents.
2. Select Add Items and then select Inbound Documents.
3. In Description: Access – <Document/Report name> .
4. In Document Type: Select ARF Supporting Evidence.
5. In Site Location: Select National Access Team.
6. In Status: Select Completed.
7. In Category 1: Select NDIA Service.
8. In Category 2: Select Access Request.
9. In Re: Business Process: Do not select any option (leave blank).
10. In Employee Responsible: Enter your details.
11. In Note: Record the specific document attached, and how and when it was received.

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12. Select Upload File.

Employee Responsible: redacted: s47F - personal privacy Team Responsible: redacted: s47F - personal privacy Assigned Queue Assigned Queue Partner

Note: Supporting Evidence Form received via the NAT Inbox on 25/08/2020.

13. In the File Explorer window: Open the relevant document.
14. Select Save.

3.3 Check an access request has been made

3.3.1 Check for existing open access application

1. In the NDIS Account screen: Select Pathway.
2. View application status.

• Examples of open application statuses include 1st Wait for Evidence and 2nd Wait for Evidence.
• Example of closed application statuses include Cancelled — Evidence Not Provided and Withdrawn.

Application: redacted: s47F - personal privacy Created on: redacted: s47F - personal privacy Employee Responsible: redacted: s47F - personal privacy Assigned To Team:

3.3.1.1 If existing application is open

1. Go to 3.4: Check authority to make an access request.

3.3.1.2 If no existing open application

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1. If evidence was received:

   • Before application was put into a Withdrawn status; or
   • Within 6 months of being put into a Cancelled – Evidence Not Provided status:

2. Create a new application. You do not have to contact the person to confirm their consent to apply again.

3. Go to 3.4: Check authority to make an access request.

If application is closed

1. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send ‘Contact attempt SMS template’ to advise you will be calling.

   Note: Only send this SMS before your first attempt to call the person.

   Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.

2. Make 3 telephone contact attempts to complete a Verbal Access Request (VAR).

   • If person is available:
     • Refer to Standard Operating Procedure – Complete a verbal access request (VAR), then
     • go to 3.5: Check evidence of age and residence has been provided.
   • If person is not available:
     • Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send ‘Unsuccessful contact attempt’ SMS to advise you tried to call.
       • Note: Only send this SMS after you make all required call attempts.
       • Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.
     • Go to 3.14: Send Letter – ARF cover letter.

3.4 Check authority to make an access request

Note: The applicant or their authorised representative must sign the ARF (electronic and written signatures are both acceptable) or provide verbal consent to make an access request.

Refer to Our Guideline – Your privacy and information and Our Guideline – Child representatives to decide if a person has authority to make an access request for the applicant.

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3.4.1 Consider if signed ARF or verbal consent has been provided

1. In the NDIS Account screen: Select Interactions.
2. Check for an Interaction confirming a verbal declaration has been completed.

Interaction Details:

Interaction #: redacted: s47F - personal privacy Category 1: Pathway Category 2: Access Category 3: Access Request Description: Access->Access Request

Channel: Internal Notes Status: Completed Employee Responsible: redacted: s47F - personal privacy Notes: redacted: s47F - personal privacy agreed to the verbal declaration read from the VAR script on 05/05/2020.

3.4.1.1 If no verbal declaration, check Inbound Documents for an ARF containing the relevant signature

1. Review Section 1 Part F of the ARF and confirm that this has been signed.

3.4.2 If applicant provided consent

1. Go to 3.5: Check evidence of age and residence has been provided.

3.4.3 If someone else provided consent

3.4.3.1 Check consent details

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1. In the NDIS Account screen: Select Details.

2. Select Consent.

3. View Details of Authorised Representative field to determine:

   • If the person’s name is listed as a legally authorised or an authorised representative.
   • The nature of the relationship to the applicant.
   • The scope of the legal authority to act or the consent to act as an authorised representative.
   • How the evidence of legal authority or consent to act was provided.

Consent to use

CRN: redacted Collect personal information from an authorised representative: Yes

• Details of Authorised Representative: Name: redacted: s47F - personal privacy Relationship: redacted: s47F - personal privacy Consent: Prospective participant provided express consent for access purposes How was consent provided: Written consent attached to record on 23/07/2019

3.4.3.2 If listed as an authorised representative

1. Go to 3.5: Check evidence of age and residence has been provided.

3.4.3.3 If not listed as an authorised representative

1. Go to Standard Operating Procedure — Identify authorised representatives at Access to determine if the person is an authorised representative.
2. Note: You must verify the representative’s authority to act on behalf of the applicant before you continue further.

3.4.4 If there is no signed ARF or verbal consent

3.4.4.1 Contact the person for their consent to make an access request

1. Refer to Standard Operating Procedure — Send SMS using Whispir messenger to send Contact attempt SMS template to advise you will be calling.

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Note: Only send this SMS before your first attempt to call the person.

Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.

2. Refer to 3.5: Check evidence of age and residence has been provided to decide whether the person also needs to provide evidence of age and residence. If so, complete the verbal declaration and request consent to access their Centrelink record during the call and record an interaction in the Business System.

3. Make 3 telephone contact attempts (a maximum of 2 calls per day at different times of day) to the applicant or their authorised representative. If you reach voicemail and the person identifies themselves, leave a brief message requesting that they contact the NDIA on 1800 800 110.

4. Ask the applicant or their authorised representative:

   Do you confirm that you wish to make an access request for <you / Applicant> to become a participant in the National Disability Insurance Scheme?

5. Read the Declaration and ask the person if they agree:

   I am now going to read you a verbal declaration, which I need you to confirm you understand and agree to before I can submit <your / Applicant’s> access request.

   You certify that all the information you have provided in the access request is true and correct. You understand that providing false or misleading information is a serious offence.

   You confirm that you are authorised to provide the personal details presented. If you provide any identity documents, such as a copy of a birth certificate, you consent to this information being checked with the document issuer or official record holder via third party systems.

