NDIS Funding and Planning
What Happens When Your NDIS Funding Doesn’t Match Your Support Needs?
Receiving an NDIS plan that does not adequately address your disability-related support needs can create uncertainty for participants and families.
Receiving an NDIS plan that does not adequately address your disability-related support needs can create uncertainty for participants and families.
You may find that funded support hours are insufficient, recommended equipment has not been included or the plan does not reflect changes in your circumstances.
Understanding the available pathways and the evidence required can help you decide what to do next.
Why Might an NDIS Plan Not Reflect Current Support Needs?
There are several possible reasons.
A participant’s functional capacity may have changed since their previous assessment.
Existing documentation may not adequately explain the frequency or complexity of support required.
Alternatively, the NDIA may have determined that particular requested supports do not meet the relevant funding criteria.
Identifying the reason for the decision is an