When we complete the internal review, there are 3 different types of decisions we can make. We can: 

  • confirm the original decision – we don’t make any changes
  • vary the original decision – we make some changes to the original decision
  • set aside the original decision and make a new decision.

We review all the information we have when we make the internal review decision. For example, we can look at new information you give us after we made our original decision.

When would we confirm the original decision?

We may confirm the original decision.  This means there’s no change to the original decision.

We confirm the original decision if we decide it was the correct or preferable decision.  This means, out of the decisions we could make, the internal reviewer decides the original decision is the one that fits best with the law for the NDIS.

For example, we might decide you’re not eligible for the NDIS, and the internal reviewer confirms the original decision. This means you’re still not eligible for the NDIS.

Example

Jasmine asked for an internal review of our decision to approve her NDIS plan. Her plan includes $3000 funding for therapy, but she believes she needs more.

Jasmine’s internal reviewer looks at all the information we have about Jasmine and her support needs. Her internal reviewer decides the original plan was the correct or preferable decision under the law. This means her plan does not change. She still has $3000 funding for therapy.

When would we vary the original decision?

We may also vary the original decision.  This means we decide to change part of the original decision.

For example, we could decide to include a different amount of funding, or a different number of hours, for a particular NDIS-funded support. If so, you’ll get a new plan with a revised amount of funding or hours for that support.

The rest of the plan will stay the same.

Example

Sam asks for an internal review of our decision to approve her plan. Her plan includes $3000 for therapy.

Sam’s internal reviewer looks at all the information we have, including a new report from her occupational therapist.

Sam’s internal reviewer decides to vary the original plan, and include $4000 for therapy in a new plan. All the other supports in Sam’s plan stay the same.

When would we set aside the original decision, and make a new decision?

Finally, we may set aside the decision and make a new decision.  This means the original decision no longer applies. The internal reviewer will now make a new decision.

We do this if we decide the original decision wasn’t correct or preferable. Out of the decisions we could make, there’s one that fits better with the NDIS law.

For example, if we originally decided you’re not eligible for the NDIS, the internal reviewer could decide you are eligible.

Example

Jamal asks for an internal review of our decision to approve his plan. His plan did not include funding for occupational therapy. We didn’t have enough evidence that it met the NDIS funding criteria. After asking for an internal review, Jamal gives us more evidence on why he needs occupational therapy.

Jamal’s internal reviewer looks at all the information, and decides the original plan wasn’t the correct or preferable decision.

His internal reviewer decides to set aside the original decision. His internal reviewer makes a new decision to approve a plan that includes funding for occupational therapy.

This page current as of
13 September 2021
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