What can I claim for with NDIS?

This topic has been very controversial for some time, what can and what you cannot claim with your NDIS funding.

All you have to do is look at your NDIS plan and see what is included.

Depending on your disability will depend on what you have been allocated for funding. Such as Autism should have Capacity Building for therapy such as Occupational Therapy, Speech Pathology, and typically Psychology.

Then it depends on their life stage and experiences, ie teenager or child, school level, etc.

We are more than happy to help you go through this if you need support.

What about equipment?

This is where it can be tricky and depends on each individual situation.

A simple rule of thumb is, if it is not included in the plan then you cannot claim for it.

For a long time, that I can remember, there was a big debate about whether you could claim a trampoline. Some were granted a reimbursement while others were not -and it depended on the person processing the claim and the “reasonable and necessary” aspect of it.

There was a pattern though which basically went along the lines of this…
If someone of the same age as the participant would use or do it, then it would simply be deemed parental responsibility. And NDIS would not cover it. For example, Sporting club fees uniform, etc. While they may fund the Support Worker to assist the person to attend and do age appropriate activities.

BUT, if it was relating to their ‘disability’, then it would be covered. Such as, some disabilities are physical which limit their capacity to engage without aids and assistance from people.

If in doubt ask your therapist for a letter of recommendation and/or an assessment of need. This may help you to justify the purchase that is not included in their NDIS plan. Make sure the letter or report includes how it would benefit the participant, how it will be used in therapy, and how it meets their NDIS Goals.

What next?

You will need to request a review of your plan to have it included. This way the funding can be added to your plan budget and not affect the other funding allocations.

Sorry that probably does sound a little confusing. Please reach out if you need me to explain it a different way.

Now this does not mean you will be granted this equipment and be included in the NDIS plan. This is what they will most likely expect (from personal experience) when having something added or new into the plan.

I heard that I could be audited, is this true?

Yes, everyone who is self-managed and I believe even registered providers can be audited under the NDIS Act. I believe it is through an independent company outside of NDIA.

What I suggest you do to ensure you are passed acceptably is to:

  • Keep a record of all transactions ie payable and receivable.
  • keep a copy of all invoices and receipts
  • have a General Ledger of outgoings and incoming that is reconciled
  • make sure you have justifications for all transactions, especially those that you were “not sure about”.

Remember, if it is not in the plan, you cannot claim for it. If you do, it could be deemed a criminal offense and therefore face prosecution.

So please be aware of your rights and responsibilities with your NDIS funding, plan and budget.

Disclaimer: at the time of writing this information, all contents were true and correct based on personal lived experience. Please note that is a guide only and over time they may change their processes and some information contained in this article may become void and irrelevant. If in doubt, please go directly to the source, NDIS to seek clarity and clarification.