NDIS Access Request: How to Apply for the First Time

Applying for the NDIS for the first time can feel like a wall of forms and jargon. The good news is that the process itself is fairly simple. What decides the outcome is the evidence you send with it. This guide explains who is eligible, how to apply, what evidence works, and what to do if you are refused.

Who is eligible

To become an NDIS participant, you generally need to:

• Be under 65 when you apply.
• Live in Australia and be an Australian citizen, hold a permanent visa, or hold a Protected Special Category visa.
• Meet either the disability requirements or the early intervention requirements.

The disability requirements mean you have an impairment that is likely to be permanent, and that it substantially reduces your ability to do everyday activities, so you usually need support from other people, assistive technology or equipment. The early intervention requirements apply where getting support early is likely to reduce how much support you need in future.

Young children under 9 usually start through the early childhood approach, delivered by an early childhood partner, which can provide support straight away and help with an access request where it is needed.

How to apply

You can start an access request by calling the NDIA on 1800 800 110, by completing the access request form, or through a local area coordinator or early childhood partner in your area. You will be asked to confirm your identity and residency, and give consent for the NDIA to collect information about you.

You then provide evidence of your disability, either in the supporting evidence section of the form or as separate reports and letters.

The evidence that matters

This is where most applications succeed or fail. The NDIA needs to understand two things: that the impairment is likely to be permanent, and how it affects daily functioning.

Who should provide it

Evidence should come from a treating professional who knows you well and is qualified to comment on your condition, such as a GP, a specialist, a psychologist, or an allied health professional like an occupational therapist or speech pathologist. Recent evidence, usually within the last 12 months, carries more weight.

What it should cover

The NDIA looks at functioning across six areas: mobility, communication, social interaction, learning, self-care and self-management. Strong evidence describes, in concrete terms, what is difficult in each relevant area and what help is needed.

For example, "has an intellectual disability" is weak on its own. "Needs prompting and physical help to shower and dress every morning, cannot manage money, and needs someone with him to use public transport" gives the NDIA something to decide on.

Treatments already tried

Evidence should also explain what treatment has been tried and whether any further treatment is expected to substantially improve things. This is how the NDIA judges whether the impairment is likely to be permanent.

How long it takes

Once the NDIA receives a complete access request, it is required to make a decision, or ask for more information, within 21 days. If it asks for more information, it then has a further 14 days after receiving it. Incomplete applications are the most common cause of delays, so sending strong evidence the first time saves weeks.

Tips for a smoother application

• Gather evidence before you lodge, so the request is complete from the start.
• Ask each professional to describe daily functioning, not just the diagnosis.
• Keep copies of everything you send, and note the date you lodged it.
• If someone helps you apply, make sure you give consent for them to talk to the NDIA on your behalf.

If you are approved

You become a participant and move into planning. It is worth preparing for your first planning meeting: think about your goals, the help you get now, and what you need. Our guide to NDIS funding categories explains how your plan will be structured.

If you are refused

You can ask for an internal review of the decision, generally within three months of receiving it. If you still disagree, you can apply to the Administrative Review Tribunal. You can also submit a new access request with stronger evidence. Read the reasons for the decision carefully, because they usually point to exactly what was missing.

How we can help

Supporting new participants through the access process is part of what we do. We help people understand whether they are likely to be eligible, work out what evidence is needed, brief treating professionals on what their letters and reports should cover, and make sure the application tells a clear, complete story.

One practical point: before you have a plan, there is no NDIS funding for this kind of help, so ask any provider upfront how they charge at this stage. Once you have a plan with support coordination in it, that help is funded.