Eligibility Reassessment
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What Is An Eligibility Reassessment & Why Do They Happen?
An eligibility reassessment is to confirm whether you’re still eligible to receive NDIS supports. If evidence suggests you may no longer meet the residence, disability, or early intervention requirements, a reassessment may be initiated.
The NDIS aims to ensure that funding is provided to those who genuinely meet the eligibility criteria. If you met the disability requirements when you first joined the NDIS, you will likely require support for life. However, if your circumstances, disability, or support needs change, your eligibility may need to be reassessed.
If you initially qualified under early intervention requirements, your support needs are expected to reduce over time as early intervention is intended to enhance your capacity and independence. Children who qualified under developmental delay will have a reassessment after turning six. For continued eligibility, evidence of a likely permanent impairment is required.
NDIS Eligibility Requirements
To be eligible for NDIS supports, you must:
Disability Requirements
To qualify under the disability requirements, you must have a permanent disability that substantially impacts your ability to take part in everyday activities. This can include physical, intellectual, sensory, cognitive, or psychosocial disabilities. The disability must be likely to be permanent and not significantly improved by treatment.
Early Intervention Requirements
To qualify under the early intervention requirements, you must have a disability that is likely to be permanent but early intervention could reduce the impact of the disability, improve functionality, or prevent further decline. Children under six with developmental delays may also qualify under early intervention. After turning six, evidence of a likely permanent impairment will be required for continued eligibility.
For more information, please refer to the full NDIS guidelines
Support Coordinator Capacity Updates
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The Reassessment Process
When your eligibility is being reassessed, you will be contacted via your preferred method of communication. This will include details about:
- Why the reassessment is happening
- What you need to do and how to provide relevant information or evidence
- What to expect from the process
If your plan is due to end while the reassessment is ongoing, a new plan will be arranged to ensure continued support until a decision is made.
You will generally have up to 90 days to provide any requested information. If more time is required, you may request an extension by explaining your reasons.
What Happens After The Reassessment?
Once the reassessment is complete, you will be informed of one of the following outcomes:
- Continuing Eligibility: You remain an NDIS participant & can continue receiving supports
- Ineligibility: You will no longer be an NDIS participant & your plan will end after a 28-day period from the decision date
If you continue to meet the NDIS eligibility criteria, you will remain an NDIS participant. This means your access to supports will continue, and your plan will be renewed as necessary. You may be asked to provide updated reports or information as part of ongoing plan reviews. If it is determined that you no longer meet the NDIS eligibility requirements, you will no longer be considered a participant. In this case, your plan will end 28 days after the eligibility reassessment decision. While you will lose access to NDIS supports, you may still receive assistance in connecting with other community or government services to help you transition away from the NDIS.
As a registered NDIS provider, all our occupational therapists are accredited and able to support you whatever your NDIS plan type or personal need
What To Do If You Disagree with an NDIS Decision
If you don’t agree with a decision that has been made by the NDIS regarding your eligibility, you should discuss your situation with the NDIS. Your ‘my NDIS’ contact can:
- Help explain the decision
- Answer any questions
- Help to understand your options & next steps
If you disagree with the decision, you have 3 months from the notification date to request an internal review
To learn more about internal and external reviews, click here
Need Help Or Have Questions?
If you are unsure about your eligibility or wish to discuss your situation, please reach out to our team. We’re here to guide you through the process and ensure you have the right information to make informed decisions.
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