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National Disability Insurance Agency
Legal, Reviews, Actuarial and Data Group
Standard Operating Procedure: Early Assessment
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Document Control
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| Document No. | NDIA-ERB-SOP-027 |
|---|---|
| Date | April 2025 |
| Status | FINAL |
| Version | 001 |
| Document applicability | National — Legal, Reviews, Actuarial and Data Group |
| Owner | Director, Continuous Improvement |
Approval Status Log
| Version | 001 |
|---|---|
| Reviewed by | Director, Early Assessment Special Counsel, Dispute Resolution |
| Endorsed by | Branch Manager, External Review Branch Deputy Chief Counsel, Dispute Resolution & Litigation Branch Branch Manager, Information Release, Privacy and Legal Operations Branch |
| Approved by | NDIA Strategic Leadership Team |
| Approval date | 30 April 2025 |
Revision History
| Revision | Date | Sections | Summary of Changes |
|---|---|---|---|
| 1 | 30/04/2025 | All | Original (formerly NDIA-AAT CM-SOP-027) |
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NDIA-ERB-SOP-027-V001-FINAL
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SOP: Early Assessment
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Contents
- Introduction 4 1.1 Purpose 4 1.2 Scope 4 1.3 Definitions 4 1.4 Roles and Responsibilities 4
- Checklist 5
- Procedure 7 3.1 Allocating matters to EA 7 3.2 Allocating matters to an EA CM and ILO 7 3.2.1 Matters which are likely to resolve at the time of first contact 7 3.3 Creating an EA Module in LEX 8 3.4 Creating a key date reminder in LEX 8 3.5 Initial review of the matter by EA CM 9 3.6 Contacting the participant or prospective participant 9 3.6.1 Determining a person’s preferred contact method 9 3.7 Receipt of legal advice and litigation strategy 10 3.8 Requesting internal specialist advice 10 3.9 Gathering further evidence 10 3.10 Determining whether a matter can be resolved 11 3.11 Resolving a matter 11 3.11.1 Developing and approving an offer to resolve the matter 11 3.11.2 Presenting an offer to a participant or prospective participant 11 3.11.3 Where an offer is not accepted, or where no response is received 12 3.11.4 Where an offer is accepted 12 3.11.5 Implementing an ART Order 12 3.12 Where the matter cannot be resolved 13 3.12.1 Where further evidence is required to resolve a matter 13 3.13 Returning matters to Legal Operations for reallocation to DR 13 3.13.1 Matters which are unsuitable for Early Assessment 13 3.13.2 Matters which cannot be resolved 14
- Process Flowchart 16
- Annexures 17 5.1 Annexure A — Email Templates 17
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5.1.1 Annexure A1 — Introductory email to a participant, prospective participant, or their representative 17 5.1.2 Annexure A2 — Email presenting an offer to resolve the matter 19 5.1.3 Annexure A3 — Email to a participant or prospective participant when a matter is transferred to DR Case Management 20 5.2 Annexure B — EA Module Fields and Definitions 21
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1. Introduction
1.1 Purpose
This Standard Operating Procedure provides general information about the Early Assessment (EA) process, and offers tailored support and guidance to EA Case Managers in managing applications to the Administrative Review Tribunal (ART).
1.2 Scope
This SOP applies nationally across the External Review Branch (ERB), the Dispute Resolution and Litigation Branch (DR&L), and the Information Release, Privacy, and Legal Operations Branch (IRPLO) and is to be used by:
- Early Assessment Case Managers (EA CM);
- Internal Legal Officers (ILO); and
- Legal Operations Officers.
1.3 Definitions
TABLE 1 — TABLE OF KEY DEFINITIONS
| Term | Definition |
|---|---|
| Early Assessment (EA) | The process of assessing ART Applications with a primary focus on reaching and facilitating early resolution outcomes (where possible), and on enhancing participant and prospective participant experience by providing information about NDIS supports and the ART process — before the matter proceeds to Dispute Resolution (DR). |
1.4 Roles and Responsibilities
The roles and responsibilities set out in the Standard Operating Procedure: Document Control Procedure apply also to this procedure.
