How to: Request a review of an NDIS decision that I don’t agree with

Home


This fact sheet was last reviewed on 10/08/2023. Please note that the law and practices relating to NDIS appeals change frequently. The fact sheet provides general information and suggestions only. The fact sheet does not provide legal advice, and might not apply to your circumstances. If you need legal advice, you can find an advocate or a lawyer to help you using the links below at ‘Getting your own advice’.


Not all NDIS decisions can be reviewed. For a full list of the types of decisions that can be reviewed, see this page on the NDIS website.

There are 2 types of reviews:

1. An internal review 

  • You can request an internal review by the NDIA (National Disability Insurance Agency) when you do not agree with a decision they have made about your NDIS plan. This could be after a change to your current plan or when you get a new plan.

2. An external review 

  • You can request an external review after the NDIA has completed an internal review, if you do not agree with the outcome of that internal review
  • At the moment, external reviews are done by the Administrative Appeals Tribunal (AAT). The AAT is going to be replaced in the future – see below under “Who does external reviews?”.

Internal Reviews

What decisions can be internally reviewed?

The NDIS Act says you can ask for an internal review of most decisions that affect you. For example, you can request a review to:

  • Change your current plan
  • Ask for all the supports you need to be added to your plan, if some of those supports have been refused 
  • Reconsider your request to change your current plan, if it was refused.

Example 1:   Jane is moving out of her parents’ home and into a house with another NDIS participant. When Jane lived at her parents’ home, her parents provided some support to her. After moving out, Jane will need more support hours than she needed when she lived with her parents. 

Jane and her therapists have worked out that she will need 7 hours of support each day and 10 hours of support overnight each night. 

Jane and her therapists plan for her to share her hours of support with the other NDIS participant.

Jane speaks about this with her NDIS Planner and gives the planner her allied health reports. However, when Jane gets her NDIS plan, the NDIA decided to only include enough funding for 4 hours of support each day and 10 hours of support overnight that will be shared with the other participant. each night that will be shared with the other participant.

Jane is unhappy she has not been funded for all of the support hours she needs.

Jane can request an internal review of this NDIS decision because her NDIS plan does not have all of the supports that Jane and her therapists believe she needs. Jane can ask the reviewer to consider approving a plan with enough funding to pay for all the support hours her treatment team have recommended.

Example 2:   Billy is 42 and has been living in a nursing home since they got a spinal cord injury in an accident 3 years ago. Billy worked with their Support Coordinator to find the best sort of home for Billy. They have worked out the most suitable sort of home is Specialist Disability Accommodation (SDA). Billy would like to live alone. 

Billy asked for NDIS funding to live alone in an SDA apartment. Billy also asked for 100 hours of physiotherapy a year, as recommended by their therapy team. 

Billy put in a lot of evidence to support the request for SDA and the amount of physiotherapy requested as a ‘reasonable and necessary’ support.

Although Billy provided lots of information, Billy receives an NDIS plan that only provides funding for them to live in shared SDA. This means Billy will not have enough funding to live alone in SDA.

The NDIS plan Billy received also only funded 25 hours of physiotherapy a year.

Billy can request an internal review of this NDIS decision because the NDIS plan does not have all the supports that Billy believes they need, and because the SDA funding doesn’t provide the kind of SDA support that Billy wants. Billy can ask the reviewer to consider approving an NDIS plan with SDA funding for Billy to live alone, and with more funding for physiotherapy.

When do I request an internal review?

If you get a decision about your NDIS plan that you don’t agree with, and that decision can be internally reviewed, you have 3 months to request a review.  This 3 months starts on the day the NDIA tells you in writing about the decision they have made.

How do I request an internal review?

You can ask for an internal review from the NDIA by:

Tip: You should request an internal review in writing if you can, so you have a record of it. You should save a copy of the request you make.

Who does the internal review?

If you request a review of a decision about your NDIS plan, the review will be done by someone in the NDIA.

