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Who is eligible for the NDIS? How do I apply?

Apr.14.2023 By Orla Garrigan MyIntegra Updates

Getting started with your NDIS journey

If you’re living with a disability or impairment, getting the right support for your unique needs is an important part of living the life you want. Support can help you gain independence, work or study more effectively, and participate more actively in social activities.

If you’re looking for disability support for yourself or a loved one to help navigate your everyday activities, the National Disability Insurance Scheme (NDIS) may be able to help. The NDIS is a government program that funds disability-related costs.

Your age, residency status, and the impact of your impairment or condition on your daily activities determine your eligibility for the program. If you’re not sure if you meet eligibility requirements, follow the step-by-step process below to find out and get on the right path for support.

Step 1: Age

Are you between 7 years old and 65 years old? 

The NDIS supports those between the ages of 7-65. If this is you, you can go on to the next step. If you fall outside of this age range, there may be alternative options for support.

Are you looking for support for a child under 7?

The early childhood early intervention (ECEI) approach provides support for children under the age of 7 who have a disability or developmental delay. The goal for ECEI is to help your child develop the skills and knowledge they need to participate in mainstream settings. You can find support through early childhood partners by reaching out to them directly – your child does not need a diagnosis to get help.

Are you over the age of 65? 

You may be able to access other available supports, including My Aged Care, which can provide help around the house or assist you in finding aged care facilities.

Step 2: Residency

Are you an Australian citizen, a permanent resident, or a holder of a protected special category visa?

The NDIS supports Australian citizens, permanent residents and holders of protected special category visas. If you fall into this category, you can move on to the next step. If you don’t fall into one of these categories, although you won’t be eligible for the NDIS, other supports may be available.

Step 3: Location

Do you live in Australia?

To access the NDIS, you must live in Australia and spend the majority of your time here in Australia. You will need to provide evidence to prove that you reside in Australia. Usually, your Centrelink record will suffice as appropriate evidence. Sometimes you may need to provide proof of your address, that you work in Australia, or that you own property in Australia, and specify how much time you spend overseas.

You’re still allowed to travel — the NDIS may just require you to answer questions about why you travel and how long to ensure that Australia is still home.

Step 4: Disability requirements

Is your disability caused by a permanent impairment?

To qualify for the NDIS, you must have a permanent impairment causing your disability. It may be an intellectual, cognitive, neurological, sensory, physical, or psychosocial impairment.

An impairment can be defined by the loss of or substantial change in one of the following areas:

  • The function of your body
  • The structure of your body
  • The way you think and learn

An impairment can fall into any of the following categories (to meet NDIS guidelines, your impairment must fall into at least one of the categories):

  • Intellectual — includes speaking and listening, reading and writing, solving problems, and managing information.
  • Cognitive — thinking, learning new things, making decisions, and paying attention are all cognitive aspects.
  • Neurological — the way your body works.
  • Sensory – such as seeing and hearing.
  • Physical – such as your body’s ability to move.
  • Psychosocial – your mental health hinders you in daily life activities (this can be fluctuating)

Not sure if you’re eligible for this step? If you have evidence of all of the following, you meet the disability requirements:

  • There is an impairment that causes your disability.
  • Your impairment is expected to be permanent.
  • As a result of your permanent impairment, you cannot perform one or more of the following activities: moving around, communicating, socialising, learning, or self-care and self-management.
  • Your permanent impairment affects your ability to work, study or socialise.
  • You will likely need support under the NDIS your entire life.

You must demonstrate that you will likely have your impairment for the rest of your life. Naturally, there will be periods where there is a smaller impact, and sometimes it may be more intense. This is still considered permanent due to the impact on your life that will likely last a lifetime. Your eligibility may be impacted if your impairment is temporary, if you are working through treatment or if there are available treatment options that you haven’t tried yet.

Do you typically require disability-specific support to carry out your everyday tasks?

If yes, you may be eligible.

Step 5: Early intervention

Do you require assistance now to lessen the need for support in the future? Or maybe you need additional support now for your family, so that they can learn the skills they need to support you in the future. If yes, you may be eligible.

If not, support through the NDIS may not be your best option. Get into contact with your Partner in the Community to find out about other potential community and government assistance that may be available.

Step 6: Other considerations

The final thing to consider is if there are any medical treatment options for your impairment. While NDIS can fund support used to reduce or sometimes overcome the impact of your impairment on your daily life, it does not fund any medical support that treats your impairment.

The NDIS will ask your treating professional to certify that there are no medical, clinical or otherwise available treatments that could alleviate your impairment and investigate whether there are any known and available evidence-based treatments that would be appropriate for treating your impairment. An example of a condition that is unlikely to be found as permanent is obesity, as there are treatment options in a broad sense, such as diet and lifestyle.

I am eligible – how do I apply for the NDIS?

Once you have read through the eligibility criteria and believe you are eligible for the national disability insurance scheme, it’s time to contact the National Disability Insurance Agency (NDIA).

You can call the NDIA on 1800 800 110 to discuss your eligibility for NDIS. If they believe you might qualify for the NDIS, they will send you an Access Request Form. Alongside returning the access request form, you will need to submit your supporting evidence.

Forms and evidence can be submitted as follows:

  • Via email to [email protected]
  • Via mail to GPO Box 700, Canberra ACT 2601
  • Or via your local NDIA office

The NDIS will decide if you are eligible or be in contact requesting more information within 21 days.

What’s next?

If all goes to plan and you’re found to be eligible, you’ll receive a letter letting you know. You’ll also have a planning meeting, where you’ll learn more about which local support and funds are available to you.

It’s helpful to arrive at your planning meeting prepared, so make sure to follow our best tips for preparing for your planning meeting.

Can I receive help with navigating the NDIS?

A Local Area Coordination partner can help you access the NDIS if you qualify. Once the NDIS has approved you, you can work with a plan manager and support coordinator. Working with experts in the field can help you get the most out of your NDIS plan. The NDIS website also has plenty of additional information about NDIS funding and NDIS services.

Discover how the NDIS works, create your plan and choose your support.

Are there other avenues to receive government help if I am not eligible?

If you are not eligible for NDIS support, other avenues of support are available. Read more about the available support for those that don’t meet NDIS disability requirements.

Need help navigating your NDIS plan?

Our friendly, knowledgeable team can help. If you’ve gone through these steps, been found to be eligible, and now have an NDIS plan, we can provide you support with NDIS Plan Management.

Navigating the NDIS can be challenging and confusing for participants and their loved ones. Our goal is to keep everyone informed and connected, help our clients make the most of their plans, and keep our partners up-to-date. Give us a call to get started today.

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