Questions
& Answers

Frequently Asked Questions

Before supporting a participant to complete an access request, we recommend using this 6-point checklist to check their suitability for the Scheme:

Generally speaking, participant must meet three requirements:

  1. AGE – be aged under 65 years
  2. RESIDENCE – reside in Australia and be an Australian citizen, or hold a Permanent or Protected Special Category Visa 
  3. DISABILITY OR EARLY INTERVENTION – have a physical, intellectual, cognitive, neurological, visual, hearing or psychosocial impairment that meets either the disability or early intervention requirements.

Your participant must have a physical, intellectual, cognitive, neurological, visual, hearing or psychosocial impairment that:

  • is (or is likely to be) permanent
  • substantially reduces their ‘functional capacity’ in one or more of the following areas: mobility, communication, social interaction, self-management, learning and self-care
  • restricts their ability to participate in work/study, engage with peers and/or interact with their wider community (i.e. has a clear social and/or economic impact)
  • requires lifelong NDIS support.

Full guidance can be found in the Access to the NDIS Operational Guideline.

For the purposes of the NDIS, ‘substantially reduced functional capacity’ means that on most days, a person’s impairment significantly limits their ability to manage/perform ordinary activities of daily living across a range of tasks in one or more of the following areas: mobility, communication, social interaction, self-management, learning and self-care.

These six areas are referred to as functional domains.

 

Mobility and motor skillse.g. moving about the home or community, getting in and out of bed or a chair, fine motor skills, gross motor skills.*
Learninge.g. understanding and remembering information, learning new skills, practicing and using new skills.
Communicatione.g. being understood in spoken, written or sign language, understanding others and expressing needs and wants by gesture and speech (age-appropriate).
Self-caree.g. showering/bathing, getting dressed, eating or preparing meals, caring for own health
Social interactione.g. making and keeping friends, interacting with peers or the wider community and coping with related feelings and emotions.
Self-managemente.g. doing daily jobs, making decisions, problem-solving and managing money

*Only includes issues that cannot be solved by commonly used items such as glasses, walking sticks, non-slip bathmats, grab rails and hand-rails installed at stairs.

Refer children under 7 years old with developmental delay or disability to an NDIS early childhood partner for assessment. They will support the family to apply for the NDIS if appropriate.

Refer participants 65 years and over who are looking for disability services and support for the first time to My Aged Care .

The role of the treating professional is to provide objective evidence that the participants has a permanent impairment that results in substantially reduced functional capacity in one or more of the following areas: mobility, communication, social interaction, self-management, learning and self-care. 

You can provide this information by:

  • completing the ‘Treating Professional’ section of the Access Request Form (Part F of the current Access Request Form); and/or
  • attaching relevant reports, letters and/or assessments from one or more treating professionals, if you feel this information is already adequately detailed elsewhere. This may include preparing your own letter/report to
    • (i) clearly articulate the diagnosis (i.e. nature of the impairment resulting in disability) and likely permanence, and
    • (ii) outline its functional impact and the types of support required.

If your participant has a psychosocial disability, you can also choose to complete the Evidence of Psychosocial Disability Form (PDF 482KB), which has prompts specific to psychosocial disability to help you detail the information required.

In this case, you should clearly mark on the Access Request Form that an Evidence of Psychosocial Disability Form is attached.

As a GP, you need to decide if you are the right treating professional to be providing this information.

If you do not have enough information on file or you don’t fully understand the functional impact of a participant’s impairment, you may need to reach out to other treating professionals (e.g. specialist doctor, allied health professional) for copies of existing reports, letters and/or assessments. 

Alternatively, if you believe another treating professional is better placed to articulate the functional impact of the participant’s impairment and the types of support required, you may choose to refer the participant on to this professional for the support they need to access the NDIS.

Requesting costly new assessments from allied health professionals or other specialists is not required if sufficient evidence of impairment and its functional impact already exists.

Please refer to our ‘Who can help?’ brochure for advice on who can assist you in the task of evidence gathering:

When completing the ‘Treating Professional’ section of the Access Request Form (Part F of the current Access Request Form), keep the following in mind:

  • Make sure you provide sufficient evidence to validate the diagnosis of a disabling condition, e.g. attach a letter of diagnosis.
  • Make sure you provide sufficient evidence that the impairment is permanent. For the purposes of the NDIS, an impairment is permanent if it has not been, and is unlikely to be, substantially alleviated by conventional treatments. Therefore,  it’s important to adequately detail the participant’s treatment history.
  • Make sure you adequately describe the functional impact of the impairment. For each affected functional domain (mobility, learning, communication, self-care, social and self-management), consider what activity limitations the person experiences everyday as a result of their disability. You only need to provide this information for the domains that are significantly impacted (this may be one or more).
  • Don’t forget to provide evidence of how the impairment has affected the participant’s ability to participate in school/study, work or the wider community (to clearly demonstrate its social or economic impact).
  • Consider whether you are the most relevant treating professional to provide this information and if not, identify which professional/s you can reach out to for this information (or refer the participant on to for the extra support they need to complete the access request).

The six NDIS functional domains (mobility, communication, social interaction, self-management, learning and self-care) aim to capture how a disability impacts upon all aspects of a participant’s life.

They provide a practical and holistic framework within which to contextualise a person’s disability and to understand the type and level of support an individual requires to live well.

When filling out this section of the Access Request Form, you only need to complete the domains which are significantly impacted by the participant’s impairment.

For example, the participant may have substantially reduced function when completing mobility and self-care activities. However, the other domains may be unaffected or only minimally affected.