Navigating NDIS Eligibility

Navigating NDIS Eligibility - Optimum Care Group

Navigating NDIS Eligibility: Understanding the Path to Support

For people with disabilities in Australia, accessing the National Disability Insurance Scheme (NDIS) can be life changing. It means receiving personalized support to enhance abilities, achieve goals, and live a fuller life. However, the first step often presents a question: “Am I eligible for the NDIS?”

Let’s demystify NDIS eligibility by exploring the essential requirements and the factors taken into account when an application is made.

NDIS Eligibility: Essential Requirements

To be eligible for the NDIS, you need to meet several key criteria:

  • Age: You must be under 65 years old when you apply for the NDIS.

  • Residency: You need to be an Australian citizen, a permanent resident, or hold a Protected Special Category Visa.

  • Disability: You must have a permanent and significant disability. This means:

    • Permanent: Your disability is likely to be with you for life.
    • Significant: Your disability substantially reduces your ability to participate effectively in everyday activities – things like communication, self-care, social interaction, mobility, learning, or managing tasks without assistance.
  • Impact and Support Needs: Your disability impacts your ability to take part in activities or work and means you require lifelong support from the NDIS to make the most of your life.

  • Early Intervention (Children under 7): For young children experiencing developmental delays, early intervention support through the NDIS can help improve their long-term outcomes and reduce the need for future support.

full shot friends with basket ball

Understanding the Application Process

  1. Making Contact: Your eligibility journey begins by contacting the National Disability Insurance Agency (NDIA) on 1800 800 110 or through their website (
  2. Gathering Evidence: Be prepared to share information outlining your disability and its impact on your day-to-day life. Supporting evidence is key and might include:
    • Medical Reports: Documentation from doctors, specialists, therapists, and other health professionals.
    • Support Letters: Written statements from people who know you well, such as teachers, support workers, carers, or employers describing your challenges and support needs.
    • Functional Assessments: Assessments that provide a more detailed picture of how your disability affects your daily activities and participation.
  3. The Access Request Form: You’ll need to complete an Access Request Form, providing your details and information about your disability. The NDIA will use this, along with your supporting evidence, to determine your potential eligibility.
  4. Decision and Planning: If you meet the eligibility criteria, you’ll have a planning meeting with an NDIS representative to discuss your support needs, develop personalized goals, and create your NDIS plan.

Considerations in Eligibility Decisions

  • Capacity Building: Does the NDIS believe the support they provide could significantly improve your overall skills and independence over time?

  • Reasonable and Necessary Support: Do your support needs align with what the NDIS considers ‘reasonable and necessary’ to assist with your day-to-day life, activities, and pursuing your goals?

  • Other Supports: Are there other mainstream services (health, education, etc.) that might more appropriately meet some of your needs? The NDIS complements, not replaces, these existing systems.

aged shoppers

Important Notes:

  • Every Situation is Unique: Every person’s disability and the way it impacts their life are unique. NDIS eligibility assessments are considered case-by-case.

  • Advocacy: If you disagree with an NDIS decision, you have the right to request an internal review. A disability advocate can help you through the process, provide support, and make sure your rights are protected.

Persistence Pays Off

The NDIS application process can seem complex, but understanding the eligibility requirements and gathering compelling evidence will increase your chances of being accepted. If you or someone you know might benefit from NDIS support, don’t hesitate to take that first step of contacting the NDIA. It might be the beginning of a journey toward greater independence, opportunities, and a brighter future.

Talk to Optimum Care Group, Melbourne’s leading NDIS support coordinator.