Applying for NDIS access is the first step to receiving disability supports. The access request process involves meeting eligibility criteria, gathering evidence, completing an access request form, and waiting for NDIA’s decision. Understanding the process and providing strong evidence increases your chances of being granted access.

This comprehensive guide walks you through every step of the NDIS access request process, from checking eligibility to appealing if denied.

NDIS Eligibility: The Four Criteria

To access the NDIS, you must meet all four criteria:

1. Age Requirement

Under 65 years old when you first apply for NDIS.

Key points:

  • No minimum age (infants can access NDIS)
  • Must apply before 65th birthday
  • If you turn 65 while waiting for decision, you may still be granted access
  • If already 65+, you cannot access NDIS (access aged care supports instead)

2. Residence Requirement

You must be:

  • Australian citizen, OR
  • Permanent resident (permanent visa holder), OR
  • Protected Special Category Visa (SCV) holder

AND:

  • Live in Australia

Not eligible:

  • Temporary visa holders (student, tourist, work visas)
  • Awaiting permanent residency decision (may be eligible once granted)

Special cases:

  • New Zealand citizens on SCV may qualify if meet specific criteria
  • Refugees and humanitarian visa holders (check individual circumstances)

3. Disability Requirement

You must have a disability that is:

Permanent:

  • Likely to be lifelong
  • Not temporary or short-term condition
  • Medical evidence confirms permanency

Significant:

  • Substantially reduces functional capacity in one or more areas:
    • Communication
    • Social interaction
    • Learning
    • Mobility
    • Self-care
    • Self-management

Caused by:

  • Impairment (physical, intellectual, cognitive, neurological, sensory, psychosocial)

Examples of disabilities that may meet criteria:

  • Autism spectrum disorder
  • Cerebral palsy
  • Intellectual disability
  • Spinal cord injury
  • Acquired brain injury
  • Multiple sclerosis
  • Muscular dystrophy
  • Psychosocial disability (from mental health conditions)
  • Vision or hearing impairment
  • Chronic conditions causing permanent functional impairment

Not usually eligible:

  • Temporary injuries (broken bones, short-term illness)
  • Conditions fully managed by treatment
  • Age-related conditions without underlying disability
  • Frailty without disability

4. Support Needs Requirement

The disability must mean you need support:

Early intervention:

  • For children and young people (especially under 6)
  • Evidence shows early intervention will reduce future support needs
  • Support will benefit development

OR ongoing support:

  • For people of any age
  • Support needed throughout life
  • Without NDIS support, cannot participate in activities effectively

Cannot be met by:

  • Health system alone
  • Education system alone
  • Other government services alone

Types of NDIS Access

Standard Access (Disability Requirements)

For people who:

  • Meet the four criteria above
  • Have permanent and significant disability
  • Need ongoing support

Evidence needed:

  • Medical diagnosis from doctor or specialist
  • Functional assessments showing impact
  • Reports demonstrating permanency

List A and List B (Streamlined Access)

Lists A and B: Specific conditions that usually grant automatic access (if diagnosis from appropriate professional).

List A conditions (automatic access if diagnosed):

  • Cerebral palsy
  • Down syndrome
  • Acquired brain injury (severe, permanent)
  • Spinal cord injury
  • Blindness or vision impairment (severe)
  • Deafness or hearing impairment (severe)

List B conditions (likely to grant access with diagnosis):

  • Autism spectrum disorder
  • Intellectual disability
  • Multiple sclerosis
  • Muscular dystrophy
  • Other progressive neurological conditions

Requirements for List A/B:

  • Diagnosis from appropriate specialist or medical professional
  • Condition meets criteria for list
  • Functional impact still assessed but process faster

Early Childhood Early Intervention (ECEI)

For children under 9:

  • Evidence of developmental delay or disability
  • Under 6: formal diagnosis not required (developmental concerns sufficient)
  • Early intervention focus

Pathway:

  • Contact Early Childhood Partner (not standard access request)
  • Partner assesses and facilitates access if needed
  • Can access short-term supports without formal NDIS plan

Evidence You Need to Apply

Strong access request = comprehensive evidence.

Medical and Diagnostic Evidence

Diagnosis:

  • Report from treating doctor, specialist, or allied health professional
  • Confirms diagnosis
  • States condition is permanent (lifelong)
  • Describes impact on function

Who can diagnose:

  • GP (for some conditions)
  • Medical specialists (neurologist, psychiatrist, developmental pediatrician, etc.)
  • Clinical psychologists (for some conditions like autism, intellectual disability)

What report should include:

  • Diagnosis (ICD-10 code helpful)
  • When diagnosed
  • Prognosis (permanent/lifelong)
  • Treatment tried and outcomes
  • Current and future support needs

Functional Impact Evidence

This is CRITICAL. NDIA needs to understand how disability affects daily life.

