Not Eligible for the NDIS? What Your Options Are

The letter usually arrives without warning, and it is short. A paragraph confirming the decision, a reference to a section of the Act, and a line about your review rights. For something that has often taken months of appointments and paperwork to reach, it can feel remarkably abrupt.

Two things are worth saying straight away.

The first is that a decline is frequently not the end of it. A substantial number of access decisions change on review, and the reason is usually not that the NDIA changed its mind about the person — it is that the second application contained evidence the first one didn’t. The decision was correct on the material in front of it. The material was the problem.

The second is that ineligibility for the NDIS is not ineligibility for support. This is the part that gets lost, because the scheme has become so dominant in how Australians talk about disability that it can feel like the only door. It isn’t, and the system of supports sitting outside it is currently expanding rather than shrinking.

This guide covers both: how to challenge the decision properly, and what exists if the decision stands or if you decide not to pursue it.

First, read the decision properly

Before deciding anything, work out what was actually decided and why.

An access decision turns on specific tests, and a decline will usually point to the one that wasn’t met. The common grounds:

Not a permanent impairment. The NDIA was not satisfied the condition is likely to be lifelong. This often reflects evidence that described a current state without addressing permanence or the prognosis.

Impact not substantial. The condition is accepted as permanent, but the evidence didn’t establish a substantially reduced functional capacity in any of the six activity domains — mobility, communication, social interaction, learning, self-care, or self-management.

Diagnosis without function. Extremely common. The application proved the person has a condition and said almost nothing about what they can and cannot do.

Age or residence requirements not met.

Supports more appropriately provided by another system — health, education, aged care.

Each of these points to a different response, which is why the first step is reading the letter closely rather than reacting to it. If the reasons are unclear, you can ask the NDIA for a fuller statement of reasons, and you are entitled to request a copy of the information held on your file.

It is also worth checking something mundane: whether everything you sent actually arrived. Evidence lost in transit, submitted to the wrong place, or uploaded but never attached to the file is more common than it should be, and it produces a decline that has nothing to do with the merits.

Internal review: the first step, and the one most likely to work

If you disagree with the decision, the first formal step is an internal review under section 100 of the NDIS Act. A different NDIA decision-maker looks at the matter afresh.

The time limit is three months from the day you received the decision. Late requests are sometimes accepted but that is discretionary, so treat three months as the deadline.

It costs nothing. You can request it by phone on 1800 800 110, in writing to GPO Box 700 Canberra ACT 2601, through the myplace portal or the NDIS app, or at an NDIS office.

The NDIA aims to decide within 60 days and must decide within 90. If it hasn’t decided within 90 days, you can take the matter straight to the Tribunal without waiting.

Here is the part that matters most, and it is the reason so many reviews succeed: an internal review is an opportunity to submit new evidence, and the single biggest predictor of success is whether you do. A review that simply restates the original application and asks for a different answer usually gets the same answer. A review that arrives with a new functional capacity assessment addressing the exact ground on which the application failed is a different proposition entirely.

So the work is not really in writing the review request. It is in getting the evidence.

Getting the evidence right

If the decline was about permanence, you need a treating specialist — not a GP, where a specialist is available — to address prognosis directly. The phrasing matters. “The condition is managed with medication” says nothing about permanence. What is needed is something closer to: the condition is lifelong, all available evidence-based treatments have been tried or considered, and no further treatment is likely to remedy the impairment. Clinicians frequently don’t write that unless asked, because it isn’t how clinical letters are normally framed.

If the decline was about functional impact, you need a functional capacity assessment, usually from an occupational therapist, and it needs to describe a real day in specific terms. Not “requires assistance with self-care” but what the morning actually involves, how long it takes, what happens without support, and what the person cannot do at all. Our guide on what an occupational therapist does covers how these assessments work and how to get a useful one.

If the decline related to psychosocial disability, the evidence needs to address functional impact on bad days as well as good ones, and the episodic nature of many conditions. An assessment conducted on a good day, describing a good day, is a well-known failure mode.

Three practical points that make a disproportionate difference:

Describe your worst reasonable day, not your best. People systematically understate their difficulties — out of pride, out of habit, or because they genuinely adapt without noticing. The assessment should reflect the range, not the peak.

Quantify. Minutes, frequency, how many times a week, how far, how long before fatigue. Numbers survive the journey through an assessment process; adjectives don’t.

Address the specific ground. If the decline said permanence, lead with permanence. Evidence that is excellent but answers a different question will not move the decision.

