Who is eligible for the NDIS?

What is the NDIS?

The NDIS stands for National Disability Insurance Scheme. It was first introduced in 2013 and its goal was to replace all other Australian Government disability funding schemes. 

The NDIS provides funding to eligible people with permanent and significant disability for any "reasonable and necessary" supports that give them greater independence, access to the community, and an improved quality of life. T

It aims to provide people living with a disability access to new skills, jobs, or social opportunities.

The NDIS now supports over 580,000 Australians with disability (both adults and children) to access the services and supports they need. 

Funding is allocated to the individual, and the individual or their guardian chooses which providers supply the funded goods and services (subject to certain restrictions).

Who is eligible for the NDIS?

You are eligible for NDIS funding if you meet the following 'NDIS Access Criteria':

1. You are aged between 9 and 65 years (If you have a child younger than 9, an NDIS early childhood partner can provide support to children before they apply, and let families know if the NDIS is right for their child)
2. You are an Australian citizen, permanent resident, or Protected Special Category Visa holder
3. You live in Australia
4. You have a disability caused by a permanent impairment (lifelong disability)

What does it mean to have a 'lifelong disability'?

Your disability is considered lifelong if the following conditions are met:

• Your disability is caused by an impairment.

  In other words, a loss or significant change in at least one of: 

  • your body’s functions - for example your neurological functioning
  • your body structure - for example a physical disability or sensory disability
  • how you think and learn - for example an intellectual or cognitive disability
     
• You may also be eligible for the NDIS if you have a psychosocial disability. This means you have reduced capacity to do daily life activities and tasks due to your mental health.
   
• Your impairment is likely to be permanent
   
• Your permanent impairment substantially reduces your functional capacity to undertake one or more of the following activities:
  • moving around,
  • communicating,
  • socialising,
  • learning, or
  • undertaking self-care or self-management tasks.
     
• Your permanent impairment affects your ability to work, study or take part in social life.
   
• You’ll likely need support under the NDIS for your whole life.

Note: If you give the NDIS evidence you have been diagnosed with one or more conditions on the NDIS List A, we’ll likely decide you meet the disability requirements.

Do I have to be born with a disability?

No, it doesn’t matter what caused your impairment. You may have been born with it, or acquired it from an injury, accident or health condition.

It also doesn’t matter if you have one impairment or more than one impairment.

What does it mean when you say my impairment must likely to be permanent?

The NDIS needs evidence that you’ll likely have your impairment for your whole life.

You might have some periods in your life where there is a smaller impact on your daily life, because your impairment may be episodic or fluctuate in intensity. That is ok.

Your impairment can still be permanent due to the overall impact on your life, and the likelihood that you will be impacted across your lifetime. 

Even when your condition or diagnosis is permanent, the NDIS will check if your impairment is permanent too.

For example, you may not be eligible if your impairment is temporary, still being treated, or if there are remaining treatment options.

Generally, the NDIS consider whether your impairment is likely to be permanent after all available and appropriate treatment options have been pursued.

If you give the NDIS evidence you have been diagnosed with a condition on the NDIS List B, the NDIS will likely decide your disability is from an impairment that’s likely to be permanent.

Will the NDIS fund treatment for your disability?

The NDIS won’t fund support to treat your impairment.

Instead, the supports they fund can help you reduce or overcome the impact your impairment has on your daily life.

They will fund supports to help you increase your functional capacity, independence, and your ability to work, study or take part in social life.

Your impairment will likely be permanent if your treating professional gives the NDIS evidence that indicates there are no further treatments that could relieve or cure it.

Your treating professional will tell us or be asked to certify if there are medical, clinical or other treatments that are likely to remedy your impairment.

Things to Note about how the NDIS defines treatment:

• The NDIS refers to "treatment" in the broadest sense and includes any changes to your diet and lifestyle. So, for example, conditions such as obesity are unlikely to be found to be permanent. 
• If you’re still undergoing or have recently had treatment, the NDIS will need to wait until you know the outcome of the treatment before they can decide your impairment is likely to be permanent. 
• In some situations, it may be clear your impairment is likely to be permanent while you’re still undergoing treatment or rehabilitation. For example, you may still need treatment and rehabilitation for a spinal cord injury, but it’s clear you’ll have a permanent impairment.
• You might still have a permanent impairment, even if its effects may change over time. 

Am I eligible for the NDIS if I have a degenerative impairment?

Degenerative impairments like Alzheimers,  Huntington's disease,  Multiple sclerosis and others that are expected to get worse over time, are considered permanent if treatment is unlikely to help or improve the impairment’s effects. 

This is especially the case if you usually need disability-specific supports to complete daily life activities.

Do I need to prove my disability every year to keep my NDIS funding?

We've all heard horror stories of LACS asking if a participant if they still have Down Syndrome. Here's the truth:

If you meet the disability requirements, it’s likely you’ll need the NDIS for a long time. This means you won’t have to prove your disability every time we reassess your plan. 

If at any time your disability support needs or situation changes, we many need to check your supports or NDIS eligibility. 

How do I apply for the NDIS?

See our resource on how to apply for the NDIS.

Sources:

• NDIS Guidelines on Eligibility
• NDIS - Am I eligible?
• NDIS Early Childhood Approach
• Connecting with an NDIS Early Childhood Partner