08 Oct Requesting a Review of Your NDIS Plan
If you’ve received your approved NDIS plan and disagree with a decision made in relation to your funding, you can request a review of your plan. Or, if your circumstances have changed so much that your current plan funding and supports are no longer adequate, you can also request a review.
To assist you in preparing for your NDIS plan review we have compiled some of our top tips and answers to the most common questions we receive.
What is an NDIS Plan Review?
An NDIS plan review is the process in which the National Disability Insurance Agency re-assesses whether your current supports are meeting your needs and helping you work towards your plan goals.
It is an opportunity for you to compare your progress to your plan goals, provide feedback, and make any adjustments to your plan that will enable you to reach your goals and receive the necessary supports.
When Does an NDIS Plan Review Occur?
An NDIS plan review may be scheduled or unscheduled.
A scheduled plan review usually occurs annually as part of the normal cycle of your plan. Your first scheduled plan review will happen 12 months after the commencement of your plan.
An unscheduled plan review happens where a participant has requested a review of their plan or on the initiative of the NDIA.
You might request a review of your plan:
- if your circumstances have changed and your plan is no longer meeting your needs;
- if you wish to change the management of your NDIS plan;
- if you are unhappy with a decision regarding your funding (this is known as an internal review); or
- if you’re unhappy with the outcome of an internal review (this is known as an Administrative Appeals Tribunal (AAT) review). The AAT is an external independent tribunal.
How do I request a plan review?
Where your circumstances have changed
If you find yourself in a situation where your circumstances have changed and have affected the reasonable and necessary supports you require, you may request a review of your plan at any time by completing a Change of Circumstances form.
You can learn more here.
Where you are unhappy with a decision
If you are unhappy with a decision made by the NDIA in relation to your funding, you can request an internal review of a decision. This can be done in writing, in person, via phone or email. In your request you must explain why you feel a decision is incorrect.
You must request an internal review within 3 months of receiving the notice of decision.
You can learn more about requesting an internal review here.
Where you are unhappy with the outcome of an internal review
If you are unhappy with the decision made after an internal review, you may request an external review via the Administrative Appeals Tribunal (AAT) , which exists outside the NDIA. If you wish to initiate an AAT review, you must do so within 28 days of receiving the NDIA’s internal review decision.
Learn more here.
If you wish to change how your plan is managed
If you feel as though your current management style is not working for you, for example you are NDIA managed and wish to change to be plan managed, you can request a change at any time by contacting the NDIA on 1800 800 110.
What is involved in a plan review?
During Covid-19 pandemic, the NDIA changed the approach to plan reviews, introducing the ‘participant check-in’. The first step in the scheduled plan review process will involve a participant check-in. An NDIA staff member will contact you to check-in prior to your plan end date, to find out how you are going with your current plan and establish whether your circumstances have changed in preparation for your review. If 6 weeks prior to the end of your plan you have not heard from the NDIA, you should contact them on 1800 800 110.
For children up to the age of six, most plan reviews will be conducted by your Early Childhood Early Intervention Partner. For children and people aged between 7 and 65 years of age, depending on your circumstances, your plan review will usually be conducted by a Local Area Coordinator or an NDIS planner.
Depending on your situation, your scheduled plan review may result in a new NDIS plan with the same supports, a new NDIS plan with minor changes to your current supports, or a full plan review.
Your LAC or NDIA planner will assess your circumstances and discuss with you the most appropriate approach.
Your plan review meeting may take place face-to-face, over the phone, or via a video call. – whichever suits you best. You may also wish to invite a support person along to your check-in, such as a family member, friend, or Support Coordinator.
How Do I Prepare for my plan review meeting?
In preparation for your plan review meeting, you should take some time to consider which parts of your plan have or have not worked for you. Perhaps you feel as though you’re not receiving enough support to reach your plan goals, or you feel as though you do not have enough funding for your disability.
Writing down the ‘pros’ and ‘cons’ of your current plan will make it easier to determine what it is you hope to get out of your plan review.
You might ask yourself:
- have I achieved my plan goals?
- What do I feel has worked well? What hasn’t?
- Am I happy with the way my funding is currently managed?
- What goals would I like to pursue in my new plan?
- Have my circumstances changed in any way?
The NDIS is an evidence-based system. So, it is important you prepare as much evidence as possible to support your request. Reports from health professionals, your support coordinator, or other providers may be useful.
Who can help me with my plan review?
If you have questions or need help with your review, your support coordinator, early childhood partner, LAC or the NDIA can assist you with the process, they can also put you in touch with an advocate.
What is an advocate?
Disability advocates provide individual advocacy, guidance, and support to people with a disability, their carers and families.
An advocate may be able to:
- assist you before and during the NDIS eligibility and assessment process
- help you exercise choice and control in relation to support options and services
- support you to make informed decisions
- help you through the Internal Review and NDIS Appeals Process
- address issues, conflict, or a complaint with a service provider
- engage in service quality processes
If at any time during your plan period your circumstances change, your early childhood partner, LAC, planner, or an advocate can assist you in reviewing your support needs and initiate a plan review if necessary to ensure that your plan will provide you with the reasonable and necessary supports you require.