Plan reviews and appeals

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Plan reviews are a normal part of your National Disability Insurance Scheme (NDIS) journey.

Key points

  • A plan review will normally take place after 12 months
  • A review lets you revise your plan to make sure you’re getting the support you need
  • Your review will be undertaken by an NDIS representative

You should receive a plan review at least once a year, but you can also organise plan reviews if something changes in your life and your plan needs to reflect that change.

What is a plan review?

A plan review is a chance to measure your progress against your goals, provide feedback on what supports are or aren’t working for you, explore and set new goals, or ask any questions.

It is expected that your first plan review will take place after your first 12 months in the Scheme. Towards the end of your first year as an NDIS participant, you will be contacted about a review of your first plan.

Things to consider when reviewing your plan are:

  • Which supports are working best

  • Identify strengths, interests, opportunities and challenges

  • Consider current informal, mainstream, funded and community supports

  • Review goals and other targets

You will be able to sit down with an NDIS representative and discuss what is and isn’t working within your plan, and where changes can be made to better support you and your needs.

Who undertakes the review?

Your review will be conducted by an NDIS representative. For children aged up to six years old, most plan reviews will be conducted by the Early Childhood Early Intervention (ECEI) Partner in person with the family. This could be in the partner’s office or in the family home.

For participants aged seven to 65 years, plan reviews will be conducted by a Local Area Coordinator (LAC) or an NDIS planner either face-to-face or over the phone.

You will also have the opportunity to talk to your representative about when to have your next plan review.

Reviews can be scheduled up to two years apart depending on your personal circumstances.

If you know your situation may change in the near future, such as moving from school to work or a change in living arrangements, you could schedule a review in 12 months’ time.

Your next plan will be developed based on your plan review conversation and formally approved by the National Disability Insurance Agency (NDIA).

Your current supports will not be impacted during the plan review period, however, you will need to talk to your providers about your plan length to make sure your Service Agreements are up to date.

Remember that any unspent funds in your plan will not roll over to your next plan. The new funding will replace your existing funding, so it’s important to make the most of your budgets. If you don’t use all your funding in a certain budget, you may not receive the same amount in your next plan even if you think you need it.

For example, if you have a $20,000 Core budget and only use $16,000 during the 12 months, this may show the NDIA that you don’t need the full $20,000, so you may only be allocated a $16,000 Core budget, or less, in your next plan.

Participant-requested review

If your circumstances change, your plan no longer meets your needs, you are unhappy with the supports outlined in your plan, or would like to change your plan management type, you or your plan nominee can request a review with the NDIA at any time.

It is important you do reach out for a review if your needs change, so you can get the necessary supports for your new needs as soon as possible.

If your circumstances have changed, you can request a review by completing a change of circumstances form which can be found on the NDIS website or at your local NDIS office.

Keep in mind, circumstances will need to have changed significantly from your last meeting for a review to take place and not all changes will require a review. Your current supports will continue during the review process.

Appealing a decision

If you do not agree with a decision made by the NDIA, you can request an internal review by completing the ‘Application form review of decisions’ on the NDIS website. Visit the NDIS website or call the NDIA on 1800 800 110 to get help to complete the form over the phone.

A review request must be made within three months of receiving notice of an NDIA decision and you should explain why you think the decision was incorrect.

A review will be conducted by an NDIA staff member who was not involved in the original decision-making process. They will reconsider the facts, law and policy and determine if the original decision was accurate.

If you do not agree with the outcome of the internal review, you may make an application to the Administrative Appeals Tribunal (AAT) requesting a further review.

You cannot ask the AAT to review a decision until the NDIA has reviewed it. For information about applying for an AAT review, visit the AAT website or call 1800 228 333.

If you or the NDIA disagrees with a decision following the outcome of an external review by the AAT, an appeal can be made to the Federal Court of Australia, which is the final avenue of review.

What do you want from your NDIS plan? Tell us in the comment section below.

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