Nothing substitutes for preparation when starting your NDIS journey.
That said, being such a new program has meant that many people are learning as they go what entitlements they may be likely to receive.
Or, in fact, what they might be missing out on.
Some are learning the hard way that if you don’t ask for it, and ask for it in a way that is clearly understood, you can’t assume to get it.
Even if you have before.
One of the most concerning elements for us at Assured Home Care has been seeing individuals receive less under the NDIS than they were previously funded for.
This is certainly not the intent or the fault of the NDIS program and assessment process. At its heart, the NDIS has a philosophy to provide increased choice and control for people living with a disability, and to help individuals achieve their goals. In this, the Scheme focuses on the longer-term goals of individuals, as well as immediate needs.
Often, the problem is that people are not fully aware of how to present relevant information that the NDIA can adequately measure in accordance with the NDIS independent assessment criteria. Knowing the terminology and the categories of eligible NDIS funding and what they cover is often the key.
Suffice to say, there is a proportion of participants who have been left unhappy with their initial NDIS Plan outcomes.
So, what to do?
An Ounce of Prevention
Assured Home Care can be involved right from the start in assisting you to get the most out of your Plan.
Having helped many people with their first Plan, we can see what people need to be aware of; the funding that they may have overlooked, and the resources that they may be eligible for (and not realise). In many cases, we also have first-hand knowledge of your circumstances and care needs and can make suggestions about appropriate levels of support.
We can help in your pre-planning preparation, and can support you in your initial meeting with the NDIA Planner.
All NDIS Plans will be reviewed after 12 months, and you can wait until this point to look at requesting changes. This is an important process more generally as many people will find that their support needs will change over time.
If you are very unhappy with your Plan, however, you can request an NDIA internal review of any aspects of your funding within 3 months of the start of your Plan. After three months, your plan will only be reviewed if you have experienced a significant change of circumstances.
At Assured Home Care, we’ve now assisted several clients through the NDIA review process, helping to identify the day-to-day consequences of any funding shortfalls, establishing the categories of NDIS support required and assisting in the coordination of supporting documentation to present the case for revised funding.
This information is vital in putting your case forward to the NDIA.
Once the NDIA has received your information and completed the review process, you will be provided with an internal review decision. This may involve overturning, or upholding, aspects of the original funding decision.
One further step.
If you are still unhappy following the outcome of the internal review, there may still be further action that you can take.
The NDIA internal review decision that you are provided with will state whether the decision is a ‘reviewable decision’ under the NDIS Act. The Disability Advocacy Network Australia (DANA) publishes a comprehensive summary of the possible bases for reviewable decision in their ‘Advokit’.
If the decision is deemed a reviewable decision, you can seek redress through applying to the Administrative Appeals Tribunal for a review.
Should you choose to take this route, you will be granted access to the NDIS Appeals Support, which will enable you to access:
- A skilled disability advocate;
- Funding for legal services, where a reviewable decision raises complex or novel legal issues (read more on the McGarrigle case as an example).
Obviously, the appeals process may be a lengthy and stressful process, and each participant will need to weigh up the benefits in pursuing this route.
A final note
Again, to avoid the potential emotional strain associated with pursuing a review or appeal, we would stress the importance of ensuring that preparation is your number one approach!