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2. Checklist
| Topic | Checklist |
|---|---|
| Pre-Requisites | ☐ An ART Application has been triaged, and assigned to the Early Assessment team; and ☐ where necessary, the jurisdiction of the Tribunal to consider the application has been confirmed or an extension of time has been granted in which to apply to the ART for review of a decision. |
| Actions | For Legal Operations Officers: ☐ 3.1 Allocating matters to EA For the Director, Early Assessment (or their proxy): ☐ 3.2 Allocating matters to an EA CM and ILO For the Special Counsel, Dispute Resolution (or their proxy): ☐ 3.2 Allocating matters to an EA CM and ILO ☐ 3.2.1 Matters which are likely to resolve at the time of first contact For EA Case Managers: ☐ 3.3 Creating an EA Module in LEX ☐ 3.4 Creating a key date reminder in LEX ☐ 3.5 Initial review of the matter by EA CM ☐ 3.6 Contacting the participant or prospective participant o 3.6.1 Determining a person’s preferred contact method ☐ 3.7 Receipt of legal advice and litigation strategy ☐ 3.8 Requesting internal specialist advice ☐ 3.9 Gathering further evidence ☐ 3.10 Determining whether a matter can be resolved ☐ 3.11 Resolving a matter o 3.11.1 Developing and approving an offer to resolve the matter o 3.11.2 Presenting an offer to a participant or prospective participant o 3.11.3 Where an offer is not accepted, or where no response is received o 3.11.4 Where an offer is accepted o 3.11.5 Implementing an ART Order ☐ 3.12 Where the matter cannot be resolved o 3.12.1 Where further evidence is required to resolve a matter |
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| Topic | Checklist |
|---|---|
| Actions (cont.) | ☐ 3.13 Returning matters to Legal Operations for reallocation to DR o 3.13.1 Matters which are unsuitable for Early Assessment o 3.13.2 Matters which cannot be resolved |
| Further Reference | ☐ 4 Process Flowchart ☐ 5.1 Annexure A — Email Templates ☐ 5.2 Annexure B — EA Module Fields and Definitions |
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3. Procedure
3.1 Allocating matters to EA
After preparing and lodging T-Documents with the Tribunal, Legal Operations Officers will allocate matters to ‘Early Assessment — Unallocated’ and to the Special Counsel, Dispute Resolution in LEX.
Note: At the same time as serving the T-Documents, the Legal Operations Officer will communicate to the participant or prospective participant that a Case Manager will make contact within ten business days, using the person’s preferred method of contact.
Where applicable, matters will only be allocated to EA after the jurisdiction of the Tribunal is confirmed, or after an extension of time is granted. The Legal Operations team is responsible for the management of jurisdictional issues arising in ART Applications (including where an extension of time is required to apply for review of a decision). For further procedural guidance, please refer to the Standard Operating Procedure: Interlocutory Applications — Jurisdiction and the Standard Operating Procedure: Interlocutory Applications — Extension of Time (EOT).
Matters will not be allocated to EA only if, at the time of potential allocation, the first Case Conference or Directions Hearing is listed within three weeks.
3.2 Allocating matters to an EA CM and ILO
Within two business days of a matter being allocated to EA in 3.1 — the Director, Early Assessment and the Special Counsel, Dispute Resolution (or their proxies) will work together to identify the matters which are likely to be resolved at the time of first contact, and to enable the concurrent allocation of the matter to both an EA CM and an internal or external Lawyer with carriage (LWC).
All matters will be allocated to an EA CM. The EA CM will receive a system-generated email notifying them that a matter has been allocated to them in LEX.
With the exception of the matters which are identified as being likely to resolve at the time of first contact — high-risk matters will be allocated to an ILO, subject to internal capacity. Low or medium-risk matters will be outsourced to an external Legal Service Provider (LSP) by a Legal Operations Officer.
The LWC will begin preparing legal advice and a litigation strategy upon allocation.
3.2.1 Matters which are likely to resolve at the time of first contact
Matters which are identified as being likely to resolve at the time of first contact will be allocated to a LWC upon receipt of instructions from the EA CM to prepare Terms of Agreement.