If the internal review doesn’t succeed

The next step is the Administrative Review Tribunal (ART), which replaced the Administrative Appeals Tribunal on 14 October 2024.

You have 28 days from receiving the internal review decision to apply. Extensions can be sought but should not be assumed.

There is no fee for an NDIS matter at the ART.

You do not need a lawyer, and most people don’t have one, at least initially.

The process generally runs through case management, where timelines and issues are identified; then alternative dispute resolution — conciliation or mediation, often by phone or video; and then, if it isn’t resolved, a hearing. Most matters settle before hearing. Timeframes vary widely, from a few months to well over a year.

The free support available here is genuinely good and consistently underused. The federally funded NDIS Appeals program provides skilled advocates through state-based disability advocacy organisations, free of charge, regardless of income. They help prepare the case, work out what evidence is needed, deal with the NDIA, and attend with you. Free legal assistance is available for more complex matters at later stages.

If you take one practical thing from this section: contact an NDIS Appeals advocate before you lodge, not after. Search “NDIS Appeals” with your state name, or ask your local disability advocacy service.

When the answer stays no

Sometimes the decision is right. A condition may be significant and still not meet the scheme’s tests, which are about permanence and functional impact rather than diagnosis or distress. The NDIS was never designed to support every Australian with a disability or health condition — around 774,000 people hold a plan, out of a disability population several times that size.

That is a real limitation of the scheme, and it is also the reason a parallel system exists. Here is what it consists of.

Foundational supports: the thing that is changing right now

This is the most significant development in the space and the one fewest people know about.

Under the National Agreement on Foundational Supports, which commenced on 2 February 2026 and runs to 2031, the Commonwealth and the states and territories jointly fund disability supports outside the NDIS. It was created precisely because of the problem this guide is about — too many people falling between mainstream services and the scheme.

It covers two kinds of support:

General supports — information, advice, peer support and services for people with disability under 65, for children with additional developmental needs, and for their families and carers. These are not individually funded packages; they are services you access.

Targeted supports — a middle tier sitting between mainstream services and specialist NDIS supports, for people who need more than the former and don’t qualify for the latter.

The first phase is Thriving Kids, covering children aged eight and under with developmental delay or autism with low to moderate support needs, together with their families and carers. Bilateral agreements have been signed with most states and territories.

What this means practically: if your child was declined on the basis that their needs are better met outside the scheme, or if they were previously supported through early childhood pathways and that changed, foundational supports are where to look. The system is being built as you read this, so availability varies by state and by month. Your state disability department and your local area coordination service are the places to ask.

State and territory disability services

Every state and territory retained disability services after the NDIS transition, and most people assume they didn’t.

What is typically available varies but commonly includes equipment and aids programs, continence aids schemes, home modification assistance, respite, community transport, information and referral services, and specialist services for particular conditions.

These are not advertised well. The most efficient way in is usually to call your state or territory disability information line and describe your situation, rather than trying to identify the right program from a website.

Health, mental health and aged care

Health. A great deal of what people seek from the NDIS is available through the health system, particularly for conditions that are serious but not permanent in the scheme’s sense. Chronic disease management plans through a GP provide subsidised allied health visits each year. Community health services offer physiotherapy, occupational therapy, podiatry, dietetics and nursing, often at low or no cost. Hospital outpatient clinics, rehabilitation services and community nursing all sit here. Waiting lists are real, but so is the service.

Mental health. Mental health treatment plans through a GP subsidise psychology sessions. Head to Health and state-funded community mental health services provide free or low-cost support. For psychosocial disability specifically, some states fund programs for people who are not NDIS participants, and these are among the least-known services in the country.

Aged care. If the person is 65 or over and does not already have an NDIS plan, aged care rather than the NDIS is the pathway. Start with My Aged Care on 1800 200 422. Support at Home, which replaced Home Care Packages, funds personal care, domestic assistance, nursing, allied health, equipment and home modifications. People who entered the NDIS before 65 can generally stay in it.

Carer Gateway — 1800 422 737 — is for the people supporting someone, and provides counselling, coaching, respite, peer support and practical help. It is free, it does not depend on the person being an NDIS participant, and it is heavily underused by families who assume support only flows through the person with disability.

What the review process feels like, and how long it takes

Worth setting expectations, because the gap between the formal timeframes and the lived experience is where most of the frustration sits.

