Reviews, appeals and decisions

This fact sheet is the fourth in a set of resources for authorised Out of Home Care (OOHC) carers about the National Disability Insurance Scheme (NDIS). This fact sheet provides key information about NDIS plan reviews, appeals and reviews of NDIS decisions.

Note: the OOHC caseworker referred to in this fact sheet is the FACS or NGO OOHC caseworker that has case management responsibility for the child or young person.

A review of a participant’s NDIS plan can be triggered in three different ways:

  1. as a normal part of the NDIS planning cycle
  2. a participant or their representative requests a review
  3. the NDIA initiates a review.

Each NDIS plan has an agreed review date which will provide the child or young person, carer, OOHC caseworker and NDIS representative an opportunity to discuss what is and isn’t working, amend goals and objectives and adjust supports. The NDIS planning cycle lasts between six and 24 months, depending on individual circumstances, with an average of 12 months for children in OOHC.

If you think the supports provided in the NDIS funded package does not meet the needs of the child or young person you care for, you should discuss this with your OOHC caseworker (the child’s representative) in the first instance.

The OOHC case worker can request a review of the child or young person’s plan.

The OOHC caseworker should take into account whether support needs have changed in the time since the NDIS plan was approved and whether information was not considered that would affect the occurrence, type and frequency of supports within their plan.

When a child or young person with a disability in OOHC’s living arrangements, informal supports or overall goals change, their OOHC caseworker will request a review.

The NDIA will not accept a request for review where:

  • a participant is unable to demonstrate that their circumstances have changed to the extent required to warrant a change to their statement of participant supports
  • there is no new information available which is likely to affect the NDIA’s assessment of a participant’s needs
  • the request is within six months of the approval of the NDIS plan, or within three months of a review date specified in the existing NDIS plan or
  • the request for review simply reflects the participant’s desire to have increased supports, or supports of a nature similar to other participants.

The NDIA will notify your OOHC caseworker about their decision to review an NDIS plan within 14 days of receiving a request for a review and the caseworker will advise you.

For more detailed information on review of NDIA decisions, see https://www.ndis.gov.au/operational-guideline/review-of-decisions.html.