Unless instructions are provided by an EA CM to prepare written Terms of Agreement within six business days of the matter being allocated to the EA CM in 3.2 — the Special Counsel (or their proxy) will allocate the matter to an
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ILO or seek to have the matter outsourced to an LSP. The LWC will begin preparing legal advice and a litigation strategy upon allocation.
3.3 Creating an EA Module in LEX
An EA Module must be created in LEX for all matters which are reviewed by EA. EA CMs are responsible for creating an EA Module upon allocation of the matter.
To create an EA Module in LEX, navigate to the Early Assessments tab, select Add early assessment, and complete the form fields as below:
- Status: Active
- Early Assessment Name: EA of [
] ART — <(Prospective) Participant first name and LAST NAME> and NDIA ( ) for example: EA of [12345] ART — John DOE and NDIA (2025/0000) - Matter Type: Access / Planning
- Early Assessment Stage: 01 Reviewing
Once created, the EA Module must be linked to the matter in LEX. To do so, select Assign early assessment to an existing matter and, when prompted, input the matter LEX ID, and use the drop-down menu to select your name, as below. Select Save in the bottom right-hand corner of the window.
- Assign the early assessment to this matter:
- EA Completed By:
3.4 Creating a key date reminder in LEX
The EA CM will create a key date reminder for three weeks prior to the first Case Conference (CC) or Directions Hearing (DH).
To create a key date reminder, locate the matter in LEX and navigate to the Reminders tab, and select Add on the right-hand side of the tab. Complete as below, and then select Save.
- Status: To do
- Due date:
- Reminder type: Key Date
- Team / NDIA staff name: Early Assessment —
- Notes: 3 weeks to
on
All matters must be referred to Legal Operations for reallocation to a Dispute Resolution (DR) Case Management team no later than three weeks before the first Case Conference or Directions Hearing.
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3.5 Initial review of the matter by EA CM
Once an EA Module and a key date reminder have been created in 3.3 and 3.4 above — the EA CM will conduct an initial review of the following:
- the internal review decision;
- the evidence which was before the Internal Review Officer;
- the ART Application, including the participant’s or prospective participant’s reasons for seeking review and their preferred method of contact;
- any evidence provided together with the ART Application, which was not before the Internal Review Officer; and
- potential risk factors arising in the ART Application or in connection with the issues in dispute, or otherwise related to the participant’s or prospective participant’s circumstances.
3.6 Contacting the participant or prospective participant
Within five business days of the matter being allocated to an EA CM in 3.2 — the EA CM will contact the participant or prospective participant (or their representative) using the person’s preferred method of contact, and:
- introduce themself and explain the EA process, and the ART pathway;
- clarify the issues in dispute before the Tribunal, and confirm the participant’s or prospective participant’s desired outcome of their ART Application;
- ask whether the participant or prospective participant would like to submit any further evidence which was not previously submitted together with their ART Application, or in support of their request for internal review; and
- determine the most appropriate next steps in the progression of the matter, and discuss an appropriate time to make further contact.
The EA CM will create a file note in LEX to record that contact was made, which also summarises their conversation with the participant or prospective participant (or their representative).
3.6.1 Determining a person’s preferred contact method
The ART Application will indicate the participant’s or prospective participant’s preferred method of contact (or that of their representative).
EA CMs will also review LEX, PACE and/or CRM and consider the nature of the participant’s or participant’s impairments to identify any accessibility-related communication needs which may inform how contact is to be made.
Where appropriate, the Agency’s preference is for contact to be made by telephone, followed by an email containing the Early Assessment Case Manager’s contact details.
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A template email to the participant or prospective participant (or their representative) is contained at Annexure A1 — Introductory email to a participant, prospective participant, or their representative.
3.7 Receipt of legal advice and litigation strategy
Unless instructed otherwise by the EA CM, the LWC will begin preparing legal advice and a litigation strategy upon allocation of the matter in 3.2.
Legal advice and a litigation strategy will be provided to the EA CM within no more than fifteen business days of the matter being allocated to the LWC.
Once received, the EA CM will upload a copy of the legal advice and litigation strategy to LEX, appropriately categorising the document upload using the document type Advice: Legal (internal) or Advice: Legal (external).
Upon receipt of legal advice and a litigation strategy, the EA CM will discuss the matter with the LWC, including their views and appropriate next steps.
