How to Appeal an NDIS Decision: Step-by-Step Guide

Disagreeing with an NDIS decision can feel overwhelming. Whether the National Disability Insurance Agency (NDIA) has denied access to the National Disability Insurance Scheme (NDIS), reduced funding, or excluded necessary supports from your plan, you have the right to appeal. This guide explains the NDIS appeals process, including internal review and external review through the Administrative Review Tribunal (ART), helping you navigate each step with confidence.

Understanding NDIS Decisions You Can Appeal

The NDIA makes decisions about who can access the NDIS, how much funding participants receive, and what types of supports are considered reasonable and necessary. Common appealable decisions include:

• Access decisions: Whether you meet eligibility criteria for the NDIS
• Planning decisions: The funding amount allocated in your NDIS plan
• Support decisions: Which supports are included or excluded
• Plan management decisions: How your funding is managed
• Support category allocations: Whether funding is placed in Core, Capacity Building, or Capital supports

If your NDIS plan does not include supports you need, or funding does not meet daily living requirements, requesting an internal review is your first step toward resolving the issue.

When to Request an Internal Review

You must request an internal review within 3 months of receiving the NDIA’s decision in writing. This timeframe is strict—missing the deadline can result in losing your right to appeal. An internal review means a different NDIS officer will reassess the decision using the information and evidence you provide.

Why Funding Does Not Meet Daily Support Needs

The NDIS determined lower functional impact than what occurs in real life. When the NDIA assesses your needs, they rely on evidence showing how your disability affects daily activities. If your NDIS plan decisions do not reflect your actual requirements, the assessment may have underestimated your functional needs.

Common situations requiring appeal include:

• Insufficient funding: Support hours allocated do not cover daily living assistance needs
• Excluded supports: Necessary supports were not included because they were considered not reasonable and necessary
• Wrong category placement: Support is needed in Core but allocated to Capacity Building
• Changed circumstances: Your health condition has deteriorated or safety risks have increased

How to Request an Internal Review

You can request an internal review by:

1. Calling the NDIS contact centre: Phone 1800 800 110 during business hours
2. Completing the internal review of a decision form: Download the application form from the NDIS website
3. Submitting via the NDIS contact web form: Access the online form through the NDIS participant portal
4. Sending a written letter: Mail your request to the Chief Executive Officer, National Disability Insurance Agency, GPO Box 700, Canberra ACT 2601

What to Include in Your Internal Review Request

Your request must specify:

• The date of the decision you disagree with
• Which part of the decision you are appealing
• Why you think the NDIA should make a different decision
• What outcome you are requesting
• Any new evidence you would like the NDIA to consider

Evidence That Strengthens Your Appeal

When learning how to appeal NDIS plan decisions, evidence is critical. The NDIA reviews decisions based on functional impact—how your disability affects your capacity to perform daily activities independently and safely.

Functional Assessments

Occupational therapy reports, physiotherapist assessments, and allied health evaluations demonstrate functional needs. These assessments should show:

• How your disability affects daily living tasks
• The level of assistance required for personal care, mobility, and community participation
• Safety risks including falls risk, choking risk, or wandering behavior
• Whether supports are reasonable and necessary to achieve your goals

Clinical Documentation

GP summaries, specialist treatment plans, and diagnosis confirmation provide medical context. However, clinical letters alone are insufficient—the NDIA needs evidence showing functional impact on everyday activities.

Daily Living Impact Statements

Describe real challenges you face:

• Morning routine difficulty and how long tasks take with assistance
• Fatigue levels affecting your capacity to complete activities
• Support required from family members or carers
• How current funding levels leave needs unmet

Carer and Family Statements

Statements from people who provide informal support offer lived experience context. These should explain:

• How much support is required and when
• Tasks you cannot complete independently
• Safety incidents or near-misses
• The impact on family members providing unpaid care

Provider Quotes and Rosters

Service provider quotes demonstrate the actual cost of supports. SIL rosters, therapy session schedules, and evidence from current support workers show:

• The frequency and duration of support needed
• Gaps between current plan funding and actual requirements
• Whether the NDIS price guide aligns with local service availability

The Internal Review Process

The NDIA aims to complete internal reviews within 90 days from the day they receive your request. During this period:

1. A different NDIS officer reassesses the decision
2. They review the information and evidence you provided
3. The NDIA may contact you for additional information
4. You receive written notification of the outcome

Your current NDIS plan remains active throughout the review process. You will not lose existing supports while appealing.

Possible Internal Review Outcomes

• Decision changed: The NDIA agrees with your appeal and revises your plan
• Partial change: Some requested supports are approved
• Decision affirmed: The original decision remains unchanged

If you are not satisfied with the internal review decision, you can apply for external review through the Administrative Review Tribunal within 28 days.

External Review Through the Administrative Review Tribunal

The Administrative Review Tribunal (previously called the Administrative Appeals Tribunal or AAT) is independent of the NDIS. The ART reviews whether the NDIA’s decision was correct based on evidence and legislation.

