What to expect and how to prepare for your NDIS plan review | MyCareSpace

How to prepare for your NDIS plan review

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This resource includes:

  • Steps in the NDIS Review Process
  • What is a plan review
  • When does a plan review happen
  • Who attends a plan review meeting
  • How to prepare for your plan review: Reports
    • What reports do I need?
    • What is the Plan Reviewer looking for when reviewing my reports?
    • Report Writing
    • Will a therapist’s report guarantee the participant gets the funding they request?
    • Tips for Report Writing for Therapists
    • What is a Carers Statement and do I need one for my plan review
  • ​How to prepare for your plan review: Funding
    • What if I haven't been unable to use all my funds?
    • What happens if I still don't get the supports I need in my new plan?
    • What language do I use when asking for supports in a Plan Review?
  • ​How to prepare for your plan review: Questions:
    • What questions will the Plan Reviewer ask?
    • How can you best prepare to answer these questions? How can you ask for extra support?
    • What is the Plan Reviewer considering
  • What happens if you miss your plan meeting, or the reviewer doesn’t contact you?
  • Now that the plan review is over what happens next?

Steps in the NDIS plan review process

Here is a summary of the steps in the NDIS plan review process:

  1. The NDIS will contact you within 100 days of your plan expiry date to book your plan review meeting. If they do not contact you, call the NDIS on 1800 800 110.
     
  2. You will need to gather reports from your therapists and other providers that are providing supports to help you achieve your goals
     
  3. All reports are sent to the Plan Reviewer prior to the meeting
     
  4. The Plan Reviewer arranges to discuss your NDIS plan on the day/time of the meeting via phone, online video or in person.
     
  5. They ask you some questions, then say goodbye and use the information in the reports, plus anything you have discussed, to write up a new plan.
     
  6. In anywhere from 6hrs to 3 months later, your new NDIS plan arrives.
     
  7. If you are not happy with your new plan, you have 100 days to dispute the new NDIS plan (and request a review).

What is a plan review?

An NDIS plan review can be a scheduled or unscheduled review of your NDIS plan.

A scheduled plan review happens at the end of your plan period. It is planned to take place before your new plan naturally rolls over (usually at the end of 12 months if that is the length of your plan)

An unscheduled plan review happens when you want to change the funding in your NDIS Plan. It can be requested by a carer/participant or by someone such as a support coordinator on a carer/participant’s behalf when there is:

  • a change of circumstances, such as funding being consumed much faster than anticipated, or
  • if there is some other change in the personal circumstances of a participant that warrants a plan review prior to the scheduled review date.

A plan review is performed by a Plan Reviewer from the NDIA. The review can be done by phone, Zoom (or similar) or in person.

The Plan Reviewer's job is to:

  • review your current NDIS plan and
  • determine how much funding will be in your next NDIS plan and in what categories (buckets of funding).

Plan Reviewers have a lot of power over your future funding, and so, what happens before and during your plan review is very important.

Luckily, there are a few things you can do to give yourself the best shot at getting the funding you need.

Here’s what you absolutely need to know about Plan Reviews

When does a plan review happen?

A scheduled NDIS plan review happens within the last 100 days (3 months) of your plan.

Similarly, an unscheduled review will happen within 100 days (3 months) after the unscheduled review is requested.

Note: Unscheduled reviews are no longer escalated in the way they once were, so even in an emergency review, there may be a lengthy delay between the time of review request and the appointment date.

Who attends my plan review meeting?

It is advisable not to attend a plan review meeting on your own. You need someone to support you or even just to remind you of what you wanted to say! Anyone can accompany you:

  • A friend/carer/family member
  • Support worker
  • Support coordinator
  • Advocate

How to prepare for your plan review: Reports

What reports do I need for my NDIS Plan Review?

You will need to present the Plan Reviewer with reports from providers who have helped you work towards your goals and who you want to include in your next plan.