3.8 Requesting internal specialist advice
For general information around the internal specialist support available to Agency staff, please refer to the Technical Advice and Practice Improvement (TAPIB) Hub.
If internal specialist advice or assistance is required, the EA CM will:
- email a completed TAPIB Advice Request Form — EA to TAPIB, attaching a copy of the T-Documents and any additional available evidence (if any). A template advice request form can be accessed from the External Review Branch Guidance Library and Directory;
- create a file note in LEX to record that internal specialist advice has been requested, and the date on which the request was made;
- create a reminder in LEX for the provision of internal specialist advice and/or assistance; and
- update the EA Module in LEX, as appropriate.
Where possible, internal specialist advice and/or assistance will be provided within five business days.
Once received, the EA CM will upload a copy of the advice to LEX, appropriately categorising the document upload using the document type Advice: TAPIB.
3.9 Gathering further evidence
The EA CM will continue to work with the participant or prospective participant (and/or their representative) and the LWC to gather and consider additional evidence, to support early resolution of the matter where possible.
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The EA CM will seek the consent of the participant or prospective participant to obtain further evidence — which may include posing targeted questions to the person’s treating practitioner, or engaging an Independent Expert Clinician (IEC).
3.10 Determining whether a matter can be resolved
Based on the available evidence and the available advice, the EA CM will determine whether the matter can be resolved.
If the matter can be resolved, proceed to 3.11.
If the matter cannot be resolved, proceed to 3.12.
3.11 Resolving a matter
3.11.1 Developing and approving an offer to resolve the matter
The Agency will adopt a person-centred, resolution-focused approach which ensures matters are resolved in a transparent and timely manner.
Where possible, the EA CM will develop an offer to either resolve the matter in full (full offer), or to narrow the issues in dispute before the Tribunal by resolving some, but not all, of the issues in dispute (partial offer).
In keeping with the Decision-Making Authority for Case Managers, EA CMs are authorised to resolve matters where their decision to do is supported by legal advice or internal specialist advice, and where their decision is approved by their line manager.
For procedural guidance around developing and recording an offer as a file note in LEX, and around submitting an offer for line manager approval in LEX, please refer to the Standard Operating Procedure: Resolved by Consent.
3.11.2 Presenting an offer to a participant or prospective participant
For detailed procedural guidance around presenting an offer to a participant or prospective participant (or their representative), please refer to the Standard Operating Procedure: Resolved by Consent.
Offers will only be presented to participants or prospective participants (or their representatives) using their preferred contact method. Where an offer is presented over the phone, the EA CM will send a follow-up email which confirms the offer made (Annexure A2 — Email presenting an offer to resolve the matter).
Note: When making a partial offer to resolve some, but not all, of the issues in dispute, it is critical that the EA CM outline (in plain English) the reason(s) for being unable to resolve the remaining issues in dispute.
The EA CM will update the EA Module in LEX to reflect that an offer has been made, the type of that offer, and the date on which the offer was made.
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If necessary, the EA CM will make multiple and varied attempts to follow up the offer presented if they have not received a response from the participant or prospective participant (or their representative).
3.11.3 Where an offer is not accepted, or where no response is received
Where an offer is not accepted, or where no response is received at least three weeks before the first CC or DH — that offer becomes the Agency’s updated position as the matter progresses before the Tribunal, and the EA CM will return the matter to Legal Operations for reallocation to the appropriate DR Case Management team.
Proceed from 3.13.
3.11.4 Where an offer is accepted
The EA CM will update the EA Module in LEX to reflect that an offer has been accepted, and to note the date on which the offer was accepted.
Once an offer is accepted, the EA CM will instruct the LWC to prepare formal Terms of Agreement for clearance by the EA CM, prior to signature by (or on behalf of) the parties, and lodgement with the Tribunal.
For further procedural guidance, please refer to the Standard Operating Procedure: Resolved by Consent.
3.11.5 Implementing an ART Order
The EA CM is responsible for implementing the ART Order as soon as possible, in accordance with the Standard Operating Procedure: Implementing an ART Decision, Order, or Notice. The NDIA has a statutory obligation to give effect to all ART Orders within 28 calendar days of the date on which the Order is received by the Agency.
