NDIS Appeals

Our NDIS appeals advocates provide advice, information and support to people who do not agree with a decision made by the National Disability Insurance Agency (NDIA). Some examples of decisions the NDIA makes are: 

  • deciding who can and who cannot access the National Disability Insurance Scheme (NDIS)
  • how much funding you receive in your NDIS plan to pay for the supports you need
  • what types of supports you can spend money on.

The NDIS has two types of appeals – Internal Review and External Merits Review

When you want a decision to be looked at again by the NDIA, your first step is to ask the NDIA for an internal review. You must request an internal review within 3 months of the NDIA’s decision. An internal review is conducted by a different decision maker employed by the NDIA. This person is called the Internal Reviewing Officer. You must have received the results of the internal review before you can take the next step. 

If you are not happy with the result of the internal review, you can apply for an external merits review by the Administrative Appeals Tribunal (AAT). This is a Tribunal that reviews decisions made by Government agencies, departments and ministers. You must request an external merits review within 28 days of the internal review decision.

 

Internal Review by the NDIA

You can request an internal review by:

  • phoning 1800 800 110
  • emailing enquiries@ndis.gov.au
  • sending a written request to:
    Chief Executive Officer
    National Disability Insurance Agency
    GPO Box 700
    Canberra ACT 2601
  • talking in person to someone at an NDIA office

The NDIA has an application form you can use to request a review on their website.

NDIA review of a decision application form

Important points about an Internal Review

  • you have 3 months from the date you received the decision to apply for an internal review 
  • there is no fee for requesting an internal review
  • you may have to pay for reports
  • an advocate can help support you.

The Internal Reviewing Officer needs to have the best information available to make a decision. Preparing your application will take time and may involve costs. Your application must state the reasons you think the decision was incorrect, and include reports describing how having a disability affects your life. These reports can be written by:

  • your GP
  • a paediatrician 
  • an occupational therapist 
  • a private or school-based psychologist
  • a speech pathologist 
  • another allied health professional. 

The Internal Reviewing Officer will decide whether:   

  • the decision will stay the same, or
  • some parts of the decision could be changed, or 
  • the decision should be overturned.

Once the internal review is complete, the NDIA must give you a written statement of reasons for the internal review decision.

Make a referral for ADACAS to help you or someone you know with an internal review

If you want to enquire about how ADACAS can help you, or someone you know with an NDIS internal review, please use the button below, or you can contact us by either ringing or emailing us.

Make a referral                   Contact ADACAS

External Merits Review by the AAT

If you do not agree with the internal review decision, you can apply to the AAT for an external merits review by:

  • filling out an online form
  • downloading a form and lodging it with the AAT in person, by email or by post.
    Address: Level 8, 14 Moore Street, Canberra, ACT 2601
    Email: generalreviews@aat.gov.au

Make an online application to the AAT for a review              Download an AAT review form and return it by email or post

The AAT have video and written guides which explain more about how to apply and the processes the AAT follows. 

Video guide to making an AAT application            Written guide to making an AAT application

A contact officer from the AAT will get in touch with you within 3 working days of receiving your application, to discuss what will happen next and find out if you need any assistance during the external merits review process.

Important points about an AAT External Merits Review

  • you have 28 days from the date you received notification of the internal review decision to apply to the AAT 
  • there is no fee for requesting an external merits review
  • while the external merits review process is taking place, the decisions made during the internal review will apply to you
  • you will need support from an advocate
  • you will need a lawyer.

 

The External Merits Review has three stages

The AAT uses 3 different stages of meetings to review a decision. 

  • Case conference
  • Conciliation
  • Hearing

The AAT will try to bring you and the NDIA to an agreement at each stage before the review proceeds to the next stage.

Stage 1 Case Conference

There is often more than one Case Conference. The first Case Conference is an informal meeting between a representative of the NDIA, yourself, your lawyer, your advocate and an AAT Registrar. You can expect a discussion about further assessments to help the NDIA to understand why their decision was wrong, and a decision will be made about who will pay for the assessments.

The same parties attend the second Case Conference, where the results of the assessments will be discussed, and the lawyers will say why the results of the assessments support their arguments. The AAT Registrar will help you and the NDIA reach an agreement if that is possible. If you can reach an agreement, the AAT Registrar will record it in writing in a document called the Terms of Agreement. This is a legal document that replaces the internal review decision.

If agreement cannot be reached during a case conference, the AAT will discuss with you and the NDIA whether the case should proceed to the Conciliation stage and then a Hearing, or whether to proceed straight to a Hearing.

Stage 2 Conciliation

Conciliation gives both you and the NDIA the opportunity to discuss the issues and information from each point of view, and to consider ways to reach a compromise agreement. Conciliation is normally scheduled 4 weeks after the last case conference.  Again, an agreement at this stage will be recorded in writing in a Terms of Agreement.

If you and the NDIA cannot reach an agreement, or only reach an agreement about some parts of your application during Conciliation, the matter will proceed to a Hearing.

Stage 3 Hearing

A hearing is adversarial, and you will need a barrister and a lawyer. At the hearing you and the NDIA will present information, call expert witnesses such as health specialists, and make arguments about your case. 

The Tribunal Member will make a decision that is binding on you and the NDIA. If possible the Member will give their decision at the end of the Hearing. If a decision cannot be made at the time of the Hearing, the Member will give you a decision within 60 days of the Hearing.

The outcome of an external merits review can be either: 

  • the internal review decision made by the NDIA becomes the final decision, or
  • changes are made to the NDIA internal review decision, or
  • the NDIA internal review decision is cancelled and a new decision is made, or 
  • the NDIA internal review decision is cancelled and the case is sent back to the NDIA to make a new decision.

Make a referral for ADACAS to help you or someone you know with an external merits review

If you want to enquire about how ADACAS can help you, or someone you know with an external merits review, please use the button below, or you can contact us by either ringing or emailing us.

Make a referral                   Contact ADACAS