   You consent to us collecting, using and disclosing <your / Applicant’s> information as indicated in <your / their> access request.

   You understand that you can withdraw consent for the NDIA to do things with <your / Applicant’s> information at any time by letting us know.

   You understand that you can access our Privacy Notice and Privacy Policy on the NDIA website or by contacting us.

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• You understand that you must inform us as soon as possible about any changes in circumstance (or likely changes in circumstance) that may affect <your / Applicant’s> access request, status as an NDIS participant, or the implementation of <your / their> NDIS plan.
• For example, you must tell us if <your / Applicant’s> disability support needs change, <you / they> move house or overseas, or <you / they> get or may get compensation relating to an injury.
• You understand that if you selected email as your preferred means of communication, we may email you sensitive or confidential information, the security of which cannot be guaranteed once it leaves our system.
• You understand that if we request further evidence or information and you do not comply with this request within the specified timeframe, <your / Applicant’s> access request may be taken to be withdrawn.
• You understand that, if applicable, access to the Commonwealth programs, Helping Children with Autism, Better Start and Mobility Allowance, will cease if <you become / Applicant becomes> a participant in the NDIS.
• Do you confirm you agree to and understand the statements I have read?

3.4.4.2 If the person provides consent

1. In the NDIS Account screen: Select Interactions.

2. Select Add Items and then select Interaction.

3. In Category 1: Select Pathway.

4. In Category 2: Select Access.

5. In Category 3: Select Verbal Access Request.

6. In Channel: Select Internal Notes.

7. In Status: Select Completed.

8. In Notes:

   Contact made with on .

   agreed to the verbal declaration.

   (Delete if not applicable) gave consent to access Centrelink to verify age and residence.

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(Delete if not applicable) Verbal consent provided by on for to act as their authorised representative for access purposes.

9. Select Submit.
10. Go to 3.5: Check evidence of age and residence has been provided.

3.4.4.3 If all three contact attempts are unsuccessful

1. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send ‘Unsuccessful contact attempt’ SMS to advise you tried to call.

   Note: Only send this SMS after you make all required call attempts.

   Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.

2. Go to 3.14: Send letter – ARF cover letter to send an ARF.

Note: The access request is not valid without a signature or verbal consent provided by the applicant or their authorised representative.

3.5 Check evidence of age and residence has been provided

The person will need to give consent to check their Centrelink record OR provide documentary evidence. For information about types of documentary evidence required, refer to Standard Operating Procedure – Verify age and residence using documentary evidence.

3.5.1 Check if Centrelink consent was provided

1. In Participant Account screen: Select Details.
2. Select > next to Consent.

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3. In Consent to Use:

   • If Centrelink is selected: Go to 3.6: Verify age and residence details.
   • If Consent to Use is blank: Check Interactions for consent to access the applicant’s Centrelink record:

3.5.2 If consent provided to access Centrelink record

1. Go to 3.6: Verify age and residence details.

3.5.3 If documentary evidence provided

1. Go to 3.6.3: Check documentary evidence provided.

3.5.4 If no consent to access Centrelink record and no documentary evidence

1. Go to 3.7.2: If all evidence has not been provided.

3.5.5 If unclear whether Centrelink consent was provided

1. Contact the applicant or their authorised representative for verbal consent to verify age and residence through Centrelink.

2. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send Contact attempt SMS template to advise you will be calling.

   Note: Only send this SMS before your first attempt to call the person.

   Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.

3. Make 3 telephone contact attempts (a maximum of 2 calls per day at different times of day) to the person or their authorised representative. If you reach voicemail and the

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person identifies themselves, leave a brief message requesting that they contact the NDIA on 1800 800 110.

4. Explain:

   I need to verify <your / Applicant’s> age and residence information. The easiest way to do this is by providing consent for us to access <your / their> Centrelink record.

   If applicant is an adult:

   • Do you consent to us using <your / Applicant’s> Centrelink record to obtain information about <your / their> age and residence for NDIA purposes?

   If applicant is a child:

   • As is a child, I will also need to access your Centrelink record for the purposes of verifying <Applicant’s> age and residence. This is because your Centrelink record and <Applicant’s> record are linked. Do you consent to us accessing your Centrelink record to verify <Applicant’s> age and residence?

3.5.5.1 If the person provides verbal consent

1. In the NDIS Account screen: Select Interactions.

2. Select Add Items and then select Interaction.

3. In Category 1: Select Pathway.

4. In Category 2: Select Access.

5. In Category 3: Select Access Request.

6. In Channel: Select Internal Notes.

7. In Status: Select Completed.

8. In Notes:

   If applicant is an adult:

   • gave consent to verify <their / Applicant’s> age and residence information through Centrelink on .

   If applicant is a child:

   • gave consent to access their Centrelink record to verify <Child’s> age and residence on .

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9. Select Submit.
10. Go to 3.6: Verify age and residence details.

3.5.5.2 If consent is not provided

1. Refer to Standard Operating Procedure – Verify age and residence using documentary evidence to provide information about the documents required.
2. Go to 3.12: Send letter – 1st evidence required.

3.5.5.3 If all 3 contacts attempts are unsuccessful

1. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send Unsuccessful contact attempt SMS to advise you tried to call.

   Note: Only send this SMS after you make all required call attempts.

   Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.

2. Go to 3.12: Send letter – 1st evidence required.

3.6 Verify age and residence details

Note: This information is not sufficient to verify Proof of Identity (POI). POI will be verified during planning if the applicant is eligible for the NDIS.

3.6.1 Check Centrelink record in the business system

Note: You can only use the Business System to search for adult applicants. If the applicant is a child, go to 3.6.2: Check Centrelink record in mainframe.

Check Centrelink by name and DOB

1. In the NDIS Account screen: Select Centrelink Search.
2. In Search Type: Select Name and Date of Birth.
3. Enter the mandatory fields.

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• If you are unsure how to spell a person’s name, do a ‘wildcard’ search using their date of birth and at least two letters of their last name.

