Posted: 2025-07-03

I'm writing these in the hope that I can mostly manualise my advocacy and focus on all the other stuff.

Get it right the first time. If you can't afford the reports, you definitely can't afford to do it another 3 times without support.

Disclaimer

The body of Australian social security law is elaborate, tightly targeted, and prescriptive.

But law it is.

Almost every issue to do with Centrelink and the NDIS is a legal issue. I am not a doctor, or a lawyer. I don't have any formal qualification in any of this.

The NDIS is less mature than the DSP and other social programs simply because it is younger.

I have a decent bit of experience doing access advocacy. Access is one of the lowest risk forms of advocacy to do, because if their access request is denied, the person hasn't lost anything (other than time and money). It is also one of the most life-changing forms of advocacy, given how hard it is to get in the door in the first place.

My approach to this, so far, has an outstanding success rate. I am going to share with you how it works. I suspect the staff in these organisations will broadly be happy about it, because higher-quality access requests will reduce the burden of untangling complex psychosocial situations. If you make it easy for them to say "tick, done" everyone wins. They must follow the law.

Access to these programs is very difficult. We have one of the most narrowly targeted systems in the world. You are really going to have to thread the needle to pull this off.

Introduction

Read Common Disability Access before this. It contains the basic principles of disability service access in Australia.

The following is some specialised comments about the NDIS specifically.

The NDIA (National Disability Insurance Agency) is the statutory body tasked with interpreting the NDIS Act. Delegates must know the relevant parts of the law in order to do so, though the vast majority will never come into direct contact with a lawyer.

Early in the life of the NDIS, there was a large amount of confusion about what it actually is. Even some participants who made successful access requests weren't sure if it was a payment or what had actually just happened.

The NDIS, by and large, provides services. This mostly means clinical staff (though not for treatment) and labour. There are a few other things it provides, but that's 90% of it.

Terms you will hear a lot are "formal" and "informal" supports.

They are quite straightforward: formal supports are provided by paid professionals. Informal supports are provided by friends and family.

NDIS Must Be Harder Than DSP

Regardless of how the legislation is written, from a public policy perspective, eligibility for the NDIS must be tighter than for the DSP.

The reason is simple economics.

The DSP pays for the subsistence living expenses of a single person. It is not an opulent life. The rate is a fraction of full time minimum wage.

The NDIS pays for a team of dedicated professionals to support a person. It must pay them market wages. At these rates, it does not take a very large number of support hours to rapidly eclipse anything the DSP can dream of costing.

DSP is a flat rate - around $30k per year. Adult NDIS plans usually start around there and can go up to seven digit numbers in extreme cases.

Regardless of how the legislation words access criteria, it is simply an economic impossibility for the NDIS to have the same number of participants as the DSP in the long-term. As a result, your access request must reach a higher burden of proof.

Access Must Be Watertight

The NDIS is absolutely flatlining the Federal budget. It currently (2025) costs more than Medicare. For all the arguing over what should or shouldn't be included, the reality is that we're extremely close to having no NDIS at all. Every single delegate is bearing this in mind with every single decision they make.

Your access request must be watertight.

One request even came back with the delegate saying "look, you've convinced me, but we need to make this absolutely legally bulletproof."

There's everything you need to make a bulletproof application here, but do not skimp out on any of it. You will need to invest money into this for reports. All of them are necessary. Doing half the job will cost you more in the long run.

You do not get into a role in social services because you do not want to help people, but realistically: delegates are between a rock and a hard place. Drastic change is needed, and getting in the front door is extremely difficult right now (mid 2025).

OTs Are Not Optional

Occupational Therapists (OTs) are the beating heart of the NDIS. They are the core providers of functional assessments and create support plans which others implement. They are the central point from which all support and capacity building flows.

Skipping the OT in the application phase is completely self defeating - you are going to be spending a lot of time with them anyway. Building a relationship sooner rather than later is absolutely critical.

The only trouble is that Medicare has unfortunately neglected access to OTs very badly. Realistically, the assessments that you must get done are going to be paid for almost entirely out of pocket. If you don't think you can afford that, you definitely can't afford going through this process many times because you skipped steps.

Private health insurance sometimes has OT funding that doesn't suck, but it is very particular to your fund.

NDIS clients are highly profitable and some OTs will cut a deal for an access request in return for an ongoing client.

Six Domains To Prove

What we need to prove - that the person has a disability which is:

*The legislation uses the word "significant", but for economic reasons delegates now interpret this much more strictly.

**Including treatments they cannot afford or which may require an organ donor. Yeah. It's rough.

"I could get better if I had the support" is unfortunately not within the purview of the NDIS.

Reports

One person I was helping showed me some reports written by their psychologist. They were laid out like pretty standard medico-legal reports -- history, diagnosis, symptoms, management, that kind of thing.

My first attempt at access, which was not successful, used this type of report.

While useful, this is not enough for a successful NDIS access request. This access request is not based on a medical condition. It is based on a disability.