Full Offers
Additionally, where the Order reflects acceptance of a full offer, the EA CM is also responsible for closing the matter in LEX. This is also the case where a participant elects to resolve the matter on the basis of a partial offer, without pursuing the remainder of the requested supports.
For further procedural guidance around closing a matter in LEX, please refer to the Standard Operating Procedure: Closing an ART Matter.
Partial Offers
Where the Order reflects acceptance of a partial offer, and the participant wishes to pursue the remainder of the requested supports, the EA CM is responsible for implementing the Order and returning the matter to Legal Operations for reallocation to the relevant DR Case Management team.
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Proceed from 3.13.
3.12 Where the matter cannot be resolved
The EA CM must return the matter to Legal Operations for reallocation to the appropriate DR Case Management team as soon as it becomes apparent that the matter cannot be resolved at this time — and in any event, no later than three weeks before the first CC or DH.
To support a warm handover of the matter to a DR CM, the EA CM will also consider and record in LEX any identified risks which could inform the most appropriate resolution pathway, or the future conduct of the matter.
Proceed from 3.13.
3.12.1 Where further evidence is required to resolve a matter
Where further evidence is required to resolve a matter, and where it would be appropriate to engage an IEC — the EA CM will work with the participant or prospective participant, the LWC, and TAPIB to identify a suitable IEC, and to determine a series of targeted questions for consideration by the IEC. The EA CM has a responsibility to ensure that the litigation strategy prepared by the LWC accurately reflects the Agency’s position around the appropriateness of engaging an IEC, as well as the questions to be considered by the IEC.
3.13 Returning matters to Legal Operations for reallocation to DR
3.13.1 Matters which are unsuitable for Early Assessment
Locate the matter in LEX and update the Early Assessments tab as follows, and then select Save:
- Status: Closed
- Early Assessment Name: EA of [
] ART — <(Prospective) Participant first name and LAST NAME> and NDIA ( ) for example: EA of [12345] ART — John DOE and NDIA (2024/0000) - Matter Type: Access / Planning
- Early Assessment Stage: 13 EA Finalised
- EA Team Review Complete: Yes
- Date of review:
- EA suitable: No
- If not suitable, why:
- Date of offer:
- Date of outcome:
- Outcome: No offer made
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- Early Assessment Notes: <note the reason(s) why it was determined that the matter is unsuitable for Early Assessment>
Once the participant’s or prospective participant’s EA Module has been updated, create an EA Unsuccessful file note in LEX. To do so, navigate to the File Notes tab, select Add on the right-hand side of the tab. Complete as below, and then select Save.
- Date:
- Type: Early Assessments — EA Unsuccessful
- Team / NDIA staff name: Early Assessment —
- Notes:
Copy the contents of the EA Unsuccessful file note you created above, navigate to the Main Details tab, select Next Steps on the right-hand side of the tab, and paste the contents of the file note you created above.
Select the Snapshot / Matter Summary tab on the right-hand side of the Main Details tab, and update the EA Update/Outcome by briefly summarising your decision that the matter is unsuitable for Early Assessment.
On the Main Details tab, locate the responsible Team / NDIA staff name and allocate the matter to Legal Operations — Unallocated EA Complete. Select Save in the bottom right-hand corner of the window.
Lastly, navigate to the Reminders tab and reallocate any future reminders to Legal Operations — Unallocated EA Complete. At the same time, ensure that any past reminders are set to Done.
The matter has now been allocated to Legal Operations, for reallocation to the appropriate state-based DR Case Management team.
3.13.2 Matters which cannot be resolved
These instructions apply when:
- a full offer was presented to the participant or prospective participant during the EA process, but has not been accepted; or
- a partial offer is accepted by a participant, but the participant intends to pursue the remaining requested supports which could not be agreed to during the EA process; or
- an offer to fully or partially resolve the matter could not be made.
Where an offer is made, that offer will be reflected in the litigation strategy and will serve as the Agency’s position as the matter progresses through DR or to a final hearing, until further evidence or and/or advice is obtained which has the potential to alter that position.