Note: Make sure you use the person’s legal name for this search function. The system can only search for a legal name, and not someone’s preferred name. To support a respectful experience, explain why we need their legal name for this search. Make sure you otherwise use their preferred name in conversation. You should also check their pronouns to make sure you refer to them correctly.

Search Criteria

Search Type: Name and Date of Birth

Name Search

Required fields are marked with an asterisk (*)

• Date of Birth: redacted

Note: To narrow your search add additional information such as Date of Birth, Phone number or State.

4. Select applicant from search results.

5. View Record Details to verify:

   • CRN
   • Name
   • Date of Birth
   • Current Address
   • Citizenship / Visa status.

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Record Details

Show Historical Addresses

Identification

CRN: redacted: [s47F - personal privacy](/library/release-materials/759e22e37354-foi-24-25-0593-decision-document/material-001__s47f-personal-privacy/) First Name: Predacted Last Name: Credacted Date of Birth: redacted: s47F - personal privacy

Address

Street: redacted: s47F - personal privacy City: redacted: s47F - personal privacy Region: Post Code: Country:

Visa

Visa Subclass: redacted: s47F - personal privacy Visa Grant Status: Visa Grant Date: Visa Expiry Date:

Citizenship

Citizenship Country: redacted: s47F - personal privacy Citizenship Start Date: Citizenship End Date: NZ Residence Status: NZ Residence Code:

3.6.1.2 Enter/update consent

1. In the NDIS Account screen: Select Details.
2. Select Consent.
3. Select Edit.
4. In Consent to Use: Select Centrelink.
5. In CRN: Enter CRN.
6. Select Submit.

3.6.1.3 Check Centrelink with CRN

Note: If unable to locate the Centrelink record by searching the person’s name and date of birth, search for the record using their CRN.

1. In the NDIS Account screen: Select Centrelink Search.
2. In Search Type: Select CRN.
3. Enter CRN.
4. Select Search.

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Search Criteria

Search Type: CRN

CRN Search

Required fields are marked with an asterisk (*)

• CRN: redacted: s47F - personal privacy

5. Select applicant from search results.

6. View Record Details to verify:

   • Name
   • Date of Birth
   • Current Address
   • Citizenship / Visa status.

Record Details

Identification

CRN: redacted: s47F - personal privacy First Name: Predacted Last Name: Credacted Date of Birth: redacted: s47F - personal privacy

Address

Street: redacted: s47F - personal privacy City: redacted: s47F - personal privacy Region: Post Code: Country:

Show Historical Addresses

Visa

Visa Subclass: redacted: s47F - personal privacy Visa Grant Status: Visa Grant Date: Visa Expiry Date:

Citizenship

Citizenship Country: redacted: s47F - personal privacy Citizenship Start Date: Citizenship End Date: NZ Residence Status: NZ Residence Code:

3.6.2 Check Centrelink record in mainframe

Note: Follow this step if the Centrelink Search function in the business system does not work, or if the applicant is a child.

1. View Record Details to verify:

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• Name
• Date of Birth
• Current Address
• Citizenship / Visa status.

Check Centrelink – Adult

2. In the PED screen: Enter the following codes into NXT.

3. For Home Address: Enter ADH.

4. For Country of Residence: Enter CRES.

5. For Citizenship Status: Enter RSLEG.

   Note: Refer to Standard Operating Procedure – Verify age and residence details using Centrelink mainframe for detailed instructions, navigation tips and list of approved screen codes.

6. Go to 3.7: Consider if access request is valid.

Check Centrelink – Child

Note: If the applicant is a child, you may need to verify their age and residence information using a parent’s record. You must ask the child’s parent if you can access their record to verify their child’s age and residence.

1. In the PED screen: Enter the following details into NXT.

2. Enter CHS: Press Hard Enter.

3. Locate the child’s name: Type S next to it and press Enter.

4. For child’s Home Address: Enter ADH.

5. For child’s Country of Residence: Enter CHCRES.

6. For child’s Citizenship Status: Enter CHRSLEG.

   Note: Refer to Standard Operating Procedure – Verify age and residence details using Centrelink mainframe for detailed instructions, navigation tips and list of approved screen codes.

7. Go to 3.7: Consider if access request is valid.

3.6.3 Check documentary evidence provided

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1. Refer to Standard Operating Procedure – Verify age and residence using documentary evidence to identify suitable types of evidence to verify the applicant’s age and residence.

2. View age and residence documentation to verify:

   • Name
   • Date of Birth
   • Current Address
   • Citizenship / Visa status.

   Note: The documentary evidence must match the information provided in the ARF. If not, you will need to request further evidence.

3.6.4 If Centrelink consent or documentary evidence not provided

1. Go to 3.7.2: If all evidence has not been provided.

3.7 Consider if access request is valid

1. Does the access request contain a signature or verbal consent from the applicant or their authorised representative?

2. Were the following details verified:

   • Name
   • Date of Birth
   • Current Address
   • Citizenship / Visa Status.

3. Has evidence of disability been provided (for non-defined/new applications only)?

3.7.1 If all evidence has been provided

Note: The access request is valid.

1. Go to 3.8: Complete review evidence for intake process task.

3.7.2 If all evidence has not been provided

Note: The access request is incomplete and not yet considered valid.

1. Contact the person to ask for the required information.
2. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send Contact attempt SMS template to advise you will be calling.

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Note: Only send this SMS before your first attempt to call the person.

Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.

3. Make 3 telephone contact attempts (a maximum of 2 calls per day at different times of day) to the person or their authorised representative. If you reach voicemail and the person identifies themselves, leave a brief message requesting they contact the NDIA on 1800 800 110.

If all 3 contacts attempts are unsuccessful

1. Refer to Standard Operating Procedure – Send SMS using Whispir messenger to send Unsuccessful Contact attempt SMS to advise you tried to call.

   Note: Only send this SMS after you make all required call attempts.

