Reviews, Changes of Circumstance, Annual Reviews and Appeals

Could it be any more confusing? Let me try and explain.

(and here’s a downloadable .pdf of this page)

  1. New Plan or Annual Review doesn’t have what you need?
    Review of a Reviewable Decision -> Internal Review

When the NDIA make a decision, such as your new plan, or whether you are eligible, or all sort of other decisions, you have three months from the date of your plan, or “decision”, to provide further information or challenge them to reconsider. This is called a “Review of a Reviewable Decision”, and there are a whole bunch of reasons your might ask for this kind of review. You do NOT need to have a change of circumstance to ask the Agency to reconsider. The Agency doesn’t have a deadline on when they have to give you their response, but you can (and should) use the Plan you have in the meantime.
Your can request this sort of review by phone, letter or email. There is a form you can use, but you don’t have to. For more info: https://www.ndis.gov.au/participants/reasonable-and-necessary-supports/decision-review/application-review-reviewable-decision.html

  1. My son just started having major seizures and now can’t walk
    Change of Circumstances -> Internal Review

This can be used when shit hits the fan during the middle of your plan, and the current funding just won’t cut it. If you’ve just been made homeless, been incarcerated (in detention/jail), have added another disability (not just a new diagnosis or label, but an actual change in how you are affected) or some other major life change has hit you hard, then you can ask for a review of your plan based on your “Change in Circumstance”. Sometimes Changes of Circumstances are good, too – like maybe you just got a job and need your transport money increased.
A “Change of Circumstance” form and further information can be found at https://www.ndis.gov.au/participants/understanding-your-plan-and-supports/change-circumstances.html

  1. I don’t like the NDIS’ Internal Review Decision and want to Appeal
    External Merit Review –> Administrative Appeals Tribunal

If you think an internal review is wrong, you can apply to the Administrative Appeals Tribunal (AAT) to do an external merits review—an independent assessment of an NDIA decision. You can appeal your eligibility, or what’s in the your NDIS Plan but only AFTER the NDIS has done an internal review. At this stage of the process, there is free support through funded advocates to help you through the AAT process. In SA, www.BrainInjurySA.org.au is who can help. Check out http://bit.ly/2l8Pj02 for more info.

fix it