However, the review will not be done by the person who made the original decision.

What happens in an internal review?

The person doing the internal review will look at the information you initially gave to the NDIA. They might contact you to ask questions about the outcome you want and why you want it, or to ask if you can give them more information or evidence. They will then make a decision. 

What if it’s taking a long time to get an outcome on my internal review?

The NDIA has said it will complete internal reviews within 60 days. But we have heard this doesn’t always happen.

If your internal review has taken more than 60 days and you still don’t have an outcome, you may be able to take your case straight to the AAT. You should get legal advice before you do this. 

If your internal review is taking more than 60 days, you can also think about making a complaint about the NDIA’s delays. This might get the NDIA to look at your case more quickly.

What happens if the original decision has not been changed, or I disagree with the new decision?

The outcome of your internal review is called an internal review decision

The decision might give you what you asked for. If this happens, great! The NDIA will put the supports you asked for in your NDIS plan.

But the decision might not give you the outcome you wanted. If this happens, you can ask for an external review by the AAT.

You can only ask for an external review if you received a written internal review decision.

Tip: things that are NOT internal review decisions The NDIA might give you information about your internal review that isn’t a decision. Sometimes, they will even say the NDIS “has decided” something about your internal review, which can be confusing. This sometimes leads to people applying to the AAT. In these cases, the AAT tells them it cannot review their case because they didn’t get an internal review decision yet.

These things are not internal review decisions if they do not include an official NDIS decision letter:

  • A phone call from the NDIA about your internal review
  • An email from the NDIA 
  • A new plan from the NDIA

These things can’t be used to take your case to the AAT. If you aren’t sure if what you have been given is an internal review decision, you should ask the NDIA to tell you. You can ask them for an official internal review decision letter.

External reviews

Who does external reviews?

The Administrative Appeals Tribunal (AAT) conducts external reviews.

The Australian Government has said they are replacing the AAT with a new review body but have not said when this will happen.

If your external review is already at the AAT it will keep going. If your external review is decided by the AAT before the AAT is replaced, the AAT’s decision on your case will be final.

If you have an external review at the AAT that is still going when the AAT is replaced, your external review will be decided by the new body. We don’t yet know exactly how this will work. 

We will update this guide when we know more about the new review body.

When do I request an external review?

If you get a decision about an internal review that you do not agree with, you have 28 days to ask the AAT for an external review. The 28 day time limit starts from the day you get the outcome letter, so you need to act quickly.

If you lodge your review after the time limit, the AAT might not agree to review your case. If this happens, the outcome of the NDIA’s internal review will stay in place.

How do I request an external review?

You can find out about requesting an external review in our guide on lodging an appeal with the AAT. 

What happens in an external review?

External reviews by the AAT can be complicated. You can find more information in our other fact sheets, including:

  • How to apply to the AAT
  • How to ask for reasons for your internal review outcome
  • What happens at the AAT

You should also consider getting legal advice about your AAT review.


Where can I get advice if I need help understanding my options?

You may be able to get advice about your options for requesting a review and help with other questions about the NDIS from a legal service. It will depend on the type of problem you have, and where you are located.

If you need help from a lawyer, National Legal Aid has the contact details for your local Legal Aid office.

If you need help from an advocate, the AskIzzy Disability Advocacy Finder is an online tool to help you find to search for advocacy providers using your suburb or postcode.

You can also look at our other fact sheets about this, including:


Learn more

Housing Hub Training has a recorded webinar about the NDIS appeal process and the role of the AAT. Visit the website here to enrol and learn more.

People with disability and their families can email UpSkill at training@housinghub.org.au for free access to this webinar.

Who made this factsheet?

The Housing Hub and the Public Interest Advocacy Centre (PIAC) made this together. Since 2021, PIAC and the Housing Hub have worked together to provide advice and assistance to participants seeking SDA funding. This factsheet is part of a series about challenging NDIS decisions.

Was this article helpful?