   Do not contact the person by SMS if they told the agency that they do not consent to this form of communication.

2. Go to 3.12: Send letter – 1st evidence required.

3.8 Complete review evidence for intake process task

1. In the NDIS Account screen: Select Pathway.
2. Select the relevant application.
3. In the Participant Lifecycle Management screen: Select Access.
4. Select Review Evidence for Intake Process task.

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Access - Staff Tasks

• Enter Access Request Form (Last updated by redacted: s47F - personal privacy on 19.01.2021)
• Request Evidence Documents
• Consent (Last updated by redacted: s47F - personal privacy on 19.01.2021)
• Review evidence for Intake process (Last updated by redacted: s47F - personal privacy on 19.01.2021)

5. Select Submit.

3.9 Complete validate request as complete task

1. Select Validate Request as Complete task.
2. In Age and Residence sections, select the appropriate Evidence Type, then select the Verified tick boxes.

Date of Birth: redacted: s47F - personal privacy Age: 0

• Evidence Type: My First Health Record
• Verified: [✓]

Are you living in Australia permanently?: Yes Are you an Australian Citizen?: Yes

• Evidence Type: Centrelink Record
• Verified: [✓]

Do you want to Add more?: ( ) no

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3. In Impairment section, select the appropriate Evidence Type.
4. Enter the access request’s validation date.

Note: An access request is valid on the date we received all the required information, not the date you processed it.

This is the date all of the following information was received:

• Valid consent – signed ARF or VAR from applicant or authorised representative (3.4: Check authority to make an access request)
• Evidence of age and residence – Name, DOB, Australian Citizenship/Visa Subclass and current residential address verified through Centrelink record with consent or document attached to the record. (3.6: Verify age and residence details)
• Evidence of disability.

The validation date must be correct so that the decision due date is accurate and an Access Assessor can make a decision within legislative timeframes.

5. Select Submit.

Note: The application status will now display as In Progress.

3.10 Add interaction – valid access request

1. In the NDIS Account screen: Select Interactions.
2. Select Add Items and then select Interaction.

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3. In Category 1: Select Pathway.

4. In Category 2: Select Access.

5. In Category 3: Select Access Request.

6. In Channel: Select Internal Notes.

7. In Status: Select Completed.

8. In Notes:

   Access request valid on , evidence of Choose an item received and attached.

   <Applicant/Authorised Representative> Choose an item.

   Consent to access Centrelink record <provided/not provided>.

   Consent for Third parties <provided/not provided>.

   <Applicant’s> disability <was / was not> caused by an accident or event.

   (Delete if not applicable) Compensation sought/received: <Yes / No>. Compensation claim finalised: . Payment amount: . Legal advice received: <Yes / No>.

   Name, DOB, Australian Citizenship/Visa Subclass and current residential address have been verified through Choose an item. by on .

   Application status is ‘In Progress’.

   (Delete if not applicable) Choose an item. provided by on for <Authorised Representative’s name> to act as their authorised representative for access purposes.

   (Delete if not applicable) does not currently have a fixed address. They have provided <verbal / written> confirmation that they usually sleep at .

• Category 1: Pathway v

• Category 2: Access v

• Category 3: Access Request v

• Channel: Internal Notes Vv

• Status: Completed Vv

Link Transaction: O NO

Notes: / Access request valid on 09/02/2021, evidence of disability received and attached. redacted: s47F - personal privacy agreed to verbal declaration read from VAR script. Consent to access Centrelink record provided. Consent for Third parties provided.

s47F - personal privacy

Name, DOB, Australian Citizenship/Visa Subclass and current residential address have been verified through Centrelink record with consent by redacted: s47F - personal privacy on 09/02/2021. Application status is ‘In Progress’.

Verbal consent provided by redacted: s47F - personal privacy on 09/02/2021 for redacted: s47F - personal privacy to act as their authorised representative for near purposes.

9. Select Submit.
10. Select Back.

3.11 Check application status — in progress

Note: This is an essential step to ensure the application is allocated to an Access Assessor to make the access decision.

1. In the NDIS Account screen: Select Pathway.
2. Select the relevant application.
3. In the Participant Lifecycle Management screen: Select Access.
4. Check the following tasks all have a green tick:
   • Enter Access Request Form
   • Request Evidence Documents
   • Consent
   • Review Evidence for Intake process
   • Validate Request as Complete.

Note: An Access Assessor will complete the remaining application tasks.

Enter Access Request Form Last updated by - Paige Pye on 02.07.2019 v

Request Evidence Documents Last updated by - Paige Pye on 02.07.2019 v

Consent Last updated by - Paige Pye on 02.07.2019 v

Review evidence for Intake process Last updated by - Paige Pye on 02.07.2019 v

Validate Request as Complete Last updated by - Paige Pye on 02.07.2019 v

Check Determine the Access Decision task has a due date. For example: Due date: 18.09.2020 (21 days to go).

Determine the Access Decision Last updated by - redacted: s47F - personal privacy on 28.08.2020 >

Due date: 18.09.2020 (21 days to go)

In the Participant Lifecycle Management screen: Select Applications.

Check the application status is In Progress.

Participant Applications

Application: redacted: s47F - personal privacy Created on: redacted: s47F - personal privacy Assigned To Team: redacted: s47F - personal privacy Sub-Status:

8. Check the Employee Responsible status is blank. If not, un-assign the application.

Participant Applications

Application: redacted: s47F - personal privacy Employee Responsible: redacted: s47F - personal privacy on 14.01.2020 Assigned To Team: redacted: s47F - personal privacy Sub-Status:

Note: An Access Assessor can now make the access decision.

End of process — no further steps to be completed.

3.12 Send letter — 1st evidence required

3.12.1 Send letter

1. Open and edit Letter — 1st evidence required.
2. Send to the applicant or authorised representative via their preferred correspondence method.

