Most people find NDIS eligibility confusing. Who wouldn’t? Government criteria are complex when you’re already managing disability challenges.
Four requirements matter. Age, residency, disability impact, support needs. Fail one? You’re out.
Quick NDIS Eligibility Requirements
Age: 9 to 65 years old
Residency: Australian citizen, permanent resident, or Protected Special Category Visa holder
Disability: Permanent condition significantly affecting daily life
Support needs: Ongoing disability-specific assistance required
Different rules apply to children under 9. Over 65? Aged care services handle that.
The NDIS Eligibility Checklist
Age Requirements
Between 9 and 65 years old?
Yes? Move to the next question.
Have a child under 9? Early Childhood Partners provide support before formal NDIS applications. They assess whether NDIS will be right for your child later.
65 or older? NDIS won’t accept new participants. Other government programs might help.
Residency Requirements
Are you an Australian citizen, permanent resident, or Protected Special Category Visa holder?
This one’s black and white. Temporary visas don’t qualify. Student visas, work visas, tourist visas – none of these work for NDIS access.
Do you live in Australia?
Physical residence matters. You can’t access NDIS services from overseas.
Disability Requirements
Do you have a disability from a permanent impairment?
The NDIS recognises six types of impairment:
- Intellectual (processing information, communication)
- Cognitive (thinking, learning, decision-making)
- Neurological (nervous system problems)
- Sensory (vision or hearing loss)
- Physical (movement limitations)
- Psychosocial (mental health affecting daily function)
Your condition doesn’t have to fit neatly into one category. Many people have multiple impairments.
Do you need disability-specific supports for daily activities?
This question trips up many applicants. Having a diagnosis isn’t enough. You need to prove your disability substantially affects these areas:
- Mobility and moving around
- Communication with others
- Self-care tasks
- Social relationships
- Learning new things
- Managing your own affairs
Evidence is everything. Reports saying “has autism” accomplish nothing. You need documentation proving how autism impacts your work capacity, study participation, or community involvement.
Early Intervention Requirements
Need support now to prevent worse outcomes?
Progressive conditions fit here. Multiple sclerosis, motor neurone disease, and early dementia. Simple concept: intervene early, prevent worse disability.
Does your family need skill-building to support you better?
Family capacity building gets funded when it directly benefits the person with disability. Training parents to manage behavioural episodes. Teaching siblings communication strategies.
What Changed in 2025
Functional Capacity Takes Priority
Forget the old approach where diagnoses mattered most. Now it’s about functional impact.
Your application needs detailed evidence showing exactly how your disability affects daily life. Vague medical reports won’t work. You need assessments that demonstrate practical limitations.
This shift hits borderline cases hardest. Conditions with variable symptoms face increased scrutiny. Intellectual disability applications with clear functional impacts still get approved readily. But fluctuating conditions like some mental health diagnoses? You’ll need stronger evidence.
Support Lists: Define What’s Covered
The NDIA released official support lists in October 2024. These lists spell out exactly which services NDIS will fund.
No more guessing whether your speech therapy or autism support services qualify. The lists provide clarity but also create boundaries.
Some supports might shift to state services. This could affect availability and require alternative funding sources.
Extended Reassessment Timelines
Good news here. Document submission deadlines have been extended from 28 to 90 days.
This change reduces panic when eligibility gets reviewed. You have more time to gather comprehensive evidence. The NDIA also committed to better communication during reassessments.
Application Process
Gathering Evidence
Strong applications answer two questions: What’s your condition? How does it impact daily life?
Essential documents:
- Recent medical reports describing functional limitations
- Therapy assessments showing daily impact
- For children: developmental delay documentation
- ID and residency proof
Generic reports kill applications. “Patient has cerebral palsy” tells the NDIA nothing useful. “Patient requires assistance with transfers, cannot walk independently, needs help with personal care tasks” – that works.
Completing the Access Request
Download the Access Request Form from the NDIS website. Or call 1800 800 110.
Section 1: Your information and circumstances
Section 2: Health professional input
Don’t rush Section 2. Your doctor, therapist, or specialist needs time to provide detailed functional assessments. Book appointments specifically for NDIS documentation.
Submitting Your Application
Email: [email protected]
Mail: PO Box 700, Canberra ACT 2601
NDIS partners can help with applications. They understand what evidence works and how to present their case effectively.
