Who is eligible for NDIS?
We have created a simple NDIS checklist that outlines the eligibility criteria necessary for individuals seeking NDIS support. Whether you are an individual with a disability, a family member, or a support worker, this checklist will provide you with the information needed to determine eligibility for NDIS support.
To be eligible for NDIS, you must be an Australian citizen, permanent resident, or eligible visa holder residing in Australia, aged 9 to 65, and have a significant disability requiring daily living assistance.
The NDIS application process can be quite complex but at Maple Community Services our primary goal is to provide you with the support and knowledge necessary to navigate the challenges of the NDIS system successfully.
By collaborating with the NDIA, Maple Community Services can offer expert guidance to help you determine your eligibility and facilitate the enrolment process. Our dedicated team is committed to ensuring that your access to the NDIS and support needs are fully addressed, including comprehensive NDIS plan management.
The NDIS operates on a person-centred approach, meaning that eligibility and support plans are tailored specifically to each participant’s goals, needs and circumstances. There is, however, a selection of general eligibility criteria that you can familiarise yourself with before you apply for NDIS funding. If you meet these criteria, you can apply to the NDIS and the rest of your assessment will depend on your unique situation.
Your eligibility for the NDIS will be determined through an assessment process conducted by the National Disability Insurance Agency (NDIA). The assessment considers the nature and impact of the disability on a participant’s life.
To be eligible to receive NDIS funding, services and supports you must meet the residency, age and disability criteria.
Residency
To be a participant of the NDIS you need to be living in Australia and either be an Australian citizen, or have one of two visa types which means you can live in Australia:
- A permanent residency visa or;
- A protected special category visa – which is only for some citizens of New Zealand.
Age
In addition to the residency requirements, age also plays a part in your eligibility for NDIS funding. To apply to the NDIS you must fall between the ages of 9 and 65. If you are outside of this age bracket when you apply, there are other accessing supports available to you:
- The NDIS has a separate early childhood approach for children younger than 9 years old. This can include children with developmental delays as well as children with disability.
- People over the age of 65 who do not currently receive NDIS funding may be eligible through other Government funded aged care programs.
- If you become a participant of the NDIS before you turn 65 years old, you can continue to receive services from the scheme for as long as it meets your needs.
Disability
To be eligible for NDIS you must meet the disability requirements and be living with a disability caused by a permanent or significant impairment and will usually require specific supports to complete daily activities and participate in the community.
NDIS eligibility may also take into account factors such as your need for support and whether you require ongoing or temporary supports and services. You may be eligible if you require some supports in the present to reduce your need for supports in the future or to enable your family to build skills to help you in the future.
There are a number of conditions that may qualify a person for disability status, but no specific diagnosis is necessary. What matters most is that you have restricted, limited, impaired, or impeded access to normal aspects of daily life or social life due to an illness or disability that you live with. Some of the most common disorders or conditions that cause people to live with a disability include:
- Severe physical injury such as acquired brain injury;
- Developmental disorders such as Autism Spectrum Disorder or Down Syndrome;
- Cognitive disorders such as Alzheimer’s Disease, Huntington’s Disease, or other forms of dementia;
- Psychosocial disorders such as Major Depressive Disorder, Bipolar disorder, PTSD, schizophrenia, or other mental health condition;
- Musculoskeletal disorders such as chronic back pain, arthritis, or other dysfunctions of the joints and bones;
- Sensory or speech issues such as vision and hearing loss;
- Neurological disorders, such as multiple sclerosis, cerebral palsy, Parkinson’s disease, and epilepsy;
- Neurodegenerative disorders such as muscular dystrophy;
- Blood disorders such as sickle cell disease or haemophilia;
- Immune system disorders, such as HIV/AIDS, lupus, rheumatoid arthritis, and chronic kidney disease.
The National Disability Insurance Scheme (NDIS) in Australia defines disability broadly, encompassing a range of conditions and impairments. According to the NDIS, a disability is characterised by a significant impairment in a person’s ability to participate in everyday activities and fully engage in community life. To give you a clearer idea, we’ve outlined a detailed explanation of what constitutes a disability for the purposes of accessing the NDIS:
Permanent impairment
A disability, as per the NDIS, is typically a permanent condition that will affect the participant for a lifetime. It may be due to a congenital condition (present at birth), a developmental delay, or an acquired condition later in life.
Functional impact
According to the NDIS a disability must significantly impact someone’s functional capacity. This means that it affects their ability to perform essential activities of daily living independently. Functional areas that may be affected include mobility, communication, self care, social interaction, learning, and other aspects of daily life.
Need for support
Those with a disability must require support and assistance to participate in activities and access service that people without disabilities can typically do without help. The level and type of support needed will vary greatly from person to person, and the NDIS assesses these support needs on an individual basis.
Goals and aspirations
The NDIS also takes into consideration the goals, aspirations and objectives of each NDIS participant. It aims to provide supports and services that help individuals achieve their goals while leading a more fulfilling life.
Who is not eligible for NDIS?
The Australian Institute of Health and Welfare (AIHW) estimates that 89% of people in Australia living with disabilities will not be eligible for the NDIS. The main reason for this is that the majority of people living with disabilities are above the age of 65, below the age of 9, or are people with temporary disabilities.
If you or your loved one don’t qualify for NDIS funding, you may be eligible for other government funding and services. Usually, the initial access point for people living with disabilities in search of support services is the Local Area Coordinators (LACs). They are well-situated to offer support to anyone, regardless of eligibility for the NDIS, in order to connect them to available support services and local resources.
Is NDIS only in Australia?
The NDIS is a government funded program specific to Australia. It is a national initiative of the Australian government and operates exclusively within the country. If you do leave the country, you can still use your supports and funding for up to 6 weeks (or longer if the NDIS gives you more time)/ This is called a ‘grace period’. If you need to use your funding overseas, you’ll likely need to self-manage your plan.
While Australia has the NDIS, other countries have their own disability support systems. These programs may have different names, structures and eligibility criteria. If you’re seeking disability support under the NDIS in another country other than Australia, it’s essential to research the programs and eligibility criteria available in that region.
How to get help applying for NDIS?
To apply for NDIS funding you will need to provide a completed access request form and supporting information about your age, residency, and disability. To apply you can call the NDIA on 1800 800 110 and they will fill out the form for you over the phone or you can fill out the access request form yourself.
You will need your treating health professional to fill out section 2 of the form unless you have existing reports or assessments you can attach to the access request form as evidence. You can send your completed form and supporting information to the NDIS by email: [email protected] or via post: GPO Box 700, Canberra, ACT 2601. For more information, visit the NDIS website.
If you meet the criteria for NDIS eligibility, Maple Community Services can help you with all the information you need to apply for NDIS funding and deliver your supports. We can put you in touch with a Local Area Coordinator and introduce you to a Plan Manager if you’d like help with managing your funding.