3.12.2 Attach letter to Inbound Documents

1. In the NDIS Account screen: Select Documents.
2. Select Add Items and then select Inbound Document.
3. In Description: Letter — 1st Evidence Required.
4. In Document Type: Select ARF.
5. In Site Location: Select National Access Team.
6. In Status: Select Completed.
7. In Category 1: Select NDIA Service.
8. In Category 2: Select Access Request.

9. In Employee Responsible: Enter your details.

10. In Re: Business Process: Do not select any option (leave blank).

11. In Note: Letter <mailed / emailed> to on by .

12. Select Upload File.

13. In File Explorer window: Open the relevant document.

14. Select Save.

15. Go to 3.13: Add interaction – ARF not yet valid.

3.13 Add interaction – ARF not yet valid

1. In the NDIS Account screen: Select Interactions.

2. Select Add Items and then select Interaction.

3. In Category 1: Select Pathway.

4. In Category 2: Select Access.

5. In Category 3: Select Access Request.

6. In Channel: Select Internal Notes.

7. In Status: Select Completed.

8. In Notes:

   Evidence received on and attached to record.

   Access request not valid – further info requested.

   Choose an item. to request further information.

   <ARF not signed by the applicant or their authorised representative – signature or verbal declaration required / Centrelink consent or documentary evidence of age and residence required / Evidence of disability required>.

   Letter <mailed / emailed> to on .

9. Select Submit.

   End of process – no further steps to be completed.

3.14 Send letter – ARF cover letter

3.14.1 Send letter

1. Open and edit Letter – ARF cover letter.

2. Attach Access Request Form.

3. Send to the applicant or authorised representative via their preferred correspondence method.

3.14.2 Attach letter to Inbound Documents

1. In the NDIS Account screen: Select Documents.

2. Select Add Items and then select Inbound Document.

3. In Description: Letter – ARF Cover Letter.

4. In Document Type: Select ARF.

5. In Site Location: Select National Access Team.

6. In Status: Select Completed.

7. In Category 1: Select NDIA Service.

8. In Category 2: Select Access Request.

9. In Re: Business Process: Do not select any option (leave blank).

10. In Employee Responsible: Enter your details.

11. In Note: Letter mailed to on by .

12. Select Upload File.

13. In File Explorer window: Open the relevant document.

14. Select Save.

3.15 Add interaction – ARF cover letter

1. In the NDIS Account screen: Select Interactions.

2. Select Add Items and select Interaction.

3. In Category 1: Select Pathway.

4. In Category 2: Select Access.

5. In Category 3: Select Access Request.

6. In Channel: Select Internal Notes.

7. In Status: Select Completed.

8. In Notes:

   Evidence received on and attached to record.

   As the previous application has been finalised, must make a new access request.

   Attempted to contact to complete a Verbal Access Request (VAR).

   Signed ARF or VAR with person or their authorised representative’s consent required.

   Letter with ARF mailed to on .

9. Select Submit.

4. Related procedures or resources

• Our Guideline – Applying to the NDIS
• Our Guideline – Child representatives
• Our Guideline – Your privacy and information
• Standard Operating Procedure – Attach evidence after Access not met decision
• Standard Operating Procedure – Attach evidence – Eligibility Reassessment
• Standard Operating Procedure – Attach evidence – further information requested (redacted: s26)
• Standard Operating Procedure – Complete a verbal access request (VAR)
• Standard Operating Procedure – Complete NDIS application tasks
• Standard Operating Procedure – Identify authorised representatives at Access
• Standard Operating Procedure – Send SMS using Whispir messenger
• Standard Operating Procedure – Verify age and residence using documentary evidence
• Standard Operating Procedure – Verify age and residence details using Centrelink mainframe

5. Feedback

If you have any feedback about this Standard Operating Procedure, please complete our Feedback Form.

6. Version control

NARB BM review and approval. | APPROVED | 2021-02-08 | | 3.0 | CW0032 | Class 2: SGP BM review and approval. | APPROVED | 2021-02-10 | | 4.0 | AJK223 | Class 1: Changed to refer to SOP — Verify Age and Residence in Centrelink Mainframe.

SGB review and approval. | APPROVED | 2021-03-15 | | 5.0 | TS0036
JC0075 | Class 2: NARB BM approval
Class 2: SGP BM approval

Content update to include reference to SOP — Verify age and residence using documentary evidence

Additional note about remote and very remote applications

Additional sentence to interaction for applicants with no fixed address. | APPROVED | 2021-07-06 |

SMS instructions to use Whispir messenger. | APPROVED | 2022-02-09 | | 7.0 | CH0026
CW0032 | Class 2: NARB BM approval
Class 2: SGPB BM approval

Updates to align with new Our Guideline — Applying to the NDIS.

New instructions to:

• save evidence as a PDF document
• use the following standard PDF naming convention: Access — — , DOB <DD/MM/YYYY>.

Step 3.9 — Complete validate request as complete task: includes clearer instructions to identify the Access Request completion date so the correct validation date is recorded in the system. | APPROVED | 2022-03-27 | | 8.0 | EMN960 | Class 1 approval.

New note to explain to use legal name for a search rather than preferred name.

Updated screenshots. | APPROVED | 2023-02-17 |

DOCUMENT 4 FOI 24/25-0113

OFFICIAL Knowledge Article

For Internal Use Only

The contents of this document are OFFICIAL.

Review the escalation and prioritisation matrix

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for a local area coordinator, early childhood partner and all NDIA staff (planner delegate, payments officer, internal review delegate, complaints officer, participant support officer, access delegate, technical advisors, National Contact Centre, liaison officers (HLO/JLO), complex support needs (CSN) planner, national reassessment delegate) to:

• record the risk level and type within PACE
• use the escalation and prioritisation matrix.

Recent updates

October 2023

Current guidance.

Before you start

You have read and understood:

• the NDIS Complaints and Feedback Framework (DOCX 486KB)
• what the Complaints and Participant Incidents Team is responsible for
• article Understand compliments, feedback and complaints
• article Create a feedback and complaints case

Record the risk level and type within PACE

When you create or update a Feedback and Complaints case, you will need to assess the Risk and Risk Type at the Complaints Categorisation screen of a Feedback and Complaints case. You can assess the Risk and Risk Type using the escalation and prioritisation matrix below.