To allocate a matter which could not be resolved to Legal Operations for further allocation to the relevant DR Case Management team, locate the matter in LEX, navigate to the File Notes tab, and select Add on the right-hand side of the tab. Complete as below, and then select Save.
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- Date: <date the full offer was rejected / date the partial offer was accepted / date the decision was made to refer the matter to DR>
- Type: Early Assessments — EA Unsuccessful
- Team / NDIA staff name: Early Assessment —
- Notes:
Copy the contents of the EA Unsuccessful file note you created above, and update the Early Assessments tab as follows. Select Save.
- Status: Closed
- Early Assessment Name: EA of [
] ART — <(Prospective) Participant first name and LAST NAME> and NDIA ( ) for example: EA of [12345] ART — John DOE and NDIA (2024/0000) - Matter Type: Access / Planning
- Early Assessment Stage: 13 EA Finalised
- EA Team Review Complete: Yes
- Date of review:
- EA suitable: Yes
- Date of offer: <date of the offer or, if no offer was made, blank>
- Date of outcome: <date the full offer was rejected / date the partial offer was accepted / date the decision was made to refer the matter to DR>
- Outcome:
- Early Assessment Notes: <copy and paste the content of the EA Unsuccessful file note you created above>
Navigate to the Main Details tab, and select the Snapshot / Matter Summary tab on the right-hand side of the window. Update the EA Update/Outcome to reflect whether an offer was made (and to direct future readers to the file note you created which explains the offer), or to reflect the reasoning behind your decision to refer the matter to DR.
On the Main Details tab, locate the responsible Team / NDIA staff name and allocate the matter to Legal Operations — Unallocated EA Complete. Select Save in the bottom right-hand corner of the window.
Navigate to the Reminders tab and reallocate any future reminders to Legal Operations — Unallocated EA Complete. At the same time, ensure that any past reminders are set to Done.
The matter has now been allocated to Legal Operations, for reallocation to the appropriate state-based DR Case Management team.
It is important to ensure that the participant or prospective participant understands that the matter has been reallocated to a new Case Manager. To guide you, a template email is contained at Annexure A3 — Email to a participant or prospective participant when a matter is transferred to DR Case Management.
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4. Process Flowchart
(Note: This page contains a large workflow process diagram detailing steps across timelines: 5+ weeks before the CC, 4+ weeks before the CC, and 3 weeks before the CC, involving Legal Operations, Dispute Resolution and Litigation Branch, Early Assessment, and TAPIB.)
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5. Annexures
5.1 Annexure A — Email Templates
5.1.1 Annexure A1 — Introductory email to a participant, prospective participant, or their representative
To: [Participant / prospective participant / representative]
Subject: Introduction to Early Assessment — [Name or Pseudonym] and NDIA — [ART Proceeding No.] — LEXD [LEX No.]
Good [morning/afternoon] [name],
[delete if not applicable] Thank you for your time on the phone today.
The Agency has received a copy of your application to the Administrative Review Tribunal (ART).
I am the Early Assessment Case Manager in the External Review Branch of the NDIA assigned to assist you with [your / participant or prospective participant name] ART application. My role is to review the available information to determine whether we can resolve the matter before the first [Case Conference / Directions Hearing] which is scheduled for [date]. I am also able to assist you to identify any possible gaps in the information provided to date, which may support the Tribunal in its review of [your / participant or prospective participant name] application.
[Planning matters — delete if not applicable] The Agency would like to confirm that in your ART Application, you seek the following supports: 1. 2.
If there is any additional information which [you / participant or prospective participant name] would like to provide at this time which is not contained in the Tribunal Documents (T-Documents), please do so by reply email, copying your email to the Tribunal.
Next Steps
General information about what happens after lodging an ART application is available on the ART website.
The matter is listed for a first Case Conference on [date]. General information about Case Conferences, why they are conducted, and what to expect is also available on the ART website.
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[delete if the participant or prospective participant has a representative]
Assistance
If you would like to discuss [your / participant or prospective participant name] ART application or the ART process in general, I am happy to call you at a time that is most suitable to you. Please let me know by reply email.
Kind regards,
[Email signature]
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5.1.2 Annexure A2 — Email presenting an offer to resolve the matter
To: [Participant / prospective participant / representative]
Subject: Offer to Resolve — [Name or Pseudonym] and NDIA — [ART Proceeding No.] — LEXD [LEX No.]
