NDIS Appeals Support
The NDIS Appeals Support provides advocacy, support, and referral to people with disability and their families for National Disability Insurance Scheme (NDIS) reviews and appeals. The objective of this service is to ensure that vulnerable people with disability and other affected persons who are going through the review or appeal process have access to a support person.
If you think a decision made by the National Disability Insurance Agency (NDIA) about you is wrong, you can apply for an internal review of a decision. Any person directly affected by a decision of the NDIA, such as an applicant, participant, or plan nominee can request such a review.
There are three levels of decisions made about the NDIS that can affect someone:
- The original decision made by the NDIA
- The internal review decision made by the NDIA
- The Administrative Appeals Tribunal (AAT) appeal decision.
What can I do if I feel a decision made by the NDIA is wrong?
Any person that is directly affected by a decision of the NDIA can submit an application for an Internal Review of a decision. There is a list of reviewable decisions in the NDIS legislation. Decisions such as being accepted as a participant of the NDIS or the level of support deemed reasonable and necessary are reviewable.
How does the internal review process work?
When you are told about an NDIA decision, you should be informed by letter how to request an internal review. A request for internal review of a decision must be made within three months of receiving notice of the decision from the NDIA.
The NDIA staff member who works on the internal review will not have been involved in the earlier decision. They may want to talk to you directly as part of this process. This person will decide whether to confirm, vary or set aside and substitute the original decision.
What if you are still unhappy after the internal review of the decision?
If you are still not happy after the internal review of the decision, you can apply for a review by the AAT, a tribunal that exists outside the NDIA.
An application can be made to the AAT within 28 days of being notified of the Internal Review decision. Individuals should be informed of their right to appeal a decision in the letter they receive advising them of the outcome of their internal review.
What we do
Our NDIS appeals advocates assist those who are going through the internal review process with the NDIA or are making an external appeal to the AAT.
Our NDIS appeals advocates may assist by:
- Explaining the review process, including what is involved with pursuing an appeal to the AAT
- Assisting with the preparation of the required documents
- Providing advice and skills so the person who is lodging the review or appeal can better represent themselves
- Attending AAT conferences and hearings to help the person to put their case to the AAT.
The extent of assistance that will be provided by our NDIS Appeals Support is at the discretion of the service, having regard to circumstances such as the needs of the person, available resources, and the capacity of the service at the relevant time.
Our NDIS appeals advocates cannot assist with:
- Applications for access to the NDIS
- Change of Circumstance reviews
- The planning process for those granted access
Who we assist
Due to the ongoing high demand for advocacy services around NDIA decisions, the service may give priority to the most vulnerable people with disability and/or those appealing to the AAT. If the service is unable to assist with a request for help, we will always attempt to refer on to another service.
The NDIS Appeals Support Program can assist:
- An NDIS applicant or participant
- A plan nominee for an NDIS participant
How to get help
You will be required to provide QAI with certain personal details which are necessary for the NDIS Appeals Support Program to deliver its services. All personal information is treated as strictly confidential.
We have a whole page dedicated to helpful resources for people dealing with the NDIS
On it you will find:
- Fact sheets
Go to → NDIS Resources
"QAI put a human touch into our circumstances treating us with respect from the very start. We really felt we had an advocate we could trust and be completely open with and that has been rare in our journey. The knowledge and abilities that our QAI advocate has in putting it all together was priceless to us."
Steven & Popi, NDIS clients
“My advocate was extremely understanding, gave fantastic advice and helped me every step of the way to achieve a satisfactory outcome. Very impressed.”
Matthew, NDIS client
Family finally achieve independence goal for their son after near 2 year battle with the NDIA.
Ryan* was one of many NDIS applicants whose first plan came through with a far lower level of supports than he was receiving under Disability Services Queensland (DSQ), an outcome that should never have occurred given the ‘Principle of no disadvantage’. Ryan has a chromosomal deletion syndrome, which presents as an intellectual disability, microcephaly, epilepsy, limited speech and has resulted in developmental hip dysplasia. DSQ had previously determined that Ryan had the highest level of both intellectual and physical need, requiring 24/7 care. It took the NDIA almost two years to agree.