The Risk and Risk Type indicate the required resolution timeframe. Once the case is submitted, the complaint case will be routed accordingly. To learn more about how different complaints levels are routed, go to article Understand compliments, feedback and complaints.

You can record the Risk and Risk Type at the Complaints Categorisation screen in a Feedback and Complaints case. For more information, go to article Record a complaint in a feedback and complaints case.

Use the escalation and prioritisation matrix

The following information will help you understand the escalation and prioritisation matrix.

There are 10 types of risk you can input within PACE:

• Risk of harm to the health or well-being of a person
• Instability of accommodation arrangements of a person
• Instability in the care arrangements of a person
• Risk associated with the nature of the person’s disability
• Risk associated with the availability of supports
• Risk of inaccurate media report is uncorrected
• Risk that the NDIA is seen as unresponsive to stakeholder and participant concerns
• Risk to the Ministers’ confidence in the NDIA’s responsiveness
• Risk of adverse finding by government stakeholder
• Deterioration of key relationship (Jurisdiction, Ombudsman, court, tribunal).

For each Risk Type, you will need to assess the Risk as low, medium, high or extreme. This assessment will help you to determine the timeframe in which you must respond to and resolve a complaint. For:

• Low risk, the timeframe for contact or a response is 2 days, and for a resolution is 15 days
• Medium Risk, the timeframe for contact or a response is one day, and for a resolution is 15 days
• High Risk, the timeframe for contact or a response is the same day (or as specified), and for a resolution is 10 days (or as specified)
• Extreme risk, the timeframe for contact or a response is 2 hours (or as specified), and for a resolution is 10 days (or as specified).

For feedback and complaints, you need to understand:

• Contact is when you make contact with the participant (or their authorised representative) to talk about and confirm escalation
• A Response is when you provide an update on the next steps and timeframes to the complainant. This may or may not be that the matter is finalised or resolved, for example Minister or Member of Parliament, Ombudsman, State Ministry. Specified timeframes apply to Ministerial or Ombudsman responses
• A Resolution means the matter is either completely finished, the safety risk has been mitigated or the next steps are clear or in progress.

Risk of harm to the health or well-being of a person

Low risk Absence of support or action is contributing to a general risk of harm.

Medium Risk Absence of support or action is contributing to a medium-term risk of harm.

High Risk Absence of support or action is contributing to a short-term risk of harm.

Extreme risk Absence of support or action is contributing to an immediate risk of harm.

Instability of accommodation arrangements of a person

Low risk The participant has a generalised risk of homelessness or inappropriate housing solution and the NDIA has a role in working with State services to rectify.

Medium Risk The participant is at risk of homelessness or inappropriate housing solution in the medium-term and the NDIA has a role in working with State services to rectify.

High Risk The participant is at risk of homelessness or inappropriate housing solution in the short-term and the NDIA has a role in working with State services to rectify.

Extreme risk The participant is at risk of immediate homelessness and the NDIA has a role in working with State services to rectify.

Instability in the care arrangements of a person

Low risk There is a risk of family or informal care breakdown and support may prevent such a breakdown.

Medium Risk Absence of supports is contributing to family or informal care breakdown or such breakdown could be prevented by timely inclusion of supports.

High Risk Absence of supports is contributing to family or informal care breakdown or such breakdown could be prevented by rapid inclusion of supports.

Extreme risk Absence of supports is contributing to an immediate risk of family or informal care breakdown.

Risk associated with the nature of the person’s disability

Low risk Absence or lack of certainty of continuation of supports is likely to contribute to deterioration or progression.

Medium Risk Absence or lack of certainty of continuation of supports is contributing to deterioration or progression of condition.

High Risk Absence of support is contributing to existing deterioration or progression of condition.

Extreme risk Absence of support is contributing to existing rapid deterioration or progression of condition.

Risk associated with the availability of supports

Low risk The plan will expire or funds will be exhausted within two weeks so that critical supports can’t be accessed.

Medium Risk The plan will expire or funds will be exhausted within a week so that critical supports can’t be accessed.

High Risk The plan is about to expire or funds exhausted so that supports that are immediately needed can’t be accessed.

Extreme risk The plan has expired or funds exhausted so that critical supports that are immediately needed can’t be accessed.

Risk of inaccurate media report is uncorrected

Low risk Where the NDIA has given an undertaking to contact and resolve in timeframe.

Medium Risk Where there has been a request from a news outlet with a credible story OR where the NDIA has given an undertaking to contact and resolve in timeframe.

High Risk Where there has been a request from a news outlet with broad coverage OR where a potential story can be prevented by timely intervention by the NDIA.

Extreme risk Where the Minister or NDIA will be engaging with the media, or there is a story already with broad coverage that is building momentum.

Risk that NDIA is seen as unresponsive to stakeholder and participant concerns

Low risk Where there is the potential for stakeholder tension if the NDIA does not acknowledge in a timely way.

Medium Risk Where an issue could potentially gain traction but can be prevented by timely intervention by the NDIA.

High Risk Where an issue could potentially gain traction but can be prevented by rapid intervention by the NDIA.

Extreme risk Where an issue is currently known and a lack of response from the NDIA will exacerbate tension.

Risk to the Ministers’ confidence in the NDIA’s responsiveness

Low risk Where the Minister’s Office (MO), Assistant Minister’s Office (AMO) or Members and Senators Contact Office (MaSCO) has requested informal or formal advice.

Medium Risk Where the MO, AMO or MaSCO has requested informal or formal advice having identified specific sensitivities.

High Risk Where the MO or AMO have identified specific sensitivities with short timeframes (e.g. Ministerial meeting).

Extreme risk Where the MO or AMO have identified specific sensitivities with extreme timeframes (e.g. Question Time Brief (QBT) or parliamentary or media appearance).

