A quick guide to your next steps when your NDIS plan comes back with a lot less funding than you need
- Request an internal review. You can do this by calling on 1800 800 110, or by emailing firstname.lastname@example.org. You have three months from receiving the decision to do this. More information is available on the NDIS website and we discuss this in more detail below, and some of the next steps will provide information that you will need to include in your internal review request.
- Make a PIAR. This is similar to a Freedom of Information request, and there is an online form to do it. We discuss this in more detail below.
- Calculate how long your funding will last. Mention this in your request for internal review. We talk some more about timeframes below.
- Check your evidence.
Internal Review request
You can make your request by telephone or email. We recommend you do it in writing if you can because:
- you have control over what is documented – in a phone conversation you are relying on the other person to write down everything you said
- you can submit documents as well as make the request – we discuss some examples of this below
- you have the sent email as evidence of when and how the request was made.
You need to send the request to email@example.com. Even if you have a direct contact, you MUST copy it to the enquiries email address. This is because:
- The team at enquiries load emails onto client records. If they don’t have it, there is a chance it will not be loaded onto your record, and may not be flagged with the review team.
- If the contact you have is the planner that made the decision, they can’t do the internal review. There is no guarantee they will do anything with your email, and may not even reply.
- People leave the NDIA, change roles, go on holiday, all the usual things. There is no guarantee an email to an individual will even be received, much less actioned. (You would expect to get a notification if the person has left the NDIA, right? Don’t count on it!)
Include everything you want them to review; don’t rely on being able to add things later on. (The AAT has given some conflicting opinions on this, but there are decisions that say if a specific funded support has not been mentioned at internal review, it cannot be considered by the AAT. Make sure you mention it!)
You have three months. It can be hard to know when to submit. Some reasons to submit as soon as possible:
- Why waste time if you know what the problem is? Get the review in!
- If you are going to run out of funding, things could become urgent. Get the review in now!
- Nothing will happen until you request the review. Send it off so it is out of your hands and you can get on with other things.
On the other hand, there are reasons to delay:
- If you are doing a PIAR and want to check the information they used to make the decision, it might be worth waiting until that comes back
- If you have more evidence coming, it might be useful to include that, so waiting might make sense in the circumstances. (But know there is a risk that the person doing the internal review won’t read it!)
- It can be better to spend some time getting your evidence documented (see below) so that the internal reviewer has a better chance of checking they have read everything relevant, and hopefully you can get a better outcome.
Making a PIAR
The online form for Participant Information Access Requests includes a tick box for this situation. You will select the option that says “NDIS plan review – Information about your recent NDIS plan review, including the information relied on to make the decision and the reasons for the decision.”
There is no cost for requesting this information, but the more information you request the longer it will take to return. You should try not to think of extra things you might want to know, because right now the focus is on the decision you want reviewed. (You can always go back later and make a separate request for other things!)
Once you get the information back you can check for:
- Are all the documents there? If you have provided evidence that is relevant to the decision, it is important to make sure that it has been included in the PIAR record returned. If not, there is likely some issue with the materials that have been available to the decision maker. You will want to resubmit these materials with the internal review request, noting when and how they were originally made available to the NDIA.
- Is there information about their reason for the decision? Is this factually correct? If not, you will want to correct any misperceptions when you request the internal review.
Calculate how long your funding will last
This is both a precaution to assist you in working out how urgently you need to make your request for review, and a strategic tool for seeking external intervention.
If your funding is going to last 11 months of a 12 month plan, you have time to go through the internal review process, and probably don’t need to request external involvement.
However if your funding is only going to last 3 months, there is a possibility of a looming crisis, and you need to start raising your concerns about this. This could include documenting the risks associated with the loss of funding, and when you anticipate that occurring, and raising this:
- In your request for internal review
- In a complaint to firstname.lastname@example.org
- To your local member of parliament (check here to find out who that is!)
If you have not had a response to your request for internal review and the funding is going to run out within weeks, you can contact your local NDIS appeal advocacy provider, and ask them to escalate within the NDIA.
Check your evidence
If you have provided evidence of the necessity for the requested support, it can be helpful to document this so that the internal reviewer can easily locate it. This could be as simple as:
“3 hours assistance for community access every Sunday afternoon” – see report by A Smith dated 1 Jan 2021, page 3.
A summary of this material can be submitted with the request for review, and if necessary you can resubmit the reports to ensure that they have them all. Try to keep this brief, and the evidence the most recent and relevant; sending too much material can make it more difficult for the reviewer to get through it all and focus on the important parts.
Good luck with your review!