We get it. The National Disability Insurance Scheme (NDIS) is a tough nut to crack and an even tougher nut to understand and navigate, which is why we will try and answer a few of your most common questions here to try and help you along the path.
For every question asked about the NDIS, you seem to get a variety of answers - but what’s right?
What’s acceptable, claimable or funded and what is not?
The scheme can be confusing, but let’s look at a few basic questions that seem to pop up all the time and give you the straight answers!
Can relatives be support workers?
It’s not a flat NO from the National Disability Insurance Agency (NDIA) which oversees the NDIS, but it’s not advised.
While recognising the informal support provided by parents, siblings and other family members is vitally important to people with disabilities, the NDIA believes funding a family member to provide supports to a participant can be detrimental to family relationships.
Generally, the NDIA will only fund family members to provide supports in exceptional circumstances. For example, when:
The NDIA will consider the circumstances of each case, any wishes expressed by the participant and also take into account what is reasonable to expect others to provide.
Will the NDIS fund a car?
Easy answer - NO. The NDIS does not generally fund a vehicle for a participant – but MAY fund modifications to a vehicle the participant regularly uses or would use to address their transport needs.
Vehicle modifications mean changes to a vehicle, or the installation of equipment in it, to enable a participant to access it and, in some cases, operate it.
Vehicle modifications may be included in your NDIS plan where it is a reasonable and necessary support that will meet your needs and help you pursue your goals.
Will NDIS pay for air-conditioning?
It’s a bit of a myth that the NDIS DOES NOT fund air-conditioning.
But not everyone who applies under those guidelines is approved for air-conditioning. The NDIA often argues that air-conditioning is not reasonable and necessary and is more a day-to-day living cost.
In a bid to dispel such a myth, the Administrative Appeals Tribunal of Australia (AAT) published the following case:
A Mackay participant, who has Multiple Sclerosis, had applied to the NDIA to replace and upgrade his home’s out-dated and ageing air-conditioning system. This was rejected by the NDIA which stated it was not a reasonable and necessary support.
The case ended up before the AAT which agreed the replacement of the ducted air-conditioning system in the participant’s home met the requirements of a reasonable and necessary support as defined in the NDIS Act.
Read the entire case here.
Clearly, the subject is a grey area and open to different interpretations and therefore definitely argued on a case-by-case basis by the NDIA.
In another example: A participant who is unable to sleep because the summer heat impacts on their ability to sleep properly and therefore function properly during the day, can have quality sleep as a goal. Therefore an airconditioner in the bedroom would help support and achieve that goal.
Will the NDIS pay for food?
The short answer is NO.
The NDIS only covers additional day-to-day living costs which are related to your disability support needs. Everyone needs to buy food and groceries, whether they have a disability or not. So, for this reason, they are not covered by the NDIS.
HOWEVER, the NDIS will cover the cost of a home-delivered meal if you're unable to cook a meal or shop for ingredients because of your disability. You should be able to use your NDIS funding to pay for meals to be prepared and delivered to you.
Also, if learning or being able to cook is part of your plan’s goals, then the NDIS also may fund cooking lessons and a support worker to help you in the kitchen.
Will the NDIS pay for gym membership?
The NDIS do not fund supports that are day-to-day living costs for people whether or not they have a disability.
If one of your goals is to get fit by going to a gym or playing sport, the NDIS may fund a support person or assistive technology to help you to do these activities, but not the gym membership itself.
Under the Act, support may mean someone to help you take part in activities that will help you with your social and economic life. The support must show value for money in relation to both benefits of the support and the cost of similar supports.
The NDIS must also consider what families and other informal support would usually provide.
To work out whether a support to help your health and wellbeing goal is reasonable and necessary, the Scheme looks at the information you give it against the NDIS Funding Criteria.
You would need to give the NDIS evidence, such as assessments from a registered therapist, to show you need the support for your disability needs.
The NDIS may fund things such as:
Will the NDIS fund a cleaner?
The NDIS funds “reasonable and necessary” support for people with disabilities.
This means if a participant can't perform tasks like vacuuming and cleaning because of their disability, the NDIS will provide funds for a support worker to do these tasks instead.
Will the NDIS fund a laptop or iPad?
In these COVID-19 times, telehealth is vital to continue with some support and virtual consultations.
To access these telehealth, video conferencing and other technologies, appropriate technology is a must.
In recognition of this, the flexible approach to purchasing low cost AT will continue and be monitored by the NDIS as participants and providers adapt to “COVID normal”.
The flexible approach introduced during the pandemic allowed participants to spend up to $1500 on low cost Assistive Technology (AT) items, such as smart devices and fitness equipment, in consultation with their existing support providers.
While the COVID-19 pandemic continues, think how this flexible approach may help you to continue services safely if physical distancing is required.
The NDIS recommends participants, their families and carers work with their existing providers to discuss the best way to receive services and support or do everyday activities.
HOWEVER, smart devices and computers are a general household appliance. Most Australian homes have them, and they are used by most of the community.
A household appliance that most people are likely to have at home is a day-to-day living cost, not funded by the NDIS.
Will the NDIS fund spectacles?
No. Prescription glasses are covered by the health system and not by the NDIS.
While it can be argued the spectacles are directly related to your disability, the NDIS is clear that items such as prescription glasses are covered by the government’s health system.
Will the NDIS fund hearing aids?
The Hearing Services Program (HSP) and NDIS fund public hearing services in Australia.
The HSP funds hearing services for Australian citizens and permanent residents, including children and young people under 26, who satisfy its eligibility criteria.
The NDIS funds hearing supports for NDIS participants aged 26 and over who are not eligible for the HSP. The NDIS also funds additional reasonable and necessary hearing supports for participants if they are not available through the HSP. This includes people under 26.
You can access the NDIS and HSP at the same time but you can’t get the same supports from both programs at the same time.
If you are an NDIS participant accessing services and support from the HSP, there will be no immediate changes to your current arrangements.
Your hearing services and supports will be discussed at your next plan review. Read more about it at Hearing supports | NDIS.
To see if you are eligible to receive fully subsidised hearing services, visit Am I eligible to receive fully subsidised hearing services?
To find out more about the HSP, head to Hearing Services Program.
Don’t forget, Hearing Australia - https://www.hearing.com.au/ - also offers free hearing checks and aids.
Will the NDIS pay for swimming lessons?
No. The NDIS would not usually fund private swimming lessons as they are unlikely to be value for money.
Read more here - Swimming lessons in early childhood | NDIS.
What types of supports are funded?
The types of supports that the NDIS may fund for participants include:
Find more information on types of funded supports
What is NOT funded by the NDIS
There are some kinds of supports that will not be funded or provided by the NDIS.
The NDIS Act and the rules made under the NDIS Act also tell us which supports will not be funded by the NDIS.
The NDIS cannot fund a support that is:
Got an NDIS question we haven’t covered? Check out https://www.ndis.gov.au/events/5123-online-ask-lac-your-questions-answered and see if it’s answered here.