How to Apply for External Review

You must lodge an ART appeal within 28 days of receiving the internal review decision. This deadline is shorter than the internal review timeframe, so act promptly.

To apply:

1. Download the application form from the Administrative Review Tribunal website
2. Complete all sections, including details of the decision being reviewed
3. Attach all evidence provided for internal review
4. Submit any additional evidence that supports your position
5. Lodge the application online or by post

There is no application fee for NDIS matters reviewed by the ART.

The ART Review Process

The ART process typically involves:

Case Conference: A private meeting between you, your representative (if you have one), the NDIA representative, and an ART member. The ART member facilitates discussion to reach agreement. Many cases are resolved at this stage without proceeding to a hearing.

Hearing: If agreement cannot be reached at the case conference, a formal hearing is scheduled. During the hearing, you present information and say why you disagree with the decision under review. The NDIA presents their position. An ART member makes a binding decision based on evidence.

The ART appeal process usually takes at least a few months. The ART member remains unbiased and allows the case to be discussed fairly. They are not authorized to make decisions during case conferences but can suggest ways to resolve the issue.

Writing Your Appeal: Language That Works

Effective appeals focus on functional needs rather than emotional statements. Use clear, factual language that demonstrates how your disability impacts daily living.

Structure Your Appeal Request

Part 1: The Decision State which decision you disagree with and the date you received notification. Be specific about which element you are appealing (e.g., “Core supports funding does not meet daily living assistance needs”).

Part 2: Why You Disagree Explain using clear examples from everyday life. Instead of stating “I need more support,” specify: “I require two hours of assistance each morning for personal care, showering, and meal preparation due to limited upper limb function and balance difficulties.”

Part 3: Functional Impact Describe real-world consequences. Detail how insufficient funding affects your safety, independence, and ability to participate in community activities. Include specific safety risks such as falls history or choking incidents.

Part 4: What You Need Request specific support types, including hours per week, frequency, and which provider delivers the service. Attach evidence—reference each attachment with numbers or labels for easy identification.

Tone to Use

• Clear and factual
• Respectful and professional
• Focused on safety, independence, and daily functioning

Avoid emotional language such as “This is unfair” or vague statements like “I need more help.” Instead, use practical examples demonstrating why current plan funding does not match your daily support needs.

Common Mistakes to Avoid

Only describing diagnosis: The NDIS funds functional needs, not medical conditions. Explain how your disability affects daily activities rather than listing diagnoses.

Submitting no new evidence: If you provide the same information, the NDIS will likely reach the same conclusion. Include updated assessments, recent incident reports, or provider statements showing changed circumstances.

Vague requests: Specify exactly what you need—hours per week, support type, and why this level of support is reasonable and necessary.

Missing timeframes: Appeals submitted outside the 3-month window (internal review) or 28-day deadline (external review) may be rejected.

How Nurse Aid Australia Supports Your NDIS Appeals

At Nurse Aid Australia, we assist participants, family members, and carers through the NDIS appeals process. Our services include:

• Evidence gathering: Coordinating functional assessments with allied health professionals
• Application preparation: Reviewing your written appeal to ensure all required information is included
• Case conference support: Preparing you for ART proceedings and attending as a support person
• Ongoing liaison: Communicating with the NDIA on your behalf to track progress and respond to requests for further information

Our team understands the NDIS review process and what evidence the NDIA considers when assessing whether supports are reasonable and necessary. We work with healthcare professionals, support coordinators, and plan managers to build comprehensive appeals that reflect your true functional needs.

Next Steps: Taking Action on Your NDIS Decision

If you don’t agree with a decision made by the National Disability Insurance Agency:

1. Review your decision notification: Identify the date and specific elements you disagree with
2. Gather evidence: Collect functional assessments, clinical reports, daily living statements, and provider quotes
3. Request internal review within 3 months: Use the internal review of a decision form or call the NDIS contact centre
4. Consider professional support: Contact Nurse Aid Australia to discuss your appeal and identify evidence gaps
5. If internal review is unsuccessful, apply for external review within 28 days: Lodge an application with the Administrative Review Tribunal

Your current plan remains active throughout the appeals process. Appealing is not complaining—it is ensuring your plan accurately reflects your functional needs and goals. Many participants successfully receive revised plans after providing clearer information and evidence showing the functional impact of their disability on daily living.

Contact Nurse Aid Australia today to discuss your NDIS appeal and access the supports you need. Our experienced team can guide you through the internal review and external review process, helping you present evidence that demonstrates why your NDIS plan decisions should be reconsidered.

Ready to Take the Next Step?

At Nurse AID Australia, we’re here to support you in turning your NDIS goals into real-world outcomes. Whether you’re looking to join community activities, improve your social confidence, or access tailored support services—we’re just a click away.

Have questions? Contact our friendly team to discuss how we can help you or your loved ones thrive through the NDIS.