This collection of pages are specifically for caseworkers and explain the NDIS
Eligibility and Access
This guide provides information on the eligibility requirements for the NDIS and the NDIS Access Request or transition process for becoming an NDIS participant. Refer to the NDIS overview page for important contextual information about these guidelines and the NDIS. These guidelines are dynamic and will be regularly updated to reflect a changing NDIS model and procedures as the Scheme is implemented.
Important information for Early Intervention, Child Protection and OOHC staff in this guide includes:
- Identifying disability in children or young people.
- When to consider whether a child or young person has a disability.
- What to do if a child or young person needs urgent disability support.
Important information for Early Intervention and Child Protection staff in this guide includes:
- How to help a parent with disability access the NDIS.
Important information for OOHC casework staff in this guide includes:
- Making NDIS Access Requests and evidencing applications.
- What to do when a child or young person entering OOHC already has an NDIS plan.
Who is able to access the NDIS?
A person is eligible for the NDIS if they are: are under 65 when their application is made are Australian Citizens, residents or permanent visa holders and meet the disability or early intervention requirements.
Under the Bilateral Agreement for transition to the NDIS in NSW, if people are currently accessing NSW specialist disability supports and do not meet NDIS residency requirements, but do meet NDIS age and disability requirements, they will be supported as participants in the scheme.
The National Disability Insurance Agency (NDIA) sets the access requirements (eligibility criteria) for the NDIS. To help people understand if they are eligible for assistance under the Scheme, the national NDIS website contains a tool, called the NDIS Access Checklist.
For further information about access requirements, see Access requirements.
If you are not sure whether a child, young person or parent with disability is eligible, you can contact the NDIA.
National Disability Insurance Agency
1800 800 110.
Becoming an NDIS participant
With so many people coming into the Scheme in such a short time it is important that there is a planned approach to how the scheme can be accessed.
From 1 July 2016, people living in the Hunter New England, Southern New South Wales, Central Coast, Northern Sydney, South Western Sydney, Western Sydney and Nepean Blue Mountains districts have been able to access the NDIS.
From 1 July 2017, the NDIS became available across the rest of NSW, for people living in Northern New South Wales, Mid North Coast, Sydney, South Eastern Sydney, Illawarra Shoalhaven, Murrumbidgee, Western New South Wales and Far West NSW.
Existing Ageing, Disability and Home Care (ADHC) clients and the NDIS
All NSW specialist disability funding will transition to the NDIS by 30 June 2018. The focus for NSW is supporting all existing NSW specialist disability clients to transition to the NDIS. How and when people with disability can access the NDIS will depend on the type of support they receive now and where they live. Current supports will continue until a person has moved to the Scheme and their NDIS plan is in place.
The NDIA requires consent from each client (or their representative) prior to being able to transition them across to the NDIS. Communities and Justice (DCJ) has provided the NDIA with consent for all children or young people under the Parental Responsibility of the Minister to transition to the Scheme via a letter to the CEO of the NDIA.
More information about the NDIS participant phasing process can be found here: NDIS participant phasing.
To become a participant of the NDIS a person must meet access requirements for either disability or early intervention pathways (explained below). There will be some capacity during the transition period for people who are considered to be ‘new’ participants to be assessed for eligibility for the NDIS.
This includes people with new incidence of disability currently accessing supports through other NSW Government agencies, including Health, Education and Justice, or other sectors, such as primary care providers and non-government organisations.
The first step in becoming an NDIS participant is completing the Access Request Form. The process for making an Access Request is explained further below.
For children or young people in the Parental Responsibility of the Minister, it will be the role of DCJ or Non-Government Organisation (NGO) OOHC casework staff as the ‘child’s representative’ to undertake the Access Request process for new entrants to the Scheme.
Early intervention requirements may be met if:
- a child or young person has one or more identified intellectual, cognitive, neurological, sensory or physical impairments that are, or are likely to be, permanent or
- a child or young person has one or more identified impairments that are attributable to a psychiatric condition and are, or are likely to be, permanent or
- a child or young person has a developmental delay which results in:
- substantially reduced functional capacity in one or more of the areas of self-care, receptive and expressive language, cognitive development or motor development, and
- results in the need for a combination and sequence of special interdisciplinary or generic care, treatment or other services which are of extended duration, and are individually planned and coordinated; and
- there is evidence that getting supports now (early intervention) will help by:
- reducing how much help the child will need to do things because of their disability in the future or
- mitigating, alleviating, or preventing deterioration of the child’s functional capacity or improving such functional capacity or
- helping the child’s family and carers to keep helping the child, and
- those supports are most appropriately funded through the NDIS, and not through another service system (such as the health system or the Child Protection and OOHC system).