Plan Development
Approval leads to planning meetings. Here, you discuss goals, needs, and required supports.
Come prepared. Know what supports you need and why. Vague requests for “help with daily living” won’t generate adequate funding. Specific needs like “multiple sclerosis care assistance for medication management and mobility support” create targeted plans.
Understanding “Permanent” Disability
What Permanent Actually Means
The NDIS defines permanent as “enduring.” Not unchanging. Your condition doesn’t have to be static to qualify.
Fluctuating conditions like epilepsy can be permanent. Progressive conditions definitely qualify. Even some mental health conditions meet permanence criteria if they have a lasting impact.
Treatment Considerations
Your impairment is likely permanent when treating professionals confirm that no further treatments could remedy it.
The NDIS evaluates whether potential treatments are:
- Known by Australian medical practitioners
- Available considering your circumstances
- Appropriate for your situation
- Evidence-based and proven effective
Still undergoing treatment? You might still qualify if your impairment is clearly permanent despite ongoing care.
When Applications Get Denied
Rejection isn’t the end. You can request an internal review within three months.
Strengthen your appeal with:
- Additional medical evidence
- Clearer functional impact documentation
- Professional advocacy support
The review process:
- Internal review (different NDIA staff assess your case)
- External review through the Administrative Appeals Tribunal
- Reapplication with new evidence
Complex Care Considerations
Many providers avoid complex cases. Amputation care, high medical needs, and behavioural challenges require specialised expertise.
Look for providers with:
- Registered nursing oversight
- Specialised equipment experience
- Complex medical training
- 24-hour support capability
Training matters. Support workers need skills in manual handling, cystic fibrosis care, seizure management, and emergency protocols.
Professional Assessment Support
Healthcare professionals make or break NDIS applications. They document functional impacts and support your eligibility case.
Occupational therapists excel at functional assessments. Speech pathologists demonstrate communication impacts. Physiotherapists show mobility limitations. Choose professionals who understand NDIS requirements.
Eligibility Reassessments
The NDIA can review your eligibility anytime. Typically happens when:
- Plans come up for renewal
- Your circumstances have changed significantly
- Someone raises concerns about your eligibility
New 90-day timeframes reduce stress. But you still need current evidence showing ongoing disability impact.
Early Intervention Pathway
Children under 6 have different criteria. Early intervention focuses on developmental outcomes rather than permanent disability.
Your child might qualify if they:
- Have developmental delays
- Need support to reach typical milestones
- Would benefit from early intensive intervention
Down syndrome support often starts through early intervention before transitioning to standard NDIS at school age.
What Happens After Approval
Approval triggers plan development. Your NDIS plan outlines:
- Funded supports and services
- Budget allocations by category
- Plan duration and review dates
Plans typically last 12-24 months before review. Use this time to track what works and what needs adjustment.
Getting Started
Ready to find out if you qualify? Start with the NDIS website’s online checker. It’s quick and gives you a baseline.
Your current medical reports might not cut it. Many doctors write generic summaries that don’t show real impact. “Patient has cerebral palsy” won’t get you approved. You need reports that explain exactly how your condition affects work, study, or daily life.
Book specific appointments for NDIS documentation. Tell your health professionals you need functional assessments, not just diagnosis confirmation. Most understand the difference once you explain.
Here’s the reality: NDIS eligibility isn’t about having a disability. Thousands of people with genuine conditions get rejected because they can’t prove functional impact.
The system works differently from what most expect. Having multiple diagnoses doesn’t guarantee approval. But one well-documented condition with clear daily impacts often does.
Some families face tougher situations. Multiple diagnoses, challenging behaviours, and round-the-clock medical needs. These cases overwhelm many providers.
You need someone who gets it. Providers experienced with complex disability care know what the NDIS actually funds versus what sounds good on paper. They’ve seen applications succeed and fail. More importantly, they understand how to position your family’s situation so reviewers see the real support needs, not just medical labels.
Finding the right match matters. When standard disability services aren’t enough and your family needs intensive, specialised support that actually works, experienced care teams help navigate both the approval process and the ongoing coordination that makes independence achievable rather than just theoretical. If you’re dealing with complex NDIS eligibility questions or need support with high-level care coordination, contact our experienced team who understand these challenges and can guide you through the process with the expertise that comes from years of working with families in similar situations.