How to: Request a review of an NDIS decision that I don’t agree with

Home


This fact sheet was last reviewed on 10/08/2023. Please note that the law and practices relating to NDIS appeals change frequently. The fact sheet provides general information and suggestions only. The fact sheet does not provide legal advice, and might not apply to your circumstances. If you need legal advice, you can find an advocate or a lawyer to help you using the links below at ‘Getting your own advice’.


Not all NDIS decisions can be reviewed. For a full list of the types of decisions that can be reviewed, see this page on the NDIS website.

There are 2 types of reviews:

1. An internal review 

  • You can request an internal review by the NDIA (National Disability Insurance Agency) when you do not agree with a decision they have made about your NDIS plan. This could be after a change to your current plan or when you get a new plan.

2. An external review 

  • You can request an external review after the NDIA has completed an internal review, if you do not agree with the outcome of that internal review
  • At the moment, external reviews are done by the Administrative Appeals Tribunal (AAT). The AAT is going to be replaced in the future – see below under “Who does external reviews?”.

Internal Reviews

What decisions can be internally reviewed?

The NDIS Act says you can ask for an internal review of most decisions that affect you. For example, you can request a review to:

  • Change your current plan
  • Ask for all the supports you need to be added to your plan, if some of those supports have been refused 
  • Reconsider your request to change your current plan, if it was refused.

Example 1:   Jane is moving out of her parents’ home and into a house with another NDIS participant. When Jane lived at her parents’ home, her parents provided some support to her. After moving out, Jane will need more support hours than she needed when she lived with her parents. 

Jane and her therapists have worked out that she will need 7 hours of support each day and 10 hours of support overnight each night. 

Jane and her therapists plan for her to share her hours of support with the other NDIS participant.

Jane speaks about this with her NDIS Planner and gives the planner her allied health reports. However, when Jane gets her NDIS plan, the NDIA decided to only include enough funding for 4 hours of support each day and 10 hours of support overnight that will be shared with the other participant. each night that will be shared with the other participant.

Jane is unhappy she has not been funded for all of the support hours she needs.

Jane can request an internal review of this NDIS decision because her NDIS plan does not have all of the supports that Jane and her therapists believe she needs. Jane can ask the reviewer to consider approving a plan with enough funding to pay for all the support hours her treatment team have recommended.

Example 2:   Billy is 42 and has been living in a nursing home since they got a spinal cord injury in an accident 3 years ago. Billy worked with their Support Coordinator to find the best sort of home for Billy. They have worked out the most suitable sort of home is Specialist Disability Accommodation (SDA). Billy would like to live alone. 

Billy asked for NDIS funding to live alone in an SDA apartment. Billy also asked for 100 hours of physiotherapy a year, as recommended by their therapy team. 

Billy put in a lot of evidence to support the request for SDA and the amount of physiotherapy requested as a ‘reasonable and necessary’ support.

Although Billy provided lots of information, Billy receives an NDIS plan that only provides funding for them to live in shared SDA. This means Billy will not have enough funding to live alone in SDA.

The NDIS plan Billy received also only funded 25 hours of physiotherapy a year.

Billy can request an internal review of this NDIS decision because the NDIS plan does not have all the supports that Billy believes they need, and because the SDA funding doesn’t provide the kind of SDA support that Billy wants. Billy can ask the reviewer to consider approving an NDIS plan with SDA funding for Billy to live alone, and with more funding for physiotherapy.

When do I request an internal review?

If you get a decision about your NDIS plan that you don’t agree with, and that decision can be internally reviewed, you have 3 months to request a review.  This 3 months starts on the day the NDIA tells you in writing about the decision they have made.

How do I request an internal review?

You can ask for an internal review from the NDIA by:

Tip: You should request an internal review in writing if you can, so you have a record of it. You should save a copy of the request you make.

Who does the internal review?

If you request a review of a decision about your NDIS plan, the review will be done by someone in the NDIA.