Functional capacity assessments:

  • Occupational therapy assessments
  • Physiotherapy assessments
  • Speech pathology assessments
  • Psychology cognitive/functional assessments

What assessments should show:

  • Tasks you cannot do independently
  • Tasks you can do with support
  • Barriers in daily life
  • Comparison to age peers (for children)

Example of strong functional evidence:

“Sophie, age 30, has cerebral palsy affecting her mobility. She requires physical assistance for all transfers (bed, chair, toilet, shower), cannot walk independently, uses powered wheelchair for mobility, requires assistance with dressing and meal preparation, and needs support for all household tasks. Without NDIS support, she cannot live independently and would require residential care.”

Weak functional evidence:

“Sophie has cerebral palsy and needs help.”

Evidence of Permanency

NDIA needs to know:

  • Disability is lifelong (not temporary)
  • Condition is stable or degenerative (not improving)
  • Support needs are ongoing

Medical reports should state:

  • “Permanent condition”
  • “Lifelong disability”
  • “No significant improvement expected”
  • “Ongoing support will be required”

Early Intervention Evidence (for children)

For young children:

  • Developmental assessments showing delays
  • Pediatrician or child health reports
  • Therapy reports (speech, OT, physio)
  • Evidence early intervention will benefit development

Under 6:

  • Formal diagnosis not required
  • Evidence of concerns sufficient
  • May access support through Early Childhood Partner without full access request

Supporting Documents

Identity documents:

  • Birth certificate or passport
  • Medicare card
  • Proof of residency (utility bill, lease, etc.)
  • Visa documents (if permanent resident)

Care and support history:

  • Current supports in place (who provides, how often)
  • History of therapies or interventions
  • Family support situation
  • Barriers to participation

Step-by-Step Access Request Process

Step 1: Check Eligibility

Ask yourself:

  • Am I under 65?
  • Am I Australian citizen, permanent resident, or Protected SCV?
  • Do I have permanent and significant disability?
  • Do I need support because of disability?

If yes to all four: Proceed with access request.

If unsure: Contact NDIS (1800 800 110) or local Early Childhood Partner (if child under 9) to discuss.

Step 2: Gather Evidence

Before submitting access request, collect:

  • Medical diagnosis and reports
  • Functional assessments
  • Identity documents
  • Any other supporting evidence

Allow time: Gathering evidence can take 4-12 weeks (appointments, reports).

Tip: Start with GP who can refer to specialists if needed.

Step 3: Complete Access Request Form

Two ways to request access:

Option 1: Phone

  • Call NDIS: 1800 800 110
  • NDIA staff will complete form over phone with you
  • You provide information verbally
  • NDIA sends you copy to check

Option 2: Online/Paper

  • Download Access Request Form from ndis.gov.au
  • Complete yourself or with help
  • Submit online via myGov or mail to NDIA

Information needed on form:

  • Personal details (name, DOB, address, contact)
  • Identity information
  • Residence status
  • Disability information (diagnosis, impact)
  • Support needs
  • Evidence attached

For children under 9:

  • Contact Early Childhood Partner first (they can complete access request on your behalf if needed)

Step 4: Submit Access Request

How to submit:

  • Online: via myGov linked to NDIS
  • Mail: NDIS, GPO Box 700, Canberra ACT 2601
  • Phone: NDIA will submit on your behalf
  • Early Childhood Partner: They submit for you (children under 9)

What to include:

  • Completed access request form
  • All supporting evidence (medical reports, assessments)
  • Identity documents
  • Clear, legible copies

Receipt:

  • NDIA will send acknowledgment within a few days
  • Provides reference number for tracking

Step 5: NDIA Assessment

NDIA reviews your request:

  • Check all four eligibility criteria
  • Review evidence
  • May request additional information

If more information needed:

  • NDIA will contact you
  • Specify what additional evidence required
  • Participant Service Guarantee (21-day) clock pauses until provided

Assessment may include:

  • NDIA planner phone call to discuss needs
  • Request for further medical reports
  • Request for functional assessments
  • Clarification questions

Step 6: Access Decision

Timeframe: 21 days from receiving complete access request (Participant Service Guarantee)

NDIA will send written decision:

Option 1: Access granted

  • You become an NDIS participant
  • Assigned to LAC or Early Childhood Partner
  • Planning process begins
  • First plan developed

Option 2: Access denied

  • Written reasons for denial
  • Explanation of which criteria not met
  • Right to request internal review
  • Options to reapply with more evidence

What to Do If Access is Denied

Don’t panic. Access denials can be challenged.