Disability requirements mean that a child or young person will meet the disability requirements if:
- the disability is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or to one or more impairments attributable to a psychiatric condition and
- the impairment is, or likely to be, permanent and
- the impairment substantially reduces the ability to take part effectively in activities (i.e. communication, social interaction, learning, mobility, self-care or self-management), or perform tasks or actions unless:
- the person has assistance from other people on most days, or
- the person has assistive technology, equipment (other than common items such as glasses) or
- they can’t take part effectively even with assistance or aids and equipment and
- the impairment affects the person’s capacity for social and economic participation, and
- the person is likely to require support under the NDIS (and not another service system such as the health system) for their lifetime.
Why is identifying disability in children and young people important?
Identifying whether a child or young person has a potential disability that requires support is increasingly important because the NDIS can support children with developmental delay or disability. The key to accessing this support will be through identifying disability or developmental delay and making an Access Request.
The Scheme’s Early Childhood Early Intervention (ECEI) approach recognises that early intervention for a child (0 – 6 years) with a developmental delay or disability in their early years is critical to achieving the best outcomes. Providing quality intervention early in a child’s life reduces the possible need for longer term intervention.
When should I be considering whether a child or young person has a disability or developmental delay?
Child Protection and OOHC casework staff and Early Intervention providers should consider whether a child or young person may have a disability upon commencing working with the child or young person and build responding to the disability into their everyday work with children and young people.
OOHC Casework staff need to consider whether the child or young person may have a disability or developmental delay upon entry to OOHC, during the health and behaviour planning process and during plan reviews.
Child Protection casework staff also need to consider whether the child or young person may have a disability as part of the child protection assessment process.
How can I identify disability in children and young people?
Family and Community Services responds to the health and medical needs of children and young people who are at risk of significant harm through a continuum from initial contact across program areas. If uncertain, caseworkers can make any necessary referrals to a medical or health practitioner for a formal diagnosis.
Family and Community Services casework staff may contact their local DCJ psychologist to perform testing for intellectual disability and advice on the level of support a child or young person may need. NGO OOHC providers may choose to utilise the psychological resources available to them to help identify disability and determine the needs of children or young people in their care. Where a child or young person is receiving case management, the child or young person’s case plan must be regularly reviewed including their health, medical and social/emotional needs.
Family and Community Services psychological services may undertake psychological assessments of children and young people in child protection and upon entry to OOHC as well as those currently in a DCJ OOHC placement. They can identify and assess intellectual disability and/or developmental delay.
Casework staff should endeavour to work closely with Health staff where appropriate to address the impact of the NDIS on the OOHC Health Pathway for children and young people. This includes working with Local Health District OOHC Coordinators to identify the presence of disability or developmental delay versus the impact of trauma/complex trauma in children or young people.
For more information about responding to health and medical needs, which includes disability and/or developmental delay, DCJ staff may refer to the Casework Practice Mandates Medical and dental needs in child protection (DCJ intranet login required), and for children and young people in OOHC, Health needs of children in OOHC (DCJ intranet login required).
NGO staff may refer to their internal policies and procedures in relation to identifying health and medical needs of children and young people.
What if I identify a child or young person who needs urgent disability support?
If a child or young person is not currently receiving funded disability support and is likely to meet the NDIS access requirements, submit an Access Request to the NDIA. Statutory OOHC Casework staff, as the ‘child’s representative’, will be responsible for working with the carer to complete the Access Request (explained below). For children and young people in Child Protection or an Early Intervention program, staff should provide information and assistance to the family around the Access Request process.
Email the Access Request Form to the National Access Team and mark it as urgent. Briefly explain to the NDIA in the email why it is urgent.
For urgent cases, under transitional arrangements, ADHC may work directly with the NDIA to seek prioritised access to the Scheme or may be able to deliver or fund interim supports until the child or young person can access NDIS funded supports.
What if I identify a child aged 0-6 with developmental delay?
Families or OOHC casework staff who have a child between 0-6 years of age with developmental delay or disability and think there is need for support can contact their local Early Childhood Early Intervention (ECEI) Transition Providers to access the NDIS ECEI gateway. A list of local providers in NDIS roll out areas is available at ECEI Providers in NSW Local Government areas.
The ECEI gateway enables young children aged 0-6 to gain timely access to best-practice early childhood intervention. The gateway process is based on the outcomes of a functional assessment undertaken by the ECEI Transition Provider, to help identify the most appropriate supports for the child. This could include referral to short term interventions, mainstream supports, information, and if necessary, an NDIS plan.
If a child is eligible to receive an NDIS plan then the local ECEI Transition Provider will work with the family or OOHC casework staff to develop an NDIS plan for the child.
If a child is already an NDIS participant, their current arrangements will continue. The NDIS will talk to the family or OOHC casework staff about the different ECEI options for the child at the scheduled plan review.
How can I help a parent with disability access the NDIS?
If you identify that a child or young person’s parent may require disability support for their own disability and that this may enhance the safety and wellbeing of their child/children in the home you can help the parent to access the NDIS. The NDIS Access Checker will help identify whether the parent is likely to be eligible for the NDIS and provide details of how to apply.