Good [morning/afternoon] [name],
[delete if not applicable] Thank you for your time on the phone today.
The Agency makes the following offer to resolve the matter. This offer is based on the available evidence and the [NDIS funding criteria / NDIS access criteria].
[Access] The Agency considers that [you / participant or prospective participant name] meet[s] the eligibility for the access to the Scheme on the basis of [disabilities, conditions, or impairments for which access is met].
[Planning] The Agency offers to fund the following supports:
[delete if not applicable] To replace current [Core / Capacity Building] funding:
- [List the supports, including duration, intensity, frequency, and care ratio]
[delete if not applicable] In addition to current funding:
- [List the supports, including duration, intensity, frequency, and care ratio]
[Planning] The Agency offers to replicate all other current plan funding on a pro-rata basis for [#] months.
Next Steps
To accept this offer, please reply to this email. If [you / participant or prospective participant name] accept[s] the offer, the Agency will prepare Terms of Agreement for your signature.
[delete if not applicable] The matter is listed for a [Case Conference / Directions Hearing] on [date]. Should you accept the offer above, the Agency proposes to vacate the [Case Conference / Directions Hearing] with [your / participant or prospective participant name] consent.
Kind regards,
[Email signature]
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5.1.3 Annexure A3 — Email to a participant or prospective participant when a matter is transferred to DR Case Management
To: [Participant / prospective participant / representative]
Subject: Notification of Handover to DR — [Name or Pseudonym] and NDIA — [ART Proceeding No.] — LEXD [LEX No.]
Good [morning/afternoon] [name],
[delete if not applicable] Thank you for your time on the phone today.
As we have been unable to resolve the matter before the first [Case Conference / Directions Hearing] on [date], [your / participant or prospective participant name] matter will be transferred to a Case Manager who will be able to assist you with [your / participant or prospective participant name] matter as it progresses through the Dispute Resolution (DR) pathway before the ART. [delete if the participant or prospective participant has a representative] General information about the DR pathway is available on the ART website.
The new Case Manager will be in touch shortly to discuss the progression of the matter moving forwards.
Kind regards,
[Email signature]
NDIA-ERB-SOP-027-V001-FINAL
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5.2 Annexure B — EA Module Fields and Definitions
Early Assessments Module
| ID | Datum | Field Type | Definition | Where Sourced | Where Stored | Recorded By |
|---|---|---|---|---|---|---|
| 1 | Status | Single-tier drop down | Identifies the status of Early Assessment | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 2 | Early Assessment Name | (Part of) Long text field | LEX Number, Name and NDIA Reference Number — e.g., “EA of (LEX Number) Participant Name and NDIA (NDIA Reference)” | LEX Matter Management system | LEX - Snapshot / Matter Summary section | Case Management Support |
| 3 | Matter Type | Single-tier drop down | Identifies if the matter is access or planning | EA Case Manager | LEX - Snapshot / Matter Summary section | EA Case Manager |
| 4 | Early Assessment Stage | Single-tier drop down | The category of the Early Assessment Stage | EA Case Manager | LEX - Snapshot / Matter Summary section | EA Case Manager |
| 5 | EA Team Review Complete | Single-tier drop down | Identifies if an Early Assessment review has been conducted | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 6 | Date of Review | Date Field | The date review of Early Assessment was conducted | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 7 | EA Suitable | Single-tier drop down | Identifies a matter has been reviewed and if it will be progressed | EA Case Manager | LEX - Snapshot / Matter Summary section | EA Case Manager |
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SOP: Early Assessment
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| ID | Datum | Field Type | Definition | Where Sourced | Where Stored | Recorded By |
|---|---|---|---|---|---|---|
