When we say disability support needs, we mean supports you need for the impairments that meet the disability or early intervention requirements, or both.
Case
Leroy needs a power assist system added to his wheelchair to support his disability. The add-on will allow him to travel medium to long distances, increasing his independence and mobility.
Would we fund this?
Yes, we would typically fund wheelchair modifications for Leroy as they are likely to meet the NDIS funding criteria.
He will need to provide evidence, such as a report from an occupational therapist, to show the equipment:
- is an effective and beneficial support
- is value for money compared to alternatives
- relates to his disability support needs.
Why would we fund this?
NDIS laws determine what we can and can’t fund. Things we can fund are called NDIS supports. You can use the funding in your plan to buy NDIS supports if they are related to your disability and are in-line with your plan.
To work out whether Leroy’s wheelchair modification is an NDIS support for him, we think about the information he gave us against the NDIS funding criteria. To do this, we need evidence or information that shows the wheelchair modification is a reasonable and necessary support for Leroy.
This evidence needs to show a number of things:
- why he needs the wheelchair modification
- why the modification is appropriate for him
- how the modification relates to Leroy’s disability support needs. This could include a report or written evidence from an allied health professional. We may already have this information
- the wheelchair modifications can be properly installed and safely operated
- how the wheelchair modifications are effective and beneficial in helping Leroy move around, and don’t impact his ability to transport his wheelchair in his car
- how the wheelchair modifications help him take part in social and economic activities
- how the wheelchair modification is value for money. This includes evidence or information to show the cost of the proposed option is reasonable in relation to its benefits. We also look at the cost of alternatives
- whether the support is fit for purpose and the modifications are likely to increase Leroy’s independence and reduce the long-term cost of other supports. For example, if the modifications would reduce home care support hours or other supports that help Leroy access the community.
What don’t we fund?
We won’t fund extra items that are not an NDIS support for Leroy. Leroy may, however, choose to pay for these with his own money. This might be if he wants:
- a particular brand, model or design of an item
- special features not related to his disability support needs.
Case example
Billy is 9 years old and has congenital muscular dystrophy. While he can walk indoors, he needs a power wheelchair for medium to long distances. Billy’s allied health professional says Billy is expected to experience more loss of mobility. This means he will need to use a power wheelchair for all activities within 2 years.
Billy is outgrowing his current wheelchair and has asked for funding to replace it. He hopes to actively participate in sports such as basketball and power soccer.
Billy supports his request with a report from his allied health professional recommending we fund a new power wheelchair. The report recommends the power wheelchair includes custom seating, posterior tilt and extra features such as seat elevation, recliner capacity and leg elevation.
In principle, based on available information, this request meets our NDIS funding criteria. Billy has previously had a wheelchair with custom seating and a power tilt.
We need more information, however, to work out if the extra features of seat elevation, recliner capacity and leg elevation will:
- be effective and beneficial
- meet Billy’s current and future disability support needs.
To support the request, we need written evidence of a successful trial that shows whether the extra features are effective for Billy’s:
- current and future disability support needs
- range of motion and strength measurements.
The trial also needs to show:
- how the extra features improve Billy’s function when using them
- whether Billy needs supervision to operate the elevated seating or reclining function
- any NDIS goals Billy is more likely to achieve relating to these extra additional features.
The planner needs to work out whether the additional wheelchair modifications are an NDIS support for Billy.
They consider the information Billy gives us against the NDIS funding criteria, including:
- the benefits of the requested power wheelchair add-ons helping Billy to achieve his NDIS goals
- whether the wheelchair is value for money. This is based on Billy’s current and future disability support needs, as well as the cost compared to other mobility options
- other services available, which are more cost-effective and achieve the same or better support and help him achieve his goals. This could include variations to his care support hours.
If there is enough evidence:
- the extra features will help Billy to build his skills to live an ordinary life
- reduce his need for different kinds of supports and be of long-term benefit.
In Billy’s case, following the trial, the planner decides the proposed modifications are likely to:
- meet Billy’s disability support needs
- be value for money
- be safe when operating the wheelchair
- be the most suitable option.
The planner assesses Billy’s request for a power wheelchair with custom seating, posterior tilt and the additional features of seat elevation, recliner and leg elevation as an NDIS support for him. We approve funding for this in Billy’s plan.
Billy then gets written advice from his allied health professional to help him buy the right power wheelchair. He works with his allied health professional to learn how to use his power wheelchair safely.
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