These may be reports from:

  1. Therapists (Allied Health Providers),
  2. Your Support Coordinator (if you have one),
  3. Other providers who are building your capacity and helping you achieve your goals

1. Therapist reports (Allied Health)

Therapist reports are the most important and could include reports from Psychologists, Occupational Therapists, Speech Therapists and any allied health professional who has been working with you over the past year.

They need to produce a detailed review of your progress so that you can justify why funding is needed in the future

You will usually have provision for these written reports in your service agreement.

Make sure you ask your therapist for your Plan Review report at least 6 weeks before your plan review date, giving them time to create them.

Reports are needed as evidence to justify further funding. Without these reports, there is very little evidence that the parent/carer can give to the NDIA to justify why funding is needed.

These reports are especially important for children.  Because children are growing and developing. As they age, they may grow out of some of their symptoms, they may have been misdiagnosed, and they may no longer require the same level of support. As such, it is very hard to justify the need for funding in children without reports showing that the disability is likely lifelong.

Reports are less essential for adults. An adult with a diagnosed disability usually has that disability for life and there is ample evidence that can be given for this. That doesn’t mean you shouldn’t try and acquire one. The NDIA will be more lenient with adults for the first year or two, but this leniency will often depend on the Plan Reviewer you get on the day. It always pays to be prepared.

Therapists should be producing these reports as part of their work with the participant anyway, and they should be updating these each year to monitor progress. However, the parent or carer is still required to request the report when the plan review is coming.

2. Support Coordinator reports

Your support coordinator will write a comprehensive progress report for your plan review.

3. Other Provider reports 

Other providers can write reports for programs, activities or supports they provide if you would like to continue to receive funding for these supports in your next plan.

Be sure to have them use the correct NDIS language that relates to your progress in achieving your goals.

What is the Plan Reviewer looking for when reviewing my reports?

It is certainly helpful to know what a Plan Reviewer is looking for when viewing reports. They will be focusing on the following information:

1. Outcomes

The report must be "outcomes-focused" and summarise the progress made through the therapy sessions. It could include:

  • What worked? What didn’t work?
  • How has progress been made over the past year?
  • How does this therapy reduce the need for funding in the future?

2. Justification for future funding

The report must use the outcomes and progress made to justify why future funding is needed and how ongoing support will result in the reduced need for funding in the future.

It should include answering questions like:

  • Why funding was used? Why funding wasn’t used?
  • Why the participant needs more funding?
  • How does this additional funding lead to less funding being required in the future?

3. Recommendations

The report must make recommendations to the Plan Reviewer as to what supports and funding in which area is needed in the next plan.

Report Writing

What if the therapist is not familiar with the NDIS?

Some therapists or providers may not be familiar with the kind of information a Plan Reviewer needs and is looking for when building a plan.

They might not use the right terminology when making recommendations for future supports or justifying why funding categories need to be included in the next plan.

NDIS language is really critical to a good NDIS report and if the therapist hasn’t communicated which outcomes have been reached and how progress has been made in the right way, then the funding categories, or amount of funding available, may be altered in the future.

See this MyCareSpace resource to help therapists with their NDIS report writing.

Will a therapist’s report guarantee the participant gets the funding they request?

No. Unfortunately, even if the therapist has produced an amazing report, the Plan Reviewer on the day may be unfamiliar with your disability and not understand the recommendations in your report, they may already have a path in their mind that they want to lead you down.

They might even just be in a bad mood. As many of us have experienced, nothing in the NDIS is a sure thing. 

You need to stick to your guns.

Make sure that each report shows:

  • a timeline demonstrating how capacity has improved over the duration of the plan period
  • how independence will continue to grow
  • reference to the participant's goals in the context of the seven life domains

Tips for Report Writing for Therapists

They might not use the right terminology when making recommendations for future supports or justifying why funding categories need to be included in the next plan.

