What to Do if Things Go Wrong?

 

If your plan is not going well, it’s important to work out why. Here are some things you can ask yourself:

• Do I have the right goals?​
• Are the people supporting me, listening and responding to my needs?​ 
• Are they doing what they want and think is right for me instead of listening to me?
• Have my life circumstances changed so that my plan no longer works for me?​
• Do I have the right mix of unpaid, mainstream, community and paid supports?
• Do I have the right supports in place?​
• Do I have the right funding ‘buckets’ (core, capacity building and capital) for my needs?​ 
• Do I feel I am at risk of harm?​

 

Once you have worked out whether the issue is with your NDIS plan or with your service providers you can take steps to make changes.

 

Issues With Your NDIS Plan

If the issue is with your NDIS plan, you may need to have a plan variation or a plan reassessment, or it may be something else with your plan that you want to question. Contact your Local Area Coordinator or the NDIS to begin this process and check your options.

Your options may include asking for a Plan variation or a Plan reassessment or requesting an internal review of a decision they have made.

There is more information about these back in Topic 3.

Have a look at the questions above again and think about what you want to change. You can discuss how to start these changes with your LAC.

 

Issues With Your Support Providers

If there is a problem with how your supports are being delivered, start with approaching the worker involved or the manager in charge. It may be a misunderstanding or something easily addressed and clarified with them.

 

If this does not fix the issue, or if you find that your needs and rights are not being met by your service and support providers, you can lodge a complaint with the NDIS Quality and Safeguards Commission. This independent agency works to improve the quality and safety of NDIS services, make improvements and resolve problems. They are bound by policies, rules and laws that guide their work and the work of NDIS providers in Australia. These policies and laws can be found here: https://www.ndiscommission.gov.au/about/legislation-rules-policies

 

The Safeguards Commission is also the place you can lodge a complaint about your provider. To read how to make a complaint follow this link: https://www.ndiscommission.gov.au/complaints

 

You can make a complaint about:

• NDIS services or supports that were not provided in a safe and respectful way
• NDIS services and supports that were not delivered to an appropriate standard
• How an NDIS provider has managed a complaint about services or supports provided to an NDIS participant

 

A complaint can be made to the NDIS Commission by:

• Phoning: 1800 035 544 (free call from landlines) or on 133 677. (Interpreters can be arranged.)
• Phoning the National Relay Service on 1800 035 544.
• Completing a complaint contact form.

 

If you have a complaint about the NDIS, you must take that up with them directly. You can do it through your LAC provider, by calling 1800 800 110 or by filling in an online complaint form here.

 

 

Your Legal Rights

NDIS participants have the right to be safe and to receive quality services from the providers and workers they choose to support them.

 

All of your rights as an NDIS participant are documented in the NDIS Legislation. The National Disability Insurance Scheme Act 2013 states that an NDIS Participant has:

• the right to determine their own best interests (Section 4)
• the right to engage as equal partners in decisions that will affect their lives to the full extent of their capacity (Section 4)
• the right as any other member of Australian society to pursue any grievance (Section 4)
• the right to request a review of their plan at any time (Section 48)
• the right to review NDIA “reviewable decisions” (Section 99) by an NDIA reviewer who was not involved in the original decision (Section 100(5))
• the right to apply to the Administrative Appeals Tribunal (AAT) against a decision of a NDIA reviewer (Section103)

 

 

NDIS Internal Reviews and AAT Rulings

Once you have your NDIS Plan, it's a good idea to check it to see if you are happy with it. If your NDIS plan isn’t suitable, or the NDIS has made a decision you do not agree with, you or a family member can request a review of your plan and support arrangements.

 

We covered some of this in Topic 3 - Manage your Supports but because these are important topics, we will cover them again here.

 

Sometimes your NDIS plan isn't quite right because your situation changes, it no longer meets your needs, or it has genuine errors.​ The first step with any of these issues is to get in touch with your LAC or call the NDIS on 1800 800 110 to raise the issue and talk about what you need changed.