Step 1: Read Decision Carefully

Understand why denied:

  • Which criteria did you not meet?
  • What evidence was missing or insufficient?
  • What did NDIA say about your situation?

Common denial reasons:

  • Insufficient evidence of permanency
  • Functional impact not clearly demonstrated
  • Disability not “significant” enough in NDIA view
  • Early intervention benefit not proven
  • Eligibility better met by other systems (health, aged care)

Step 2: Options After Denial

You have three options:

Option A: Provide more evidence and reapply

  • If denial due to insufficient evidence
  • Gather stronger medical and functional reports
  • Reapply with comprehensive evidence

Option B: Request internal review

  • Within 3 months of decision
  • Free
  • Different NDIA staff review decision
  • Can overturn denial

Option C: Accept decision

  • If genuinely not eligible
  • Explore other support options (aged care, state disability services, health system)

Step 3: Request Internal Review

How to request:

  • Phone: 1800 800 110
  • Online: myplace portal
  • Email: [email protected]
  • Mail: NDIA, GPO Box 700, Canberra ACT 2601

In your request:

  • State you want internal review of access decision
  • Provide your details and decision date
  • Explain why you disagree
  • Provide any additional evidence

Timeframe: 60 days for internal review decision (can extend to 90 days)

Outcome:

  • Affirm: Original decision stands (still denied)
  • Vary: Partial change (rare for access decisions)
  • Set aside and substitute: Decision changed (access granted)

Step 4: Appeal to AAT (if needed)

If internal review still denies access:

  • Appeal to Administrative Appeals Tribunal (AAT)
  • Within 28 days of internal review decision
  • Free to appeal
  • Independent review
  • Can take 6-18 months

Seek support:

  • Free advocacy services
  • Legal Aid (in some cases)
  • Disability rights organizations

Tips for a Strong Access Request

1. Provide Comprehensive Evidence

Don’t assume NDIA knows your situation.

Include:

  • Multiple reports from different professionals
  • Detailed functional assessments
  • Clear statements of permanency
  • Examples of daily challenges

2. Be Specific About Functional Impact

Weak: “I have trouble getting around.”

Strong: “I cannot walk more than 5 meters without severe pain and fatigue. I require a wheelchair for community access and cannot independently transfer from wheelchair to toilet, bed, or shower. I need physical assistance for all personal care tasks.”

Show how you meet each criterion:

  • Age: “I am 32 years old.”
  • Residence: “I am an Australian citizen living in Melbourne.”
  • Disability: “I have cerebral palsy (ICD-10 G80.1), a permanent neurological condition affecting mobility and speech.”
  • Support needs: “Without support I cannot live independently, participate in community activities, or maintain employment.”

4. Use Professional Reports

Reports from:

  • Medical specialists (neurologist, psychiatrist, developmental pediatrician)
  • Allied health professionals (OT, physiotherapist, speech pathologist, psychologist)
  • Current support providers

Reports should:

  • Be recent (within 12 months)
  • Clearly state diagnosis and permanency
  • Detail functional impact
  • Recommend supports

5. Include Psychosocial Disability Evidence (if applicable)

For mental health conditions:

  • Psychiatrist or psychologist report
  • Evidence of Psychosocial Disability (EPD) form
  • Functional impact on daily life (not just symptoms)
  • Permanency (chronic, ongoing condition despite treatment)

Common challenge:

  • NDIA often denies psychosocial disability access
  • Need very strong functional and permanency evidence
  • Advocate if denied

6. For Children: Emphasize Early Intervention

Show:

  • How early intervention will benefit development
  • Evidence-based therapies recommended
  • Risk of not providing early support
  • Critical developmental period

Under 6:

  • Formal diagnosis not required
  • Evidence of delay or concerns sufficient

Special Situations

Degenerative Conditions

For conditions that worsen over time:

  • Medical evidence of progressive nature
  • Current functional impact
  • Expected future deterioration
  • Support needs now and projected future

Examples:

  • Multiple sclerosis
  • Muscular dystrophy
  • Motor neurone disease
  • Progressive neurological conditions

NDIA should consider: Future support needs, not just current state.

Fluctuating Conditions

For conditions that vary:

  • Describe range of functional capacity (good days vs bad days)
  • Average impact over time
  • Support needs on bad days
  • Barriers to consistent participation

Examples:

  • Mental health conditions (psychosocial disability)
  • Chronic pain conditions
  • Episodic conditions

Key: Show overall impact is permanent and significant, even if fluctuating.

