The National Disability Insurance Scheme: What is a disability?

The National Disability Insurance Scheme (NDIS) is Australia's national approach to supporting people with disability. Its core purpose is to provide funding and support to eligible individuals with permanent and significant disabilities, enabling them to live more independently and participate more fully in their communities.

Interestingly, the National Disability Insurance Scheme Act 2013 (Cth) (the Act) does not provide an exhaustive list of conditions that constitute a disability for the purposes of the NDIS: there’s no golden ticket for automatic entry.

Rather, participants must satisfy a set of criteria to be eligible for the NDIS (namely, s24/s25 of the Act). This approach can be a double-edged sword, as it allows for a broader interpretation of what constitutes a disability but also creates a higher access threshold for prospective participants. However, this flexibility in the Act is crucial, given the ever-evolving medical discoveries and the existence of rare, unconventional disabilities that significantly impede functional capacity.

The criteria is:

• 1. To have a disability that is either intellectual, cognitive, neurological, sensory or physical, or be a psychosocial impairment attributable to one or more impairments.
• 2. The impairment is likely to be permanent (in that you have had the condition for a significant period and exhausted all available treatment options); and
  • a. The impairment results in reduced functionality in one or more of the following:
    • i. communication;
    • ii. social interaction;
    • iii. learning;
    • iv. mobility;
    • v. self-care;
    • vi. self–management, and,
  • b. the impairment impacts your capacity for social and economic participation, and;
  • c. it is likely that your will require NDIS support for the rest of your life.

When applying for access to the NDIS, it is essential that your disability or disabilities are accurately documented. This ensures the NDIS can develop a plan that is appropriately funded and tailored to your needs. We have encountered numerous cases where we’ve supported participants through an internal or external review of an NDIS decision, only to discover that their disabilities had been incorrectly recorded from the outset.

At Burke Lawyers, our team has extensive experience assisting clients through both the internal review process with the NDIS and the external review process to the Administrative Review Tribunal.

If you would like to learn more about how we can support you if you are unhappy with a decision made by the NDIS, please contact our office on +61 3 9822 8588.

NDIS Goals: Why They Matter More Than You Think

Your NDIS goals aren’t just aspirations—they’re powerful tools that shape your plan and the supports you receive.

A core principle of the NDIS Act is choice and control—you have the right to lead the way in pursuing your goals. Supports funded by the NDIS must align with a participant’s goals, which are shaped by their personal choices.

Each year when your NDIS plan is under review, your goals and aspirations are more than just “nice to have.” They play a critical role in determining whether the supports you’re requesting are considered reasonable and necessary.

What Does “Reasonable and Necessary” Mean?

In summary, a support is considered reasonable and necessary if it:

1. Is related to your disability
2. Helps you pursue the goals and aspirations outlined in your plan
3. Supports your social and economic participation
4. Represents value for money, considering both cost and benefit
5. Is effective and beneficial, based on good practice and evidence
6. Takes into account what can reasonably be provided by informal supports (like family or friends)

As you prepare for a review of your plan each year, it’s important to ensure that the supports you’re requesting clearly align with your goals and aspirations.

At Burke Lawyers, our team has extensive experience assisting clients through both the internal review process with the NDIS and the external review process to the Administrative Review Tribunal.

If you would like to learn more about how we can support you if you are unhappy with a decision made by the NDIS, please contact our office on +61 3 9822 8588.