When and How to Request an NDIS Plan Review?

The National Disability Insurance Scheme (NDIS) plays a vital role in supporting Australians with disabilities by providing funding for essential services and supports. However, as life changes, so do the needs of NDIS participants. This is why requesting an NDIS plan review is a critical aspect of ensuring that your plan remains aligned with your current circumstances, health, and goals. An NDIS plan review gives you the opportunity to reassess your support, goals, and funding to ensure that your plan is adequately supporting you. Whether your needs change unexpectedly or at the end of your plan period, understanding when and how to request a review is essential for staying on track. In this detailed guide, we’ll walk you through when to request a plan review, how to make a request, and what you can expect throughout the process.

What is an NDIS Plan Review?

An NDIS plan review is a formal process in which the National Disability Insurance Agency (NDIA) evaluates whether your current NDIS plan still meets your needs and whether your support is adequate. The review allows you to discuss any changes in your life, goals, or requirements that might need to be reflected in your plan. The outcome of the review may result in adjustments to your funding, services, or the overall structure of your plan. This review can happen periodically at the end of your current plan cycle or at other times when there are significant changes in your needs.

When Should You Request an NDIS Plan Review?

Understanding when to request a NDIS plan review is key to ensuring that you continue to receive the right level of support. There are a few key moments when requesting a review may be necessary:

1. End of Your Plan Cycle (Annual Review)

Typically, your NDIS plan is reviewed at the end of its 12-month cycle. The NDIA will contact you about three months before your plan ends to notify you of the upcoming review.

• When to Request: You can request a review 3 to 6 months before your plan is due to end if you believe your plan should be updated sooner.
• What Happens: The review meeting will involve a discussion about your progress, the goals you’ve achieved, and any adjustments needed to your funding, supports, or services. This is also an opportunity to discuss whether the current funding allocation is still appropriate.

2. Change in Your Needs or Circumstances

If your circumstances or needs change significantly during your plan period, you can request a review at any time. Common reasons for requesting an early review include:

• Health Changes: A change in your medical condition, diagnosis, or treatment plan (e.g., surgery, illness, or new diagnosis).
• Changes in Daily Living: Moving to a new home, changes in your care arrangement, or modifications to your living environment.
• Major Life Events: Family changes, significant life transitions, or major changes in your support network (e.g., the loss of a caregiver or change in family circumstances).
• Increased or Decreased Support Needs: If you find that you require more or less support than you originally planned for, this could be a reason to request a review.
• When to Request: As soon as you notice a change in your situation, it’s best to reach out to your Local Area Coordinator (LAC) or planner for a review.

If you’re facing challenges with your current NDIS provider, such as poor communication or unmet expectations, it might be time to consider switching providers. Our blog on 8 Red Flags That Suggest It’s Time to Switch NDIS Providers offers insights into identifying when a change is necessary.

3. When You Need More Support or Funding

If your current plan is insufficient to meet your needs—for example, you’ve experienced a change in health, your services have become more expensive, or you’ve discovered new support options that are better suited to you—you may need to request additional funding.

• When to Request: If you feel that the current funding doesn’t adequately support you or doesn’t cover the costs of necessary services or equipment, it’s time to request a review.

4. Achieving or Changing Your Goals

Your NDIS plan is developed around specific goals that you want to achieve. Over time, as you reach or reassess these goals, your needs may change. If your goals have been met, or if they’ve changed significantly, a review is essential to ensure your plan reflects your new objectives.

• When to Request: You can request a review when your goals evolve, and especially if you’re ready to set new, more challenging goals.

How to Request an NDIS Plan Review?

Now that you know when you should request a plan review, let’s walk through the steps to initiate the process. Requesting a review is straightforward, but it’s important to follow the correct procedures to ensure everything is in place for a smooth review.

1. Contact Your Local Area Coordinator (LAC) or the NDIA

Your first step is to contact the NDIA or your Local Area Coordinator (LAC), who can assist you in initiating the review. You can do this in several ways:

• Phone: Call the NDIS Helpline on 1800 800 110 to discuss your situation and request a review.
• Online: You can also request a review via the NDIS website or by logging into your NDIS participant portal.
• Email: Alternatively, you can email the NDIA or your LAC directly to request a review.

2. Explain Your Reason for Requesting a Review

When you request the review, you’ll need to clearly explain why you believe a review is necessary. This may involve explaining:

• A change in your disability-related needs or circumstances.
• A need for additional services or funding.
• Achievements or changes in your goals.

The more detailed you are in explaining the reasons for your request, the easier it will be for the NDIA to process your request and consider adjustments to your plan.

3. Provide Supporting Documentation

To support your request, you may need to provide relevant documentation, such as:

• Medical reports that describe changes in your condition.
• Reports from service providers that outline your current and future support needs.
• A new assessment that highlights any changes in your functional capacity or needs (e.g., from a physiotherapist, psychologist, or occupational therapist).

Providing this documentation will help strengthen your case for a review and ensure that your updated needs are properly understood.

4. Prepare for Your Review Meeting

Once the review request is accepted, the NDIA will schedule a meeting with you. This could be over the phone or in person. During this meeting, you will discuss the following:

• Progress on your current goals: Review whether your goals have been met or whether they need to be updated.
• Current supports and services: Examine the services you’ve been receiving and whether any changes are required.
• New goals or needs: If your goals or needs have changed, discuss what adjustments should be made to your plan.

It’s a good idea to prepare for this meeting by:

• Reviewing your current goals and achievements.
• Writing down any concerns or needs you want to address.
• Bringing along any supporting documents or evidence.

5. Wait for the Decision

After your meeting, the NDIA will assess your request and supporting evidence. This process typically takes 6 to 8 weeks, but timelines can vary depending on your individual case. Once the decision is made, you will receive a letter or email outlining the outcome.

• If your review is successful, your updated plan will be issued, detailing new funding, goals, or services.
• If your review is unsuccessful or doesn’t fully address your needs, you can appeal the decision.

Important Timelines to Remember

• Review Notice: You will be notified by the NDIA when it’s time for your annual review, typically a few months before your plan is due to end.

• Review Requests: You can request a review anytime during your plan, but it’s advisable to give at least 3 months’ notice if your needs have changed significantly.

• Plan Review Outcome: After a review, you should expect to receive a decision within 6 to 8 weeks. However, this timeline can vary depending on the complexity of the review and the NDIA’s workload.

If you’re new to the NDIS, understanding how to navigate the system can be overwhelming. Our blog on Tips for New NDIS Participants provides valuable information to help you get started and make the most of your plan.

What Happens After the Review?

Once your NDIS plan review is complete, you will receive an updated plan that reflects any changes made to your supports, funding, or goals. If your plan is updated with additional support or funding, the NDIA will provide you with a clear outline of what is included in the new plan. If you’re not happy with the outcome, you have the option to appeal the decision. You can request an internal review by the NDIA or take your case to the Administrative Appeals Tribunal (AAT).

Conclusion

Requesting an NDIS plan review is a critical step to ensuring that your supports and services continue to meet your needs. Whether it’s because of a change in health, life circumstances, or goals, being proactive in requesting a review helps you maintain the right level of support for your evolving needs. At Ambition Health Group, we understand how important it is to have a plan that truly reflects your needs and aspirations. If you need assistance navigating the NDIS plan review process or require support in preparing your review, our dedicated team is here to guide you every step of the way. Don’t hesitate to reach out to us today to ensure your NDIS plan remains aligned with your needs and continues to support your goals. For more information on NDIS plan management and how we can assist you, visit our NDIS Plan Management page.