Disabilities not supported by the NDIS

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If you’re wondering whether your disability is covered by the NDIS, this article will list a number of conditions which are not funded by the Scheme.

Key points:

  • The NDIS approves access on a case-by-case basis and approved funding is not guaranteed for life
  • Disabilities listed in this article may be considered for approval if they are a significant impairment in life
  • Conditions throughout this guide may also be subject for approval if they are diagnosed in addition to existing disabilities which make life difficult

The National Disability Insurance Scheme (NDIS) supports over half a million Australians and is, to date, the second most costly social services program in the country, aside from the aged pension.

Since it was introduced in 2013, knowing whether you were eligible for access to NDIS support has been confusing, with some even having to provide evidence that they are still disabled in order to keep receiving support thereafter.

If you’re wondering whether your disability is covered by the NDIS, this article will list a number of conditions which are not funded by the Scheme.

Some conditions, which are not considered disabilities (such as type 1 diabetes, which is considered a disease rather than a disability), have their own respective program, such as the National Diabetes Services Scheme (NDSS). Make sure to ask your physician what you can do to receive support.

Attention-deficit hyperactivity disorder (ADHD)

Attention-Deficit Hyperactivity Disorder (ADHD) is considered to be a neurodevelopmental disorder and is not generally covered by the NDIS, as it is seen to be a treatable condition.

In adults with the disorder, ADHD is characterised by symptoms of inattention, hyperactivity, impulsivity, restless sleep and can lead to difficulties in academic situations and in relationships.

ADHD in both childhood and adulthood diagnoses are treated with prescription stimulant medication, such as Ritalin (methylphenidate), along with therapy.

Due to available medication and therapy operating as treatments, the NDIS rarely recognises an ADHD diagnosis as permanently debilitating, impacting social or financial outcomes, or requiring ongoing Government support.

However, people living with ADHD in addition to other mental, cognitive or neurodevelopmental disabilities, may be considered eligible on a case-by-case basis.

Auditory or visual impairment (glasses or hearing aid)

For many with visual or auditory impairments that can be corrected with glasses or hearing aids, the NDIS will not consider these disabilities to be eligible for funding.

Much like ADHD, they can be corrected without necessarily requiring intensive ongoing support and are not considered to be debilitating in social or financial outcomes for the applicant.

Disabilities that are the result of drug or alcohol use

Individuals with a disability caused by narcotics, prescription drugs or alcohol abuse/use are not covered by the NDIS for funding for their dependency, which is categorised under conditions requiring ‘mainstream’ channels of support.

However, the NDIS does consider alcohol or drug dependency eligible if it is co-morbid with a psychosocial disability and on a case-by-case basis.

Disabilities caused by ageing

While disabilities can be caused by ageing, the NDIS does not generally consider people with these disabilities to be eligible for funding.

If you are a recipient of the NDIS support prior to the cut-off date for eligibility (NDIS funding is only available to those under the age of 65), you can continue to receive support through the national Continuity of Support program.

For more information about accessing disability support funding for seniors aged 65 or over, read our ‘Seniors 65+ years’ article.

Mild intellectual disabilities

Intellectual disabilities are considered ‘mild’ or ineligible for funding, if they are debilitating or if the person with an intellectual disability scores an intelligence quotient (IQ) of 70 IQ points or higher.

The average IQ is 100 and for people living with an intellectual disability who score 70 – 100 points are considered to be capable which does not require substantial ongoing support and funding.

However, IQ tests are considered to be highly impractical in discerning intelligence, let alone whether the conditions and performance of the test itself is conducive to their overall ability to function on a daily basis.

Additionally, many people within the 70 – 100 point IQ range who live with intellectual disabilities may require support, so eligibility is assessed on a case-by-case basis.

Manageable mental health conditions

The NDIS draws a line in the sand between mental health conditions and psychosocial disabilities and considers mild or manageable mental illnesses or states to be ineligible for funding.

A psychosocial disability is a disability that comes from the mental health condition that a person has. Conditions such as schizophrenia, post-traumatic stress disorder (PTSD), agoraphobia (fear of social interaction) or obsessive-compulsive disorder (OCD) are some diagnoses which may prevent people from being able to perform everyday duties without support.

For mental health conditions such as depression or anxiety, mainstream support channels such as therapy are not eligible for NDIS funding and although people with these conditions require support, these are generally not regarded as psychosocial disabilities.

To find out more about psychosocial disabilities, support and mental health eligibility, read our guide: ‘Mental health and the NDIS’.

Undiagnosed developmental delay or learning disabilities

Although diagnoses do not necessarily dictate whether a person is eligible for NDIS funding, the screening process for both developmental delay and learning disability funding is typically dependent on early childhood partners (occupational therapists, speech pathologists and early childhood teachers).

These partners can help to observe, assess and provide evidence that they meet the diagnostic criteria to the National Disability Insurance Agency (NDIA). After all, you can’t spell undiagnosed without ‘NDIA’.

For parents seeking funding for their child’s learning disability or require NDIS coverage for developmental delay, the treating doctor or specialist will need to fill out the Professional’s Report in the second section of the Access Request Form.

Along with the Professional’s Report, the NDIA will require information about your child, including the severity and lifelong prognosis (how long the impairment will impact their life and the correct course of support).

Temporary impairments

Temporary impairments, such as a broken arm or fractured leg, are not considered permanent impairments and are not covered by the NDIS.

The NDIS seeks to provide long-term support for lifelong impairments, rather than fund treatment or remedies, in order to ease the burden of how their disability may impair their life.

The NDIS funds support for eligible impairments, whether they are obtained through birth, injury, disease or accident.

For someone that was born without or lost a limb, for instance, the NDIS may provide funding for a prosthetic limb (referred to under the Scheme as ‘assistive technology’), if the recipient can provide evidence of the impairment that they face in life as a result of their disability and the benefits of their access to assistive technology.

To learn more about the NDIS and eligibility, check out the NDIS category on the Disability Support Guide website.

Does this list surprise you? Share your opinions in the comments.

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