National Disability Insurance Scheme (NDIS) Appeals

On this page:

(show below)(hide below)

    For legal aid to be granted to assist an applicant in seeking an external merits review of a decision made by National Disability Insurance Agency (NDIA), the following tests must be satisfied:

    • An application for a review of an NDIA decision has been lodged with the AAT, and
    • The applicant meets guideline 12 – National Disability Insurance Scheme Appeals, and
    • There are sufficient funds available from the funding that has been provided to Legal Aid Queensland by the Department of Social Services, and
    • The Civil Justice Team of Legal Aid Queensland has the capacity to represent the applicant, and
    • There is a significant likelihood that legal representation will lead to wider community benefit, or
    • The applicant is experiencing disadvantage and would likely realise a substantial benefit from legal representation, and
    • The applicant meets the merits test.

    Documentary requirements

    Documentary requirements

    Applicants seeking a grant of legal assistance should forward all of the following documents for assessment:

    • a completed and signed Legal Aid Queensland application form
    • a copy of the NDIA decision in dispute
    • a copy of the application to the AAT for a review of an NDIA decision
    • a copy of any NDIA internal review decision
    • a copy of the most recent plan (if applicant is a participant in the NDIS)

    National Disability Advocacy Program (NDAP) disability advocates seeking a grant of legal assistance on behalf of a person with a disability or other person affected by a decision of the NDIA should forward the following documents for assessment:

    • a completed and signed Legal Aid Queensland application form (clearly marked NDIS APPEALS on the front page)
    • a copy of the NDIA decision in dispute
    • a copy of the application to the AAT for a review of an NDIA decision
    • a copy of any NDIA internal review decision
    • a copy of the most recent plan (if applicant is a participant in the NDIS)
    • details of the issues considered complex or novel

    Interpretation

    NDIS Appeals

    The AAT reviews those decisions made by the NDIA that the Act states are reviewable decisions, including decisions about who is eligible to access the scheme, supports provided under the scheme and the registration of providers of supports.

    In an attempt to ensure the external merits review process is accessible and as non-adversarial as possible a designated division of the AAT has been established, there is a fee waiver for applicants seeking a review of NDIA decisions and funded support services are available at all NDIS sites.

    NDIS Appeals is the mechanism that has been set up to ensure that all people with disability, and other people affected by the decisions of the NDIA have access to support when seeking a review of NDIA decisions.

    NDIS Appeals funding is provided for two types of supports:

    • access to a skilled disability advocate who acts as a support person, and
    • access to funding for legal services, where a case raises complex or novel legal issues

    Disability advocates role in NDIS Appeals

    Support Persons are National Disability Advocacy Program (NDAP) disability advocates who:

    • provide assistance and advice to applicants who wish to self-advocate for a review of NDIA decisions
    • provide individual advocacy support
    • explain the review process, including what is involved in appealing to the AAT
    • help to prepare documents, attend AAT conferences and hearings
    • refer AAT applicants to the relevant Legal Aid Commission (LAC) if they require legal advice on their application for external review

    The disability advocacy agencies that are NDIS Appeal providers in Queensland are detailed at the Department of Social Services website.

    LAQ role in NDIS Appeals

    Limited funding has been provided to LAQ in order to:

    • provide legal representation throughout the AAT process for applicants eligible for legal assistance under NDIS Appeals
    • provide advice to AAT applicants and their support person on their application for an external review, upon referral from a support person
    • assess eligibility for legal services, using national guidelines

    Wider Community Benefit

    Factors relating to the National Disability Insurance Scheme Act 2013 (NDIS Act) and rules

    Whether interpretation or application of a provision under NDIS Act, or rules made under the NDIS Act (rules):

    • has been considered and fully addressed by the AAT or a court;
    • is not comparable to another provision that has been considered and fully addressed by the AAT or a court;
    • is not well understood or does not have an obvious meaning, including where there is ambiguity.

    The evidence base (including where there is limited or no evidence base) in relation to a disability, therapy or support.

    Factors relating to the administration of the National Disability Insurance Scheme (NDIS)

    Whether a decision in relation to the matter:

    • will clarify an uncertain or contentious area of law in relation to the NDIS Act or rules or the application of policy;
    • will resolve an important question of law arising under the NDIS Act or rules;
    • may result in improvements or beneficial changes to the administration of the NDIS;
    • is likely to affect a significant number of participants in the NDIS.

    The applicant is experiencing disadvantage and would likely realise a substantial benefit from legal representation

    In deciding whether a person experiencing disadvantage would likely realise a substantial benefit from legal representation, LAQ may consider:

    • the applicant’s capacity to self-represent;
    • the applicant or family/carer’s ability to access support to self-represent;
    • the availability of other sources of legal assistance.

    The Legal Aid Queensland Grants Officers may determine the weight to be given to relevant factors.

    Allocation of a solicitor

    All NDIS appeals matters are to be allocated to a lawyer within the Civil Law team of Legal Aid Queensland.

    Grant(s) of aid

    The initial grant of aid for an NDIS appeal is ND10 – NDIS Appeals – solicitor to investigate prospects of success

    Extension(s) of aid

    The following extensions of aid are available:

    • ND11 – NDIS Appeals – counsel opinion
    • ND12 - NDIS Appeals - case conference (solicitor only)
    • ND13 – NDIS Appeals – conciliation conference (solicitor only)
    • ND14 – NDIS Appeals – hearing – day one (solicitor and counsel)
    • ND15 – NDIS Appeals – hearing - additional day (solicitor and counsel)
    • ND16 – NDIS Appeals – expert report
    • ND17 – NDIS Appeals – expert witness

    Review of decisions

    An LAQ decision to refuse legal aid for this type of matter may be appealed to the external review officer (refer to review of decisions).

    Last updated 19 September 2019