Internal review is a paperwork process. You lodge, you wait, and in most cases nobody contacts you in between. The NDIA may request further information, and if it does, respond quickly — delays at your end extend the clock. The 90-day maximum is real, and if it passes without a decision you can proceed to the Tribunal, which is a useful lever that very few people use.

The Tribunal is slower and more involved. Case management conferences are usually short phone hookups about timetabling. Conciliation is where most matters resolve, and it is less adversarial than people expect — often a conversation in which the NDIA’s representative, seeing the evidence properly for the first time, agrees to vary the decision. Matters that proceed to hearing are a minority.

Two practical points:

The NDIA frequently settles once good evidence appears. A large share of Tribunal matters resolve without a hearing, and the trigger is usually a report that addresses the failed test directly. This is why advocates spend most of their effort on evidence rather than argument.

You can keep living your life in the meantime. If circumstances are urgent, ask about an urgent plan variation while the review runs, and keep using whatever mainstream and community services are available. The review is not a reason to stop looking elsewhere.

Keeping records while you wait

A dull but genuinely useful habit.

Keep a dated file containing every letter and email, notes of every phone call including the date, time and who you spoke to, copies of everything you submitted, and a running log of day-to-day difficulties. If the matter goes to the Tribunal, that file is the backbone of the case, and if you reapply instead, it is the raw material for a much stronger application.

The daily log matters more than people expect. An account written at the time — the morning that took two hours, the appointment missed because there was no transport, the fall in the bathroom — carries far more weight than a summary written months later from memory. Advocates will ask for exactly this, and almost nobody has it.

A realistic word about reapplying

You can lodge a fresh access request at any time, and for many people that is the better route than an appeal — particularly where circumstances have changed or where the original application was weak and there is now proper evidence to support a new one.

Reapplying makes sense when:

• The condition or its impact has changed materially
• You now have assessments you didn’t have before
• The first application was made without support and was thin
• Time has passed and permanence is now better established

Appealing makes more sense when the evidence was already strong and you believe the decision was wrong on the material submitted.

Either way, the thing that changes outcomes is the same: evidence that addresses function, in specific terms, from the right professional, speaking directly to the test that wasn’t met.

Three things that catch people out

Confusing the different kinds of review. A section 100 internal review of a decision is not the same as a section 47A plan variation or a section 48 plan reassessment. They have different purposes and different timeframes, and asking for the wrong one costs months. If what you want is a change to a plan you already have, that is a variation or reassessment. If you want a decision reconsidered, that is a section 100 review.

Letting the 28-day Tribunal window pass. The internal review decision letter starts a short clock, and because the internal review itself can take three months, the letter often arrives when people have stopped watching the post. Extensions are possible but discretionary. Diarise the date the moment the letter arrives.

Assuming a decline closes the door permanently. It doesn’t. Circumstances change, evidence improves, and people are found eligible on a second or third application every day. A decline is a decision about the material submitted at a point in time, not a permanent judgement about the person.

Where to get help with any of this

Disability advocacy organisations exist in every state and territory, are free, and do this work daily. They are the single most useful resource mentioned in this guide and the least used. Advocacy is not only for appeals — they help with access requests, evidence and dealing with the NDIA generally.

The NDIS Appeals program, for ART matters specifically.

Your local area coordinator or early childhood partner, who can point to mainstream and community services whether or not you are a participant.

The National Disability Advocacy Finder, run by the Department of Social Services, lists advocacy services by location.

Legal aid and community legal centres, some of which have disability law practices.

Where to next

If you are preparing a fresh application, who is eligible for the NDIS covers the four tests and the six functional domains in detail, and how to describe your support needs covers the specific skill of writing about function in a way the NDIA can act on — which is the same skill an access request requires.

If you have been found eligible since reading this, understanding your plan budgets is the sensible next stop.

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We’re a registered NDIS provider delivering supported independent living and related supports across NSW. We don’t handle access requests or appeals — that’s advocacy work, and the free services above do it better than any provider would. But if you’ve recently been found eligible and want to talk through what comes next, call 1300 271 824.

General information only. This guide explains review pathways and alternative supports; it is not legal advice. Review time limits are strict — three months for an internal review and 28 days for the Administrative Review Tribunal — and you should confirm them against your own decision letter. The NDIS is undergoing substantial reform and the foundational supports system is being built progressively, so availability differs by state and changes frequently. Confirm current rules with the NDIA on 1800 800 110 or at ndis.gov.au, and with the ART at art.gov.au.