NDIS language is really critical to a good NDIS report and if the therapist hasn’t communicated which outcomes have been reached and how progress has been made in the right way, then the funding categories, or amount of funding available, may be altered in the future.

See this MyCareSpace resource to help therapists with their NDIS report writing.

What is a Carers Statement and do I need one for my plan review?

A carers statement is a statement written by a carer and submitted along with the reports ahead of the plan review meeting.

A carers statement can take many forms but will usually talk a little bit about:

  • any relevant circumstances of the participant that may influence their funding
  • other contextual information that the Plan Reviewer might need to consider

They are not as essential as you might think. Because of the biased nature of a carers statement, reports and other assessments are more important.

If you would like to include a carers statement, be sure to make it short and keep it broad. Don’t tell a personal story and don’t ask for very specific items.

​How to prepare for your plan review: Funding

What if I haven't been unable to use all my funds?

That’s okay! As long as you can justify why the funding hasn’t been used.

There are many reasons that you may not have been able to spend your funds including long waitlists, COVID, lack of services in remote areas. Did I say COVID?

All of these are justified reasons for you not yet having used your funding.

As long as you can explain why the supports haven’t been accessed and why they are still needed, then that’s okay.

What language do I use when asking for supports in a Plan Review?

Keep it broad. For example:

Don't Say: I want surf lessons.

Do say: I want to focus on community access and making friends.

Use the NDIS terminology to your advantage. Where you can also use this to your advantage is in the therapist reports. If you have gone through section 34 and determined that what you are asking for is reasonable and necessary, then talk to the therapist writing your reports about it. Get them to include your requests in their recommendations using the right language. 

If the reviewer informs you that what you are asking for is not something that is funded by the NDIS, don’t assume they are correct.

They don’t know everything! If you know there are NDIS providers offering services they say the NDIS doesn’t offer (like group activities for an 11yr old with Autism), then tell them.

Stand your ground (politely and within reason, of course).

Be aware that the Plan Reviewer will use your words against you. Their aim is to reduce each amount in the plan until the participant has no funding, because in theory, the participant should be building capacity, and so, need less funding over time.

For participants with Autism

It is especially important to try and get as much core support funding the first time, as core supports are often something that gets cut from plan to plan.

You need to work harder to justify increases in these supports and in keeping them the same. This is mainly the case for high functioning children. 

What happens if I still don't get the supports I need in my new plan?

If the reports are sound, and you still don’t get the plan you want, you can:

1. Call the NDIA and apply for a ‘reviewable decision’

This must be done within 100 days of the plan being generated.

By applying for a reviewable decision, the Plan Reviewer will have to reconsider the plan they have created.

Unfortunately, the plan is reviewed by the same person that created your plan. The Plan Reviewer will either accept or reject your request and then you cannot ask them again.

2. If you still aren’t happy with your plan you can apply for an ‘unscheduled review’

This time, a new Plan Reviewer will look at your plan. They will call you to talk through your plan and approve the unscheduled review, after which you will attend a review meeting just as you would in a scheduled review.

Note: the way an unscheduled review is conducted is changing as of July 2021. Rather than getting a call from a Plan Reviewer, where you are able to advocate for yourself, your request will now go before a review team who will either accept or reject your request for an unscheduled review.

​How to prepare for your plan review: Questions:

What questions will the Plan Reviewer ask?

Now that you have gathered your reports, you are almost ready for your plan meeting!

Technically, there is nothing else you need to do to prepare for your meeting.

On the day and time of the review, the Plan Reviewer will contact you (hopefully not too late or early!) as agreed. If they don’t contact you, there are some things you can do but more on that later.

They will ask you some questions then say goodbye, build a new plan and that’s it! If you are happy with your previous plan, it really is that simple.

It is not uncommon for plan meetings to last a few minutes and for the Plan Reviewer to just roll over the previous plan (if you are happy with that scenario), giving you the same supports and funding for next time.

