What is the National Disability Insurance Scheme (NDIS)?
The National Disability Insurance Scheme (NDIS) is a government scheme established under the National Disability Insurance Scheme Act 2013 (NDIS Act) and delivered by the National Disability Insurance Agency (NDIA).
The NDIS provides a range of supports and services to eligible Australians between ages 7 and 65 with a permanent and significant disability. For children under 7, Early Childhood Early Intervention (ECEI) support can be received through local Early Childhood Partners across Australia.
The NDIS is designed to help people with a disability get the support they need so their skills and independence improve over time. The types of supports that are funded through the NDIS include:
- Daily personal self-care activities such as getting out of bed, showering, dressing and assistance with household tasks, such as cooking and cleaning
- Participation in community social and recreational activities
- Accessing transport
- Support to get or keep employment
- Therapeutic supports including behaviour support
- Accessing specialised aids or equipment, installation and training
- Home modifications including design and construction
- Mobility equipment and vehicle modifications
How does the NDIS work?
The NDIS is delivered through Local Area Coordinators (LAC). They can help to connect you to the NDIS and available community supports. You can find your nearest LAC on the NDIS website or call 1800 800 110.
Am I eligible?
You are eligible for the NDIS if you are:
- Aged between 7 and 65
- Are an Australian citizen, permanent resident, or Protected Special Category Visa holder, and
- Have a disability caused by a permanent condition that significantly affects how you take part in everyday activities.
You must also meet at least one of the following requirements:
- You usually need support from a person because of a permanent and significant disability.
- You use special equipment because of a permanent and significant disability.
- You need supports now to reduce your future needs.
It might be helpful to think about how you might address these requirements before completing your application.
You want to check your eligibility by going to the NDIS eligibility checklist.
Children younger than 7
The NDIS supports children aged 0-6 who have a developmental delay or disability under its Early Childhood Early Intervention (ECEI) program. An ECI partner can help support your family by helping children develop the skills they need to take part in daily activities. An ECI partner can provide support before you apply, and let families know if the NDIS is right for their child. To find out more about help for children under 7 go to the early childhood approach on the NDIS website.
Other support services
You must be under 65 to be eligible for the NDIS. If you are over 65 with a disability, there are a number of other services that you may be able to access. Visit the NDIS website for more information.
Disability Support for Older Australians Program
The Disability Support for Older Australians Program (DSOA) replaced the Commonwealth Continuity of Support Program (CoS). If you are over 65 and had previously received disability services from the CoS Program, but were not eligible for the NDIS, you could be eligible for the DSOA Program. Visit the Department of Health's website for more information.
If you are over 65 and did not previously receive disability services from the CoS program visit My Aged Care website for more information on aged care supports.
What conditions are recognised by the NDIS?
These may include physical and mental health conditions and intellectual disabilities. Your eligibility is determined by the condition type, the severity of the condition and how it impacts your life. Each person is assessed on their own functional capabilities and needs.
The NDIS has categorised many types of conditions eligible for support into the below categories:
- List A: Conditions which are likely to meet disability requirements as they are considered to cause permanent impairment and disability, such as cerebral palsy and blindness.
- List B: Permanent conditions for which functional capacity is impaired. Further assessment of functional capacity is generally required.
- List C: People who currently receive disability support services are eligible for the NDIS. The NDIA will contact you as the NDIS becomes available in your area.
- List D: Conditions that are likely to meet the early intervention requirements for children younger than 7.
If your condition is not included on any of these lists, you may still be eligible. Each application is processed on a case-by-case basis.
Is arthritis covered under the NDIS?
Some forms of arthritis are covered under the NDIS. Rheumatoid arthritis (RA) and juvenile arthritis (JA) are categorised under List B as conditions that are likely to result in permanent impairment. This means that, while RA and JA are recognised as permanent conditions, the way it impacts each person will vary. Therefore, an individual’s level of physical impairment may require further assessment.
While other forms of arthritis, like axial spondyloarthritis (axSpA), are not listed, it is possible that you may still be eligible. Applications are assessed on a case-by-case basis. Which means that while some people with axial spondyloarthritis may be eligible for assistance, someone else with the same condition may not.
How can I apply?
If you think you are eligible and want to apply, you can do so by:
- Calling 1800 800 110 to make a verbal application
- Completing an Access Request Form including information to support your request
You will need to provide evidence of your permanent disability how it impacts your daily functioning. The more supporting evidence you have from your treating health providers, the better. Go to the How do we weigh evidence of disability on the NDIS website to find information on the type of evidence you will need and who should provide it. For a complete overview of the application process, download Booklet 1- Understanding the NDIS.
NDIA access decision
Once you have submitted your NDIS access request form and supporting evidence, the NDIA will contact you within 21 days with either a decision or a request for further information.
If you are not granted access and you believe the decision of the NDIA is incorrect, you can request an internal review by the NDIA of the decision. More information on this process and future steps is available at How to review a planning decision on the NDIS website.
If you are found ineligible to access the NDIS, further supports may also be available through your LAC.
If you are granted access to the NDIS, you will start working with your LAC to create your NDIS plan.
Creating your plan
You will work with your LAC to create your NDIS plan, establishing goals and the supports you will need to achieve them. Your goals might be to use public transport independently, to start studying, to participate in community activities, to become more independent with personal care activities or to have modifications done to your home. Your LAC will have a conversation with you to understand your current situation. For example, you may be asked how you perform daily activities, like showering or cooking.
During your planning conversation, you will be asked about how you want to manage the funding in your plan to pay for supports and services. There are 4 ways to manage your funds:
- Self-management – You request funds from the NDIA to pay your providers directly. To find out more about self-management see the Guide to Self-Management on the NDIS website.
- Plan-managed funding – The NDIA will provide funding in your plan to pay for a Plan Manager who pays providers on your behalf.
- NDIA-managed funding – The NDIA will pay your providers on your behalf.
- A combination of the above options.
You can find out more information on your NDIS plan by going to Creating your plan on the NDIS website or download Booklet 2 - NDIS Planning.
Using your NDIS Plan
Once your plan has been approved by the NDIA, you can access your NDIS information and funds via the MyGov website. You can now start using supports and services. Your LAC can help you get your plan started and help you choose the right providers if needed.
Towards the end of your plan, your LAC will work with you to review your plan and outcomes and create a new NDIS plan.
To find out more about using your NDIS plan download Booklet 3 – Using your NDIS plan on the NDIS website.
Importance of self-managing arthritis
Remember that applying to NDIS does not guarantee support. It is important to work alongside your healthcare team to help treat and manage the disease. This includes playing an active role in your own care to help self-manage your arthritis.
Self-management includes learning about your arthritis and its treatments. As well as adopting behaviours that benefit your own health and wellbeing. Some self-management techniques for arthritis include:
- Understanding the disease and its treatments
- Physical activity and exercise
- Pain management
- Fatigue management
- Stress management
You can read more about ways to help self-manage your arthritis in our things you can do section or call the Arthritis Infoline on 1800 011 041.