Risk of adverse finding by government stakeholder

Low risk Where a failure to respond or act would affect the NDIA’s ability to provide general information in an effective way.

Medium Risk Where a failure to respond or act would affect the NDIA’s ability to provide pertinent information in an effective way.

High Risk Where a failure to respond or act in the timeframe would prevent the NDIA providing critical information.

Extreme risk Where a failure to respond or act in the timeframe would lead to the NDIA breaching mandated timeframes.

Deterioration of key relationship (Jurisdiction, Ombudsman, court, tribunal)

Low risk Where a failure to respond or act would prevent the NDIA effectively engaging with the stakeholder.

Medium Risk

Where a failure to respond or act would be seen as disrespectful to the role of the stakeholder.

High Risk Where a failure to respond or act in the timeframe would breach convention or agreed timeframes.

Extreme risk Where a failure to respond or act in the timeframe would lead to the NDIA breaching mandated timeframes.

Next steps

1. Record the complaint case in PACE using the steps in article Record a complaint in a feedback and complaints case.

Article labels – internal use only

PACE user role names

Add: User role name label Delete: User role name label No change.

Topics

Add: Topic label Delete: Topic label No change.

Case names

Add: Case name label Delete: Case name label No change.

Ownership

Add: Ownership label Delete: Ownership label

No change.

Version control

DOCUMENT 5 FOI 24/25-0113

OFFICIAL Knowledge Article

For Internal Use Only

The contents of this document are OFFICIAL.

Create a participant plan change request where the legislative type isn’t specified

Guidance in this document is not approved for use unless you view it in PACE.

This article provides guidance for a local area coordinator, early childhood partner, planner delegate, payments officer, review officer, complaints officer, participant support officer, access delegate, technical advisors, National Contact Centre, liaison officers (HLO/JLO) or planner (non-partnered area) to:

• create a plan change case
• create a participant plan change request where the legislative type isn’t specified
• add a subject to the plan change case.

Note: This article is for a plan change request where the plan change type hasn’t been specified. Don’t use this article for specific requests for a plan variation (s47A) or a plan reassessment (s48). You’ll need to go to article Create a plan variation (s47A) request or Create a plan reassessment (s48) request.

Recent updates

24 June 2024 Updated guidance to include link for new scripting article Discuss a participant’s plan change request.

28 May 2024 Update to reflect new mandatory subject line drop-down feature.

Before you start

You have:

• received a plan change request from a participant or their authorised representative
• completed steps in article Prepare to submit a plan change request
• read and understood Our Guideline – Changing your plan (external).

Create a plan change case

You can receive a plan change request verbally, in an email or in a change of circumstances form. The change of circumstances form doesn’t have to be completed to submit a plan change request, however supporting evidence and information should be provided.

You must use the scripting in section Check supporting information to submit a plan change of article Discuss a participant plan change request when speaking to the participant or their authorised representative.

To request changes to a participant’s plan, you’ll need to create a plan change case. A plan change case can also be initiated from other cases such as a check-in case.

To create a plan change case:

1. From the Person Account, select the Cases tab.
2. Select New.
3. Select Plan Change from the list of case types.
4. Select Next.
5. Confirm the Status is set to Draft. The plan change case should remain in Draft status as the default status when creating the case.
6. Select Case Origin from the drop-down list.
7. Add Internal Comments about the case, if required.
8. Select Save. You have now created the plan change case.

Create a participant plan change request where the legislative type isn’t specified

You’ll use a participant plan change request when you’ve received a request for a plan change, but the legislative type is not specified. This is the preferred option unless the participant or authorised representative clearly indicates the plan change type. When submitted, the delegate will decide what legislative type matches the request.

To create a participant plan change request:

1. From the Plan Change case, select the Request tab.

2. Select the Requested Date of the plan change. This will default to today’s date. Note: Plan change requests can be backdated.

3. Under How is the request being initiated?, select Participant plan change request.

4. Select Who is requesting the plan change?. If selecting Related Party, you’ll need to select the authorised representative making the request from the list that appears.

5. Select Next.

   Note: Save for Later won’t work when you add a new plan change request in the same plan change case after it has been submitted.

Plan Change Requests

To progress a participant plan change request where the legislative type isn’t specified select the checkbox next to each plan change request that applies:

• An emergency situation has occurred that impacts the funding needs. Go to section Emergency Situation in this article.
• Change to the fund management type. Go to section Fund Management Type in this article.
• Change the reassessment date. Go to section Reassessment Date in this article.
• A correction of a minor or technical error. Go to section Minor or Technical Error in this article.
• Minor change to the funding. Go to section Minor change to funded supports in this article.
• Change in Situation. Go to section Change in situation in this article.

When you select a checkbox, it’ll automatically add the change request to the workflow for completion. Complete the relevant steps for each plan change request you have selected.

Emergency Situation

For more information about what is considered an emergency situation for plan variations go to section We believe that you need crisis or emergency funding because of a significant change to your support needs in Our Guideline – Changing your plan (external).

Follow the steps below to record a request due to an emergency situation:

1. Select Date (calendar) for When did the emergency situation first happen?.
2. Describe the emergency situation in the free text field.
3. Record details which support the request in the free text field.
4. Select Next.
5. If applicable, use the Documents tab to add documents related to the emergency situation. Refer to articles Add documents to a case and Add and link evidence to a case.
6. Select Next.

Fund Management Type

To understand what a change to a plan management type is go to section Update how the funds or other aspects of your plan are managed in Our Guideline – Changing your plan (external).

When you record a request to change the fund management type, record:

• how the participant or authorised representative wants the funding for supports to be managed
• any reasonable risks or other impacting circumstances. For example, if the participant becomes insolvent under administration, they can’t self-manage the supports in their plan
• information relating to the misuse of funds. This will impact the management of funding for supports under the plan.

