Navigating Plan Reassessment Timeframes in the NDIS: A Strategic Approach

If you need to undertake a plan reassessment within the National Disability Insurance Scheme (NDIS) and find that the standard timeframes may not be met, taking a proactive approach is essential. This detailed guide will provide strategic steps to expedite the reassessment process and ensure timely decisions.

Understanding the Key Timeframes

The NDIS has specific timeframes for various stages of the plan reassessment process. Here’s a breakdown of these timeframes based on the most current performance data as of September 2023:

• Start setting up a plan reassessment: 56 days before the review date (73% performance).
• Decide whether to do a plan reassessment, if requested: 21 days (72% performance).
• Conduct the agreed plan reassessment: 28 days (64% performance).
• Make small changes to a plan: 28 days (93% performance).
• Make big changes to a plan: 50 days (88% performance).
• Provide a copy of the changed plan: 7 days (reporting starts in 2024).
• Review decisions if needed: 60 days (94% performance).
• Implement changes as directed by the AAT: 28 days (99% performance).

Steps to Expedite the Plan Reassessment

1. Initiate Early Contact

As soon as you know that a plan reassessment is necessary, contact your NDIA planner or partner. Although the NDIA’s check-in process begins 56 days before the review date, reaching out earlier can provide you with a head start. Early contact allows you to discuss reassessment options and begin gathering necessary information.

2. Submit a Request for Reassessment

If your reassessment is urgent, submit a formal request immediately, clearly explaining the reasons for urgency. Highlight any significant changes in your circumstances or critical needs that necessitate prompt action. Detailed and compelling reasons can help prioritise your request.

3. Follow Up Regularly

After submitting your request, maintain regular contact with your NDIA planner to ensure your reassessment is being processed. Regular follow-ups can help keep your request on track and address any additional information the NDIA might need.

4. Prepare Comprehensive Documentation

Ensure you have all relevant documentation ready to support your reassessment request. This may include:

• Medical reports
• Support needs assessments
• Therapy assessments
• Any other pertinent evidence

Comprehensive documentation helps substantiate your request and can streamline the decision-making process.

5. Request Small Changes if Applicable

If the changes required in your plan are minor, specify this in your request. Small changes tend to be processed more quickly, typically within 28 days, as evidenced by a 93% performance rate. Minor adjustments can sometimes be sufficient to meet your immediate needs while awaiting a full reassessment.

6. Use the Complaint Process if Delayed

If your reassessment is delayed beyond the expected timeframes, utilise the NDIA’s complaint process. The complaint process involves several steps:

• Acknowledgment of Complaint: 1 day
• Initial Contact: 2 days
• Resolution: 21 days (61% performance)

Filing a complaint can prompt quicker action on your reassessment request.

Escalating the Process

1. Escalate to Senior Management

If your reassessment request is not progressing as needed, request that your case be escalated to senior management or the NDIA’s internal review team. Escalation can sometimes expedite decision-making and bring more attention to your case.

2. Lodge an Appeal with the AAT

If the NDIA’s decision or the delay in reassessment is unacceptable, consider lodging an appeal with the Administrative Appeals Tribunal (AAT). The NDIA is required to implement changes as directed by the AAT within 28 days, and they have a high compliance rate (99%).

Example Scenario for Fast-Tracking a Plan Reassessment

Step-by-Step Scenario

1. Initial Request: You realise that your current NDIS plan is insufficient due to a significant change in your disability needs. You immediately contact your NDIA planner, detailing your situation and requesting an urgent reassessment.
2. Documentation Preparation: You gather all necessary documents, including medical reports, therapy assessments, and any other supporting evidence that justifies the need for a reassessment.
3. Formal Request Submission: You submit a formal request for reassessment to the NDIA, including all prepared documentation, and request an expedited process due to the urgency of your situation.
4. Regular Follow-Ups: You follow up with your NDIA planner weekly to check on the progress of your reassessment request. You ensure they have all the information needed and stress the urgency of your situation.
5. Escalation if Needed: If, after 21 days, you haven’t received a decision about whether a reassessment will be done, you request to escalate your case to senior management. You outline the impact of the delay on your well-being and the urgency of your needs.
6. Complaint Lodging: If escalation doesn’t yield timely results, you lodge a formal complaint with the NDIA, emphasising the delay and its impact on your support needs.
7. AAT Appeal: If the complaint doesn’t resolve the issue, you prepare to lodge an appeal with the AAT. You gather all correspondence and evidence to present your case, aiming for a directive that the NDIA must implement within 28 days.

Conclusion

To expedite a plan reassessment within the NDIS, it’s crucial to start early, maintain regular communication, and prepare comprehensive documentation. Utilise the complaint process and escalate your case if necessary. If delays persist, lodging an appeal with the AAT can be a powerful tool to ensure timely and appropriate decisions.

By being proactive and persistent, you can navigate the plan reassessment process more efficiently and secure the necessary supports without undue delay. Taking these strategic steps can help you achieve a faster resolution and ensure that your needs are met promptly and effectively.