It is worth noting that the NDIS is designed to allow for psychosocial disability access by someone who does not acknowledge they have a mental illness at all.

The NDIA will not put any effort into evaluating the person's condition. They must organise all their specialists to gather the evidence and provide it.

The contents of what you write during the access request will be directly translated into the person's first plan. This means that the bulk of it has to directly address exactly which permanent impairments the person has in the 6 major domains (mobility, learning, communication, social, self-care, self-management) and suggest supports to be funded for each. Once the access request is granted, the process sometimes unfolds very quickly as all the legwork has already been done.

There are KPIs regarding the time access requests must be processed by, and they will almost certainly meet those KPIs, but they will cheat a tiny bit by not beginning the processing for a week or two. This is kind of not their fault — the request has layers of bureaucracy to get through before it can be added to the queue, and setting an end-to-end response goal would put some links in the chain under unreasonable stress.

The other way they sometimes cheat is by asking for more information regarding things they already know about to reset the clock. The best way to avoid this is to hit them with a large, strong and consistent body of evidence upfront.

Advice on report structure and language is out of scope for this essay. There are some excellent resources around.

Rating Scales

The rating scales are mostly out of scope here, as they're the domain of your clinicians.

The central things you need to know are:

Working Is A Major Sign

The eligibility criteria for the NDIS do not include financial or employment status (means testing).

This is because a central objective of it is getting people (back) into mainstream work and education. If you give someone the supports they need to function, then take them away as soon as they start working, you're back to square one.

Despite this, the default assumption is that anyone who has held down a stable full-time job long term without large amounts of informal support will not meet access requirements.

Making an access request for someone who is working should include a detailed explanation of how others are filling in their support needs - otherwise it'll be extremely easy to simply assume that they aren't needed.

Support within the roles of regular relationships (domestic partners, friends, family) are not enough; you need to demonstrate that they went above and beyond as carers.

As an aside, it is completely acceptable and even encouraged for NDIS participants to themselves provide NDIS-funded services for others. The more flexible nature of the work and plethora of lived experience makes it a great match.

Peak Generosity

My estimation is that the NDIS reached peak generosity just before the COVID pandemic, and finished just after (roughly 2020-2022). This includes for access requests.

While COVID represented a strong incentive to use public sector funding as stimulus, and the nation kind of had bigger problems in the period anyway, the generosity was already clearly on an upward trend before that.

There are good structural reasons for this. Disability work is gruelling and has a very real human cost. Drawing a large amount of surplus labour into the sector very quickly realistically necessitates creating a gold rush. And we were still in the earlier stages of gathering data at this point, so there was an element of throwing shit at the wall.

There are also bad structural reasons for this. I will go through those in a future essay.

The other reason is that the Coalition was deliberately trying to make the Scheme as expensive to run as they possibly could, so that they could simply scrap it wholesale.

Part of this was ideological, part of it was electoral (since Howard, the LNP's brand largely revolves around bloated public social spending, plus people with disabilities do not usually vote for conservative parties), part of it was self-interest (lots of opportunities to shift public money to consulting agencies run by friends), and part of it was sheer spite (killing Shorten's brainchild).

Some of the really sinister tricks were intended to drive long-term participant behaviours - such as making funding "use it or lose it" where plans were cut by the exact amount of their underspend. Even when the new administration stated that this would no longer be the case, it is/was extremely difficult to get participants to trust that they don't have to spend every penny they possibly could out of self-preservation.

On top of all this, the original projections and use cases for the Scheme were quite far from the reality, and the economics of reconciling them with the intersection of a large chunk of society's problems at once are frankly diabolical.

This is how we end up with a disability support Scheme (which supports a subset of the disabled population) costing more than the entire country's medical system (supporting the entire population).

Autism Level 2

NDIS access used to be separated into lists.

List A was automatic access for someone with the diagnosis. List B was a default yes on the balance of probabilities.

Autism is separated by the DSM into three levels: 1, 2 and 3.

One trick that used to be extremely pervasive among advocates, when someone had an autism diagnosis, was to give the diagnosis without a level then provide extensive (genuine) functional evidence indicating severe impairment. The delegate would then have to assign a number, and if it was "2", you were on List B.

This is one of the approaches that has been cracked down on heavily, because autism is utterly dwarfing participant numbers of every other category. Autism applications now require an explicit number given from a clinical team.

It also speaks to the significance of successful access: once they're in the door, they have a team and reports are paid for. This is not the explicit intent of that funding, but has always been the reality lived by anyone at the intersection of disability and poverty.

Advice for Anyone Who Isn't Sure

If you have a major disability, and you rely on others to survive, and you're not sure whether or how formal supports can help - make a quality application, and let your newly acquired support team figure that out.


This document is an exception to the site license: it is licensed under Creative Commons Zero - No Rights Reserved

This document has not been reviewed or approved by any of our partners, and does not necessarily reflect their views. We have no relationship with the NDIA except as participants.

The NDIS has an unofficial theme song.