| 8 | If not EA suitable, why? | Single-tier drop down | Identifies category which determines why the EA will not be progressed | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 9 | Date of Offer | Date Field | The date offer was made to participant | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 10 | Type of Offer | Single-tier drop down | Determines the type of offer made to the participant | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 11 | Date of Outcome | Date Field | The date an offer was accepted/declined, access was met or matter deemed unsuitable for EA | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 12 | Outcome | Single-tier drop down | Identifies the outcome of Early Assessment | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 13 | TAB Advice Sought (Y/N) | Short text field | Identifies if TAB advice has been sought | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 14 | TAB Advice Detail | Long text field | Additional notes regarding TAB advice | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 15 | Legal Advice Sought (Y/N) | Short text field | Identifies if Legal Advice has been sought | EA Case Manager | LEX Matter Management System | EA Case Manager |
| 16 | Further Info Required | Long text field | Space to record any necessary additional information | EA Case Manager | LEX Matter Management System | EA Case Manager |
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| ID | Datum | Field Type | Definition | Where Sourced | Where Stored | Recorded By |
|---|---|---|---|---|---|---|
| 17 | H & L Advice sought (Y/N) | Short text field | Identifies if H&L advice has been sought | EA Case Manager | LEX Matter Management System | EA Case Manager |
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Early Assessment Stage Definitions
| Early Assessment Stage | Definition |
|---|---|
| 01 Reviewing | EA has been created, review in progress |
| 02 Awaiting Further Information | Waiting on further documentation or information on participant before proceeding with review |
| 03 Awaiting Advice | Waiting for TAB, H&L or Legal advice prior to proceding further |
| 04 Offer formed | Case Manager has reviewed the plan and generated an offer to be made to the participant. |
| 05 Offer made | Offer has been made to the participant but offer has not been accepted or declined |
| 06 Participant counteroffer received | Offer has been made to the participant, the participant has retumed with a counteroffer |
| 07 Offer accepted | Participant has accepted the offer |
| 08 Access Met | Access request has been met |
| 09 Awaiting TOA from DR&L | Agreement sent to DR&L to draft Terms of Agreement |
| 10 TOA with participant to sign | Terms of agreement sent to participant for signing |
| 11 Awaiting Order from ART | Agreement has been submitted to ART, awaiting completion of ART order |
| 12 Plan build requested | Plan build for accepted offer in progress |
| 13 EA finalised | EA process has been completed |
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Early Assessment Outcome Definitions
| Outcome | Definition |
|---|---|
| *Awaiting Outcome* | Offer has been made, participant yet to accept or decline offer |
| Applicant withdrew - EA Intervention | Provided further information/advice to participant and they have withdrawn the applicant with no offer made by EA |
| Applicant withdrew - No EA Intervention | Participant has independently withdrawn application with no interaction with EA |
| No offer made | EA has been deemed unsuitable |
| Offer accepted | Participant has accepted the offer / Access has been met |
| Offer accepted - withdrawn application | Participant has accepted offer and withdrawn the application |
| Not accepted - allocated to DR | Participant has not accepted offer made, matter reassigned to DR to progress |
| Partial Offer Accepted - Allocated to DR | Participant has accepted part of the offer, reassign to DR to manage remainder of matter |
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Our reference: FOI 25/265-0062 (LEXD 1326)
GPO Box 700 Canberra ACT 2601 1800 800 110 13 March 2026 ndis.gov.au
David Wright
By email: foi+request-13384-6c92cd3c@righttoknow.org.au
Dear David Wright
Freedom of Information request — Notification of Decision
Thank you for your correspondence of 8 July 2025, in which you requested access to documents held by the National Disability Insurance Agency (NDIA), under the Freedom of Information Act 1982 (FOI Act).
The purpose of this letter is to provide you with a decision on your request.
Scope of your request
You have requested access to copies of the following documents:
- Standard Operating Procedure: Resolved by Hearing
- Standard Operating Procedure: Appeals and Litigation Oversight Committee (ALOC) and Pre-ALOC
- Standard Operating Procedure: Requesting an Independent Expert Clinician Report
- Standing Instructions Administrative Appeals Tribunal
- Case Management Guide – Conciliation.
Date of this decision
As you submitted your FOI request on 8 July 2025, we ought to have provided you with a decision by 8 August 2025. Due to our failure to meet that deadline, we are deemed to have refused your request. However, we have continued to process it and advise that, although you do not have a right to an internal review, your right to external review remains.
Decision on access to documents
I am authorised to make decisions under section 23(1) of the FOI Act. My decision on your request and the reasons for my decision are set out below.
1