When moving to the NDIS, Ryan’s parents, Melissa* and David*, hoped the scheme would enable Ryan to become independent so he could “live away from the family home and create a life for himself into the future”, as any parent of a child in their mid-twenties would hope for. Though they quickly realised the path to Ryan’s independence through the NDIS would not be easy or fast.
Ryan’s first plan came through in July 2018 and it fell woefully short of his support and therapy needs. By August, they recognised they would need help and sought out an advocate from QAI. With the advocate’s assistance, they submitted an Internal Review and in January 2019, after months of follow-ups, proceeded to a review meeting.
Their major requests were one-to-one support for Ryan and home modifications for a property they had purchased to enable Ryan to live independently. During the review meeting and in conversations following, the Senior NDIA Planner blatantly ignored multiple medical reports and other evidence submitted with the review. Instead, they simply said the requested supports were ‘not related to his disability’, and in a later conversation with QAI’s advocate, cited a Google search to support their decision. Melissa said it was “like their mind was made up before we entered the room”. The behaviour and attitude of this planner became such an issue and impediment to Ryan’s support needs, the advocate felt compelled to write a letter of complaint to the CEO of the NDIA. Melissa and David also wrote a letter to their local MP to convey their intense dissatisfaction with the implementation of the NDIS and ask for a commitment to take action.
After all attempts to resolve the issues with senior NDIA officials were unsuccessful, the family lodged an external appeal at the Administrative Appeals Tribunal (AAT) seven months after Ryan’s first plan came through. The appeal spanned 11 months during which three case conferences were held and the NDIA funded an Independent Functional Assessment and Home Modifications Assessment, Engineer Plans for the home, information from the family, specialists and therapists.
Finally, in March 2020, twenty months after Ryan’s first plan, he received a new plan with more supports than they had originally requested. Ryan now had the means to transition to living independently.
Ryan’s new plan included:
- Home modifications
- 8 weeks 1:1 short term accommodation
- 1:1 support in the home 12 hours per day
- 24/7 1:1 support when he moves into his new home
- Fortnightly speech therapy, physiotherapy, occupational therapy and exercise physiotherapy
- Transport funding
- Additional transition support
- Support coordination and plan management
- Fortnightly domestic assistance
- Yard maintenance
- Wheelchair repair
Looking back on their experience with the NDIA, Melissa called it “horrendous” and “quite arduous” and said they had to deal with “poor communication, broken promises and inappropriate people”. David had a similar response describing it as “frustrating, inconsistent, unnecessarily lengthy and complex”. Melissa said, “I am very harsh on the NDIS but equally so I think they were extremely unwarrantedly harsh on our family… I think they need a lot more education. You know, a lot of [NDIA] people [haven’t] been touched by disability before and they’re… making decisions, life decisions about people who are compromised and those who don’t have the support of a strong advocate like David* and myself, I wonder how much success they would have – it scares me to be honest”.
Melissa also feels the NDIA wasted money throughout the process, recalling when they flew an independent Occupational Therapist up to Brisbane from Sydney instead of simply finding one locally.
Reflecting on QAI’s assistance Melissa said “I don’t think David and I could have done it without [the advocate] in all honesty because the information is really hard to find”. David said, “everyone we spoke to had a different understanding of what was required. [The advocate] understood the processes, so provided clarity. [They were] immediately able to advise when some correspondence or communication was manifestly wrong – which was a regular occurrence”.
Since getting his new plan, Ryan has moved into his own home and Melissa said he has “transitioned very well, surprisingly well. We’re very fortunate to have a good support team who followed him to continue their work with him”. Melissa said she has gone through a variety of emotions herself, “a bit of grief, a bit of loss, a bit of I don’t know what to do with myself… a little freedom for the first time in 28 years, and a little bit of spontaneity. But also relief that I see Ryan is going forward and having that good life, he is very happy”.
*Name has been changed.