Refer the parent to an NDIS Local Area Coordinator (LAC) if you think they will need support to navigate the Access Request process. NDIS LACs can help to streamline a participant's NDIS experience and assist them to understand and access the NDIS. LACs have three key roles: they will link people to the NDIS link people to information and support in the community, and work with their local community to make sure it is more welcoming and inclusive for people with disability.
Three community based organisations have been commissioned to be partners in the Community to deliver NSW Local Area Coordination transition services for participants aged 7 years and over until 30 June 2018: Uniting, St Vincent de Paul Society NSW and Social Futures.
For contact details for LAC services, please see the following links:
Uniting: NDIS Local Area Coordination
St Vincent de Paul: Local Area Coordination for the NDIS Rollout
Social Futures: NDIS Local Area Coordination
For further general information about LAC services, go to Local Area Coordination
Where can I get an Access Request Form?
Access Request Forms can only be provided by the NDIA. The first step to getting an Access Request Form is to call the NDIA on 1800 800 110 to ask for one to be sent to you. The Access Request Form is generated by the NDIA with a specific identification number used to track a participant’s NDIS journey. This targeted approach means the NDIA will not provide forms in bulk, but in response to details about a specific prospective NDIS participant.
Completing an Access Request Form
A person must fill in an Access Request Form to apply to become a participant of the NDIS. Where the applicant is under 18 years, the consent section of the form can only be completed by a person who has Parental Responsibility for the child or young person or, in the case of statutory OOHC, DCJ or NGO casework staff as the ‘child’s representative’. All sections of the Access Request Form must be filled in.
NGO Early Intervention providers and DCJ Child Protection caseworkers may be asked to help their client’s family apply to access the NDIS. NDIS LACs can also help to link people to the NDIS.
For further information about completing the Access Request Form, go to Completing your Access Request.
What evidence should I provide with the Access Request Form?
Prospective participants must provide the NDIA with evidence of the diagnosis of disability or developmental delay from a treating doctor, specialist, or health professional (this includes a physiotherapist, an occupational therapist, speech pathologist, psychologist or a nurse).
To determine eligibility and appropriate disability supports the NDIA need to know what the child or young person’s disability or developmental delay is, how long it will last and the impact on the child or young person’s life.
DCJ Child Protection and OOHC casework staff may want to utilise their local DCJ Psychologist to review Access Request Forms prior to lodging them with the NDIA to ensure that the child or young person’s disability and evidence is accurately described for the NDIA to make an appropriate decision about funding supports. NGO OOHC providers can use the psychological services available to them.
For information about what evidence to include in an Access Request Form, see: Evidence of your disability and Evidence of disability or developmental delay for children under 7 years of age.
What if the child or young person’s impairment varies over time?
An impairment that varies in intensity, such as an impairment that is of a chronic episodic nature, may still be permanent and the person may require support under the NDIS for the person’s lifetime, despite the variation. In this instance the child or young person may still be able to access the NDIS.
What if the child or young person is not eligible for the NDIS but requires additional support?
The NDIA will provide information and referrals to existing mainstream and community services. Initially during transition this will be through Ability Links until NDIS Information, Linkages and Capacity Building (ILC) services have been established. Ability Links and ILC will provide information on what services and support are available. Ability Links or ILC will refer and link the child or young person to mainstream and community supports where these are more suited to meeting their identified needs than NDIS funded supports.
NDIS LACs can also help to link people to information and supports in their local communities. For more detailed information about LACs, please see the How can I help a parent with disability access the NDIS? section above.
What if a child or young person entering care already has an NDIS plan?
Some children and young people who enter care may already be receiving a package of support from the NDIS. Where possible, discussions should be held with the child or young person’s parents or whoever was caring for them prior to entering care to determine what supports and services they have previously accessed.
OOHC Casework staff will be responsible for notifying the NDIA about the child or young person’s change of circumstances (entry to OOHC) and reviewing the NDIS plan and supports to determine if they meet the child or young person’s needs in their current placement. Refer to Plan Preparation and Plan Process for things to consider in relation to determining the child or young person’s support needs.
The caseworker should ensure that, as the ‘child’s representative’, their name replaces the child or young person’s parent/carer’s name on the NDIA portal and that parent/carer electronic access has been removed.
You may also consider seeking advice from Psychological Services (DCJ staff) or for NGO staff, utilising psychological resources available to you. If the plan does not appear to meet the child or young person’s support needs, refer to Monitor and Review Plan for information about requesting a review of a plan.
What if I have a question or need more information or clarification?
If you have a question about the NDIS and Early Intervention, Child Protection and OOHC email email@example.com
If you encounter a situation with the NDIS that differs from these guidelines and needs clarification, speak to your manager to determine whether the matter needs to be raised with the NDIA locally or go through the DCJ NDIS issues escalation pathway for resolution.