However, the review will not be done by the person who made the original decision.

What happens in an internal review?

The person doing the internal review will look at the information you initially gave to the NDIA. They might contact you to ask questions about the outcome you want and why you want it, or to ask if you can give them more information or evidence. They will then make a decision. 

What if it’s taking a long time to get an outcome on my internal review?

The NDIA has said it will complete internal reviews within 60 days. But we have heard this doesn’t always happen.

If your internal review has taken more than 60 days and you still don’t have an outcome, you may be able to take your case straight to the AAT. You should get legal advice before you do this. 

If your internal review is taking more than 60 days, you can also think about making a complaint about the NDIA’s delays. This might get the NDIA to look at your case more quickly.

What happens if the original decision has not been changed, or I disagree with the new decision?

The outcome of your internal review is called an internal review decision

The decision might give you what you asked for. If this happens, great! The NDIA will put the supports you asked for in your NDIS plan.

But the decision might not give you the outcome you wanted. If this happens, you can ask for an external review by the AAT.

You can only ask for an external review if you received a written internal review decision.

Tip: things that are NOT internal review decisions The NDIA might give you information about your internal review that isn’t a decision. Sometimes, they will even say the NDIS “has decided” something about your internal review, which can be confusing. This sometimes leads to people applying to the AAT. In these cases, the AAT tells them it cannot review their case because they didn’t get an internal review decision yet.

These things are not internal review decisions if they do not include an official NDIS decision letter:

  • A phone call from the NDIA about your internal review
  • An email from the NDIA 
  • A new plan from the NDIA

These things can’t be used to take your case to the AAT. If you aren’t sure if what you have been given is an internal review decision, you should ask the NDIA to tell you. You can ask them for an official internal review decision letter.

External reviews

Who does external reviews?

The Administrative Appeals Tribunal (AAT) conducts external reviews.

The Australian Government has said they are replacing the AAT with a new review body but have not said when this will happen.

If your external review is already at the AAT it will keep going. If your external review is decided by the AAT before the AAT is replaced, the AAT’s decision on your case will be final.

If you have an external review at the AAT that is still going when the AAT is replaced, your external review will be decided by the new body. We don’t yet know exactly how this will work. 

We will update this guide when we know more about the new review body.

When do I request an external review?

If you get a decision about an internal review that you do not agree with, you have 28 days to ask the AAT for an external review. The 28 day time limit starts from the day you get the outcome letter, so you need to act quickly.

If you lodge your review after the time limit, the AAT might not agree to review your case. If this happens, the outcome of the NDIA’s internal review will stay in place.

How do I request an external review?

You can find out about requesting an external review in our guide on lodging an appeal with the AAT. 

What happens in an external review?

External reviews by the AAT can be complicated. You can find more information in our other fact sheets, including:

  • How to apply to the AAT
  • How to ask for reasons for your internal review outcome
  • What happens at the AAT

You should also consider getting legal advice about your AAT review.


Where can I get advice if I need help understanding my options?

You may be able to get advice about your options for requesting a review and help with other questions about the NDIS from a legal service. It will depend on the type of problem you have, and where you are located.

If you need help from a lawyer, National Legal Aid has the contact details for your local Legal Aid office.

If you need help from an advocate, the AskIzzy Disability Advocacy Finder is an online tool to help you find to search for advocacy providers using your suburb or postcode.

You can also look at our other fact sheets about this, including:


Learn more

Housing Hub Training has a recorded webinar about the NDIS appeal process and the role of the AAT. Visit the website here to enrol and learn more.

People with disability and their families can email UpSkill at training@housinghub.org.au for free access to this webinar.

Who made this factsheet?

The Housing Hub and the Public Interest Advocacy Centre (PIAC) made this together. Since 2021, PIAC and the Housing Hub have worked together to provide advice and assistance to participants seeking SDA funding. This factsheet is part of a series about challenging NDIS decisions.

Was this article helpful?