You meet the disability requirements if we have evidence of all of the following:
- Your disability is caused by an impairment.
- Your impairment is likely to be permanent.
- Your permanent impairment substantially reduces your functional capacity to undertake one or more of the following activities: moving around, communicating, socialising, learning, or undertaking self-care or self-management tasks.
- Your permanent impairment affects your ability to work, study or take part in social life.
- You’ll likely need support under the NDIS for your lifetime.
If you give us evidence you have been diagnosed with one or more conditions on List A, we’ll likely decide you meet the disability requirements.
If you meet the disability requirements, it’s likely you’ll need NDIS supports for your lifetime. This means you won’t have to prove your disability every time we reassess your plan.
If at any time your NDIS support needs or situation changes, we may need to check your NDIS eligibility. We will talk with you if this happens.
Learn more about how we check if you are still eligible for the NDIS.
Is your disability related to an impairment?
When we consider your disability, we think about whether any reduction or loss in your ability to do things, across all life domains, is because of an impairment.
An impairment is a loss of or damage to your body’s function.
We will look at:
- your body’s functions
- your body structure
- how you think and learn.
To meet the disability requirements, we must have evidence your disability is attributable by at least one of the impairments below:
- intellectual – how you speak and listen, read and write, solve problems, and process and remember information
- cognitive – how you think, learn new things, use judgment to make decisions, and pay attention
- neurological – how your body functions
- sensory – how you see or hear
- physical – the ability to move parts of your body.
You may also be eligible for the NDIS if you have a psychosocial disability. This means you have reduced capacity to do daily life activities and tasks due to your mental health.
It doesn’t matter what caused your impairment, for example if you’ve had it from birth, or acquired it from an injury, accident or health condition.
It also doesn’t matter if you have one impairment, or more than one impairment.
Is your impairment likely to be permanent?
To meet the disability requirements, we need to know that your impairment is permanent, or likely to be permanent. Permanent under the law for the NDIS means enduring. This means we need to know whether your impairments are enduring so that you require NDIS supports on an ongoing basis.
We will focus on your impairments, and not on the cause of your impairments, or your diagnoses.
You might have some periods in your life where there is a smaller impact on your daily life, because your impairment may be episodic or fluctuate in intensity . Your impairment can still be permanent due to the overall impact on your life, and the likelihood that you will be impacted across your lifetime.
Even when your condition or diagnosis is permanent, we’ll check if your impairment is permanent too. For example, you may not be eligible if your impairment is temporary, or if there are known, available and appropriate evidence-based clinical, medical or other remaining treatments options that are likely to remedy the impairment.
Generally, we’ll consider whether your impairment is likely to be permanent if all available and appropriate treatment options are pursued.
If you give us evidence you have been diagnosed with a condition on List B, we’ll likely decide your disability is from an impairment that’s likely to be permanent.
Is there any medical treatment for your impairment?
We don’t fund supports to treat your impairment. The Australian health system provides health services to treat illnesses or health conditions.
Your impairment will likely be permanent if your treating professional tells us there are no further treatments that could remedy it.
Your impairment will likely be permanent if your treating professional gives us evidence that indicates there are no further treatments that could relieve or cure it.
Your treating professional will tell us or be asked to certify if there are medical, clinical or other treatments that are likely to remedy your impairment. We need to understand whether there are treatments which are:
- known – the treatment can be identified by an Australian medical practitioner as a suitable treatment for your impairment
- available to you – we need to take account of whether there are genuine barriers that prevent you from accessing treatment including, but not limited to, the nature of your impairment and your ability to access treatment
- appropriate for you and your impairment – we need to consider whether the treatment could remedy your impairment and is suitable and safe for you to undergo. Your ability to undergo treatment will be assessed according to your capabilities, your health and other personal circumstances, including your living arrangements
- evidence-based – there’s proof the treatment is likely to be effective.
When we look at what treatments are available to you, we think about whether the treatment is suitable for your personal situation. The word treatment should be understood in a broadest sense and may include changes to your diet and lifestyle.
If you’re still undergoing or have recently had treatment, we may not be sure you have a permanent impairment if that treatment could remedy the impairment.
In some situations, it may be clear your impairment is likely to be permanent while you’re still undergoing treatment or rehabilitation. For example, you may still need treatment and rehabilitation for a spinal cord injury, but it’s clear you are likely to have a permanent impairment.
You might still have a permanent impairment, even if its effects may change over time.
For degenerative impairments, or those that get worse over time, we consider them permanent if treatment isn’t likely to remedy the impairment. That is, the treatment won’t cure the impairment or come close to removing its effects.