PWDA Submission to the consultation into NDIS Access changes
About the consultation
The Department of Health, Disability and Ageing (DHDA) is seeking feedback on proposed changes to how people are assessed to see if they can access the National Disability Insurance Scheme (NDIS). The proposed changes aim to make access decisions clearer, fairer and more consistent. They would focus on how a person’s disability affects their everyday life, rather than only on their diagnosis.
The DHDA sought feedback to help the Technical Advisory Group (TAG) develop advice for the Australian Government. The TAG will provide independent, evidence-based advice to support the development of these changes to the NDIS access. More information on the TAG is available on: Technical Advisory Group (TAG).
The NDIS Review found that the access process can be unclear and inconsistent. People may have different experiences when the access rules are applied. This includes rules about whether a disability is permanent and how much it affects everyday life.
What is being proposed
The current access process relies on a person’s diagnosis and the type of evidence they can provide. Currently some people are found eligible because they have a diagnosis which is on an access list. Other people who experience similar functional impacts need to provide more detailed evidence to show how their disability affects their everyday life. This means some people with certain diagnoses can more easily access the NDIS than others with similar needs. This process is difficult to understand and often leads to inconsistent and unfair outcomes.
From 1 January 2028, this will change. Access to the NDIS will no longer rely mainly on a person’s diagnosis. Instead, eligibility for the NDIS disability requirements will be based on a standardised, evidence-based assessment of a person’s functional capacity and how it impacts their day-to-day living.
The access lists that currently determine eligibility based on diagnosis will be replaced by a decision-making process. People applying to the NDIS will complete a functional capacity assessment as part of demonstrating their eligibility for the Scheme. The TAG will provide advice to help develop those standardised evidence requirements.
PWDA position on changes to to NDIS Access
PWDA supports efforts to improve fairness, consistency and transparency in NDIS access arrangements.
However, access reforms must not become primarily a mechanism for limiting NDIS growth or reducing participant numbers.
The proposed shift toward functional capacity assessment represents a fundamental redesign of the Scheme. If implemented appropriately, it could improve consistency and equity. If implemented poorly, it risks excluding many people with disability who genuinely require lifelong disability support.
Recommendations
- Recommendation 1 – Consider a wide enough meaning of “reliable evidence” so that decisions aren’t made automatically based on general information about groups, but instead take into account each person’s individual situation.
- Recommendation 2 – Evidence frameworks should not be created only from a limited medical or clinical point of view. They need to include the different and ever-changing ways disability can happen and be designed together with people with disability. This way, they better represent the many different experiences of disability.
- Recommendation 3 – Share all the rules for how assessments will be done, how scores will be given, thresholds and the evidence needed before starting to use them.
- Recommendation 4 – The Government, in coordination with the NDIA, should design and implement alternative evidence pathways made for individuals who face systemic barriers to accessing mainstream specialist assessments.
- Recommendation 5 – Incorporate mechanisms to capture the peak impact of episodic, fluctuating, and degenerative conditions, rather than a single “snapshot” day where a person may be tracking better than usual.
- Recommendation 6 – Introduce safeguards specifically addressing psychosocial, episodic, fluctuating, degenerative and rare disabilities.
- Recommendation 7 – Ensure all assessment methodologies and tools undergo public validation and extensive disability-led testing before implementation.
- Recommendation 8 – Apply a presumption of continuing eligibility for existing participants unless compelling evidence demonstrates otherwise.
- Recommendation 9 – Ensure participants are not removed from the NDIS until equivalent alternative supports are demonstrably available.
- Recommendation 10 – Develop and implement a formal, transparent review and appeals mechanism specifically tailored to functional capacity assessments. To ensure efficacy, equity, and procedural fairness, these safeguards must be co-designed in direct partnership with people with disability and their representative organisations.
- Recommendation 11 – The Australian Government should adopt a communication and engagement strategy for NDIS access reforms that ensures participants, prospective participants and families receive clear, timely and accessible information about proposed changes, reassessment processes, review rights, safeguarding arrangements and available supports, with the objective of rebuilding trust and confidence in NDIS decision-making.
- Recommendation 12 – Any treatment considered appropriate must be demonstrably accessible, affordable, clinically suitable, culturally safe, and available within a reasonable timeframe for the individual.
- Recommendation 13 – Ensure information collected and verified by one agency or provider is automatically reusable across all assessment stages to drastically reduce administrative burdens on participants, carers, and families.
- Recommendation 14 – Establish an independent, ongoing public evaluation framework to monitor the impact of access reforms across disaggregated disability cohorts, with findings published in a comprehensive annual report.