Dual Disability (Multiple Conditions)

If you have multiple disabilities:

  • Include evidence for all conditions
  • Show cumulative impact
  • One condition alone may not meet criteria, but combined they do

Example:

  • Mild intellectual disability + chronic health condition + mental health condition
  • Each alone may be manageable
  • Combined, significant functional impact

Acquired Disability (Injury or Illness)

If disability acquired recently:

  • Medical evidence of permanency (rehabilitation outcomes, prognosis)
  • Functional assessments post-stabilization
  • Evidence ongoing support needed
  • Timeframe (usually 12+ months post-injury before considered permanent)

Examples:

  • Acquired brain injury
  • Spinal cord injury
  • Stroke

Autism Access

For autism:

  • Can access under List B if diagnosed by appropriate professional
  • Diagnosis from clinical psychologist, psychiatrist, or developmental pediatrician
  • ADOS-2 or ADIR assessment often used
  • Functional impact still assessed

Challenges:

  • High-functioning autism sometimes denied (NDIA says not “significant”)
  • Need strong functional evidence of barriers
  • Advocate if denied

Frequently Asked Questions

Can I apply for NDIS if I don’t have a formal diagnosis yet?

You can submit an access request, but NDIA will likely request diagnosis before making decision. For children under 6, you can access Early Childhood Approach without formal diagnosis. For others, start gathering diagnostic evidence before submitting access request.

How much does it cost to apply for NDIS?

Applying for NDIS is free. However, you may need to pay for medical appointments, assessments, and reports to gather evidence. Some GPs and specialists bulk-bill (Medicare covers), others charge gap fees. Functional assessments (OT, speech pathology) may be out-of-pocket costs unless covered by Medicare or existing funding.

Can I work and still access NDIS?

Yes. NDIS is not means-tested (no income or asset limits). Working or not working does not affect eligibility. NDIS supports many participants to find and keep employment.

What if I have a rare condition NDIA doesn’t recognize?

Rare conditions can access NDIS if you meet the four criteria. Provide detailed medical evidence about the condition, its permanency, and functional impact. Rare conditions may require more comprehensive evidence as NDIA may be unfamiliar with them.

Can I access NDIS for my child while they’re on waiting list for diagnosis?

For children under 6, you can access Early Childhood Approach without formal diagnosis. For children 6+, you may be able to submit access request with evidence of suspected diagnosis and developmental concerns, but NDIA may wait for formal diagnosis before deciding.

What if my condition is managed by medication but I still have functional limitations?

NDIS looks at your functional capacity with current treatment. If even with optimal treatment you have permanent and significant functional impairment, you may be eligible. Provide evidence of ongoing impact despite treatment.

Where to Get Help with Access Requests

Early Childhood Partners (children under 9):

  • Help complete access request
  • Gather evidence
  • Submit on your behalf
  • Phone: 1800 800 110 to find your local partner

Local Area Coordinators (LAC):

  • Can assist with access process
  • Provide information and support
  • Connect you to community resources

Disability advocacy organizations:

  • Free advocacy support
  • Help gather evidence
  • Review access requests before submission
  • Support with internal reviews and appeals

Find an advocate: National Disability Advocacy Program: 1800 818 338

Health and allied health professionals:

  • GPs can coordinate evidence gathering
  • OTs, psychologists, speech pathologists provide functional assessments
  • Medical specialists provide diagnosis and permanency evidence

Key Takeaways

NDIS access requires meeting four criteria:

  • Under 65 when apply
  • Australian citizen, permanent resident, or Protected SCV
  • Permanent and significant disability
  • Need support because of disability

Strong access request needs:

  • Medical diagnosis from specialist or doctor
  • Functional assessments showing impact on daily life
  • Evidence of permanency (lifelong)
  • Clear demonstration of support needs

Process timeline:

  • Gather evidence: 4-12 weeks
  • Submit access request
  • NDIA decision: 21 days (if complete)
  • If denied: 3 months to request internal review
  • Internal review: 60 days
  • AAT appeal: 28 days from internal review decision

If denied:

  • Understand reasons
  • Provide more evidence and reapply, OR
  • Request internal review (free), OR
  • Appeal to AAT after internal review
  • Seek advocacy support

For children under 6:

  • Contact Early Childhood Partner
  • Formal diagnosis not required
  • Evidence of developmental concerns sufficient

Support available:

  • Early Childhood Partners
  • Local Area Coordinators
  • Disability advocates (free)
  • Legal services for AAT appeals

The NDIS access process can be complex, but with comprehensive evidence and support, eligible people with disability can successfully access the scheme and receive the supports they need.