For further details, you can read the Plan Review Quick Guide on the Peer Connect website. This Guide explores ways to request changes and make things right.

 

If your circumstances or your support needs change and your plan is no longer working for you, you can ask for a plan reassessment. You can ask for this at any time.
For example, this could include  things like:

• being made homeless
• needing to move out urgently
• a change in your disability

 

Contact your LAC or the NDIS as soon as possible to discuss this with them. If you ask for a plan reassessment, they have to respond within 21 days.

More information and what to do in changes of circumstance here.

Sometimes, if there are only minor changes needed with your plan, like technical errors, minor changes with supports or new information is received, a full plan reassessment is not needed and they can do a plan variation instead. As always, contact your LAC or the NDIS to discuss your situation and what you need. If you ask them to vary your plan they have to respond within 21 days.

If you are not happy with a decision that the NDIS have made about your plan, you can ask them to do an internal review of that decision. They legally have to check and explain why they made the decision that they did.

They will contact you if they need more information, and you can also supply any additional information that you think will support your review.  

Remember that you have the right to request access to your personal information that the NDIS has on file about you. You can request information about your access to the NDIS or your NDIS plan or their reasons for their decisions in your plan reassessment. Getting this information can really help you when requesting an internal review of a decision.

You can find more information about your Participant information access on this page here.

The NDIS say that they aim to complete all internal reviews within 60 days from when they receive your request.

There is information about how to ask for a review of an internal decision here. The Reviewing our decisions page on the NDIS Our Guidlenes site also has more information about internal reviews here.

You should always keep using the funding in your plan while you are waiting for the outcome of the review.

You can find more information about Changes in circumstances, internal reviews and the AAT here.
 

Appeals: What to do if you still aren't happy with decisions

If your review is complete and you’re still not happy with the outcome, you can appeal the decision through the Administrative Appeals Tribunal (AAT). The AAT is an independent body where people can take their NDIS issues and have them viewed and discussed. This is an external review and can only be done after the NDIS has done an internal review as outlined above.

You must lodge an application for review within 28 days after you receive the decision from the NDIS. Contact your LAC or the NDIS about applying to the AAT as soon as possible. You can apply for an AAT review on this link here.

There is free support through funded advocates to help you through the AAT process. Each state has local free advocacy help. There is information, including how to find your local NDIS appeals advocate provider here. These providers are also part of the National Disability Advocacy Program, which you can learn more about here.

 

The image below provides a quick summary of the steps in the review process. There is also more information about steps in the AAT process here.

 

The Australian Government have announced that the AAT will be abolished and replaced with a new federal review body. All cases currently before the AAT will continue. Once the new body is established, any remaining cases will transition to the new body. Please see the AAT website for more information about these changes here.

 

Information, Linkages and Capacity Building (ILC)

If you cannot get approved to become an NDIS Participant, all is not lost. You are still eligible to access ILC programs including LACs and ILC funded grant programs - like the SKILL project for example!

 

The National Disability Insurance Scheme has two parts:​

• NDIS plans for eligible people with a disability, and​
• Information, Linkages and Capacity building or ILC

 

You might not have heard much about ILC until now. That’s because ILC was not part of the NDIS trial period but is currently being rolled out around the country. This is being done through grants to organisations so they can run programs for people living with disabilities and their allies. For example, the SKILL Project is an ILC funded grant project, being run by Purple Orange. You can read more about ILC grants here. 

 

The focus of the ILC is making sure people with disability are connected with their communities and have the opportunity to build their skills. While ILC activities aim to help NDIS participants, they also fund activities that include people who do not have an NDIS plan so they can get the help they need.​

 

Local Area Coordinators (LACs) are also part of the ILC. LACs should help people develop and manage their plans and ALSO connect people to services and local and community-based supports. 

 

Click below to move on when you are ready…