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Reasonable and necessary

 Quick Summary

The N.D.I.S. will only fund supports that are Reasonable and Necessary for you.

This means that the supports must be: something you cannot do without, value for money and something that will help you achieve your goals. The supports you are asking for must also relate to how your disability affects your life, and be backed up by evidence.

You can choose to:

  

The N.D.I.S. uses three tests to see if what you are asking for is OK.

These are:

Reasonable – this means is it fair for you to expect this at your age and stage of life, and is it enough to meet your needs?

Necessary – this means do you really need it?

Is it more appropriate get it through a mainstream system?

 

When the N.D.I.S. are working out if what you are asking for is reasonable and necessary, they will look at:

– is it working on your goals?

– is it helping you with your long-term aspirations, things you want to do in the future?

– can you prove it will be good for you?

– is it value for money?

– is it helping you to do more things for yourself?

– is it helping you to be a part of your community?

– is it something that your family or friends could help you with?

AND

Should the N.D.I.S. pay for it, or:

– is it something that everybody pays for? The N.D.I.S. does not pay for day to day living expenses like rent and groceries. You can get help with these costs through Centrelink;

– is there another government system that pays for this for everybody? For example, Medicare helps to pay for medical costs;

– is it something your friends or family or a volunteer can help you with?

 

Keep in mind that the N.D.I.S. will want evidence that confirms your disability and how it affects your daily life. They will use the evidence to help decide if what you are asking for is reasonable and necessary.

 

Good evidence is:

– written down;

– by someone with the right background, such as a therapist, doctor, or psychologist;

– recent;

– clear about what is needed and why it is needed;

– signed and on a letterhead with contact details of the writer.

 

If you are asking for Home Modifications or Assistive Technology, the N.D.I.S. wants the request and evidence to be written on their General Assistive Technology Template and given to them. See Get Started for more information and links to the documentation required.

GET STARTED

Watch this short video

Get more information about Reasonable and Necessary Supports under the N.D.I.S.

Also, have a look at Choice and Control on the Finding Your Way website.

You can find some information on things the NDIS will and won’t fund on their ‘Would we fund it’ page.

 

A good question to ask is...

Does everybody have to pay for this?

If the answer is ‘no’ and it relates to your goals, it may be ‘reasonable and necessary’.

For more information on Home Modifications and Assistive Technology, visit the N.D.I.S. website page Providing Assistive Technology.

ACTION STEPS

Here you can find a simple list of the best actions to take if you are interested in this topic:

1 .

Think about what you need and why you need it. Talk with your family, friends, doctors and therapists and get as much information as possible. This will help you AND the N.D.I.S. to make the right decisions.

2 .

Ask your doctor or therapists to write letters or reports about what you need and how it will help you. Find out from the N.D.I.S. if there is a form or template that the doctor or therapists should use to write the report on.

3 .

Find and give the N.D.I.S. extra information such as research articles, fact sheets, video links and examples of how other people have used what you are asking for, and how it has helped them.