Follow the steps below to record a request to change the fund management type:

1. Select the Update checkbox next to the support categories where a change to the fund management type is being requested.
2. Select the Plan Management Type from the drop-down list.
3. Capture Details of the change in fund management in the free text field.
4. Provide detailed reasoning for request in the free text field.

5. If you need to update fund management for another support category, go back to step 1. Otherwise, select Next.
6. If applicable, use the Documents tab to add documents relating to the change in fund management. Refer to articles Add documents to a case and Add and link evidence to a case.
7. Select Next.

Reassessment Date

This type of request is to bring the reassessment forward or extend the reassessment date. For example, when a participant would prefer to have a longer plan duration and their support needs are stable. To learn more go to section Change the reassessment date in Our Guideline – Changing your plan (external).

Before creating a request to change the reassessment date, make sure the participant or authorised representative:

• knows continuing with the same supports means they’re working towards the same goals with the same supports
• is continuing to work towards pursuing the same plan goals
• agrees to continue with the same supports in their plan
• confirms their current funded supports are meeting their ongoing needs
• confirms their support needs and situation are likely to be stable for the new plan duration
• understands their options for an internal review if they disagree with the plan reassessment date
• understands they can ask for a plan change if their circumstances change before their next plan reassessment.

Follow the steps below to record a request to change the reassessment date:

1. Select the New Reassessment Date Year from the drop-down list.
2. Select the New Reassessment Date month from the drop-down list.
3. Select Calculate New Reassessment Date.

4. Capture Details of the request to change the reassessment date in the free text field.
5. Provide detailed reasoning for request in the free text field. Note: Include specific reasons why the participant would like to change the reassessment date. For example, the participant’s disability or living situation isn’t stable, or the participant entered the NDIS under the early intervention criteria and is likely to have met their goals and likely to leave the scheme in the next 3 years.
6. Select Next.
7. If applicable, use the Documents tab to add any documents relating to the change in reassessment date. Go to articles Add documents to a case and Add and link evidence to a case.
8. Select Next.

Minor or Technical Error

To understand what can be changed under a minor or technical error, go to section Fix a small or technical error in Our Guideline – Changing your plan (external).

Follow the steps below to record a request to fix a minor or technical error:

1. Capture Details of the error in the free text field.
2. Provide detailed reasoning for request in the free text field.
3. Select Next.
4. If applicable, use the Documents tab to add any evidence related to a minor or technical error.
5. Select Next.

Minor change to funded supports

It’s important to remember that adding a significant amount of funding wouldn’t be considered a minor change. To understand what a minor change to the statement of participant supports that increases funding is, go to section Change the statement of participant supports that is in your current plan, or of the funding of supports under the plan in Our Guideline – Changing your plan (external).

Follow the steps below to record a request about a minor change in funding:

1. If the request is for an existing support, select the Update checkbox next to the support category where a change of funding is being requested. If the request is for a new support category, select the Support Category from the drop-down list.
2. Describe change to funding for each selected/added support category in the free text field.
3. Provide detailed reasoning for request in the free text field.
4. If you need to update or add an additional support category, go back to step 1. Otherwise, continue to step 5.
5. Select Next.
6. If applicable, use the Documents tab to add any documents relating to a change in funding for a support category. Refer to articles Add documents to a case and Add and link evidence to a case.
7. Select Next.

Change in Situation

To learn more about what a significant change in situation for a participant is go to section What is a plan reassessment? in Our Guideline – Changing your plan (external).

Follow the steps below to record a request about a change in situation:

1. Select the Change in Situation from the drop-down list.
2. Select Date (calendar) for When did this change happen?
3. Provide details of the situation in the free text field.
4. If the new plan requires a change in fund management, select the checkbox next to Change to fund management required.
5. If required, Provide Reason for fund management change in the free text field.

6. If you need to provide an additional change in situation request, select Add on the top right hand side of this screen and complete the above steps until all change in situation requests are captured. Otherwise, select Next.
7. If needed, use the Documents tab to add any documents relating to the change in situation. Refer to articles Add documents to a case and Add and link evidence to a case.
8. Select Next.

Risk Matrix

Check for any risks associated with the plan change request which could impact on the participant, nominee or NDIS.

If you don’t identify any risks:

1. Select No.
2. Select Next to progress the case.

If you identify a risk:

1. Go to article Identify and escalate risks in plan change request to complete this section.

Request Confirmation

1. If required, select a section to review from the Steps workflow.
2. You’ll need to add a subject to the plan change case. This is to make sure cases can be routed efficiently. Go to section Add subject to the plan change case in this article, before going to the next steps.
3. Select the checkbox next to I confirmed the information recorded is accurate (mandatory in order to proceed for submit).
4. Select Submit.

Note: Don’t manually move the case status from Draft. Refresh your browser after the plan change request has been submitted. The case status will automatically change to New.

Add a subject to the plan change case

To assist delegates with managing work, you’ll need to add a subject to the plan change case before submitting the case.

1. From the Plan Change case, select the Details tab.
2. Under the System Information heading, select Edit Subject (pencil).
3. Select the correct Subject from the drop-down options. Use the table below to understand each subject.

Note: If there’s more than one subject, you should select the most urgent. If Exhausted Funds or Breakdown of Informal Supports are a factor, make sure this is the subject used.

| Other | Should only be used where no other relevant theme is identified |

4. Select Save.

Next Steps

Once submitted, a plan change case will automatically be allocated to the Plan Change Routing Queue. The request information will no longer be available under the Request tab in the Plan Change case.

1. If you’re not the decision maker on the plan change request, there are no further steps.
2. If you’re the delegate making the decision on the plan change:
   • Assign and review the plan change case. Go to article Assign and review a plan change case.

Article labels – internal use only

PACE user role names

Add: User role name label Delete: User role name label No change.

Topics

Add: Topic label Delete: Topic label No change.

Case names

Add: Case name label Delete: Case name label No change.

Ownership

Add: Ownership label Delete: Ownership label

No change.

Version control