Lets set the scene:

The day has come for you or your loved one’s plan review meeting. The planner calls or dials in and they will say something along the lines of:

Hi, my name is x, I am calling from the NDIA, am I speaking with (participants name)?

Just to confirm, you have requested a plan review, with your current plan running until date x?

If you have requested an unscheduled review, the reviewer will ask you to confirm why you have requested the review (e.g. to ask for more core supports, or whatever the reason might be)

Is there anyone else here with you today?

Here you let the reviewer know who else is in the room. It is a good idea for the support coordinator to be there if you have one, or at the very least a family member of friend to support you.

Depending on why you are having your review (is it scheduled or unscheduled?) they might ask any of the following:

  • Are you happy with your funding?
  • Do you want the same funding next year?
  • What worked? What didn’t work?
  • Tell me a bit about your year, what has been happening since you received your plan a year ago?
  • Where are you living now? What is your living situation?
  • How old are you?
  • Can I speak to your representative if you are a child?
  • I can see you have required more support than your funding allowed in x areas, why was that? What has happened that required you to access so much more support?
  • What are your goals?
  • How long have you needed additional supports for?

Then they might ask questions around specific funding categories (different for children and adults):

  • How do you access the community?
  • How do you get to and from work?
  • Who helps you around the house?
  • How do you manage your finances?
  • Is what you are currently doing building your capacity?

If you have a support coordinator present, they might ask for more information, such as a support coordinator report that provides details of some of the additional supports the participant wants to access.

How can you best prepare to answer these questions? How can you ask for extra support?

Rather than trying to learn responses to any of these questions, focus on learning the language you need to use and what the Plan Reviewer is looking for when they ask these questions, that way you can be prepared for anything!

What is the Plan Reviewer considering:

Section 34 of the NDIS Act (2013): Reasonable and Necessary

When you ask for something in a plan review meeting, the Plan Reviewer is asking themselves:

  1. Is this reasonable and necessary?
  2. How can we reduce the need for funding and
  3. How can we increase reliance on mainstream (non-disability) supports

It is a good idea to ask yourself these question before you ask for additional supports at your plan review meeting.

To give yourself the best shot at getting what you ask for, become familiar with section 34 of the NDIS act that defines 'what is reasonable and necessary.

Remember that the Plan Reviewer doesn’t know you and are making their decisions based on the evidence you give them (reports or verbal).

You need to justify:

  • That the request will reduce the need for funding in other areas in the future, and
  • Is reasonable and necessary in order for you to achieve your goals

Then you are more likely to convince the Plan Reviewer that what you are requesting should be included in the next plan.

Keep in mind that if you have expressed a need for more supports, but haven’t run out of funding early, they will question that the request for additional reports if not necessary and reasonable.

They might be thinking, if this person really needed that support, they should have used it and requested an unscheduled review.

If you used the funding up early, it will be easier to justify that the support was needed so keep this in mind.

This isn’t always the case and remember, if you use your funding early and then schedule for an early review, you might have to wait months before the appointment, so keeping track of your funding is very important.

Tip: they are expecting you to justify why it is reasonable and necessary for the NDIS to increase funding in certain areas in order to meet the needs you have identified.

What happens if you miss your plan meeting, or the reviewer doesn’t contact you?

The Plan Reviewer might call late, or they might not call.

If you get cut off it’s quite hard to get back in touch. If you miss your call the reality is, by the time you have called the NDIA inquiries line and asked for a receipt number, and they have followed up on the Plan Review, the Plan Reviewer might have already built your plan without your input. Calling the NDIA, emailing them or calling and emailing your LAC are pretty much your only options.

Now that the plan review is over what happens next?

Now that the plan review meeting is over, the plan reviewer will go about building your new plan.

This can take anywhere from 6hrs to 3 months. Most plans come within 14 days.

You might not be notified adequately when the plan is complete, so keep checking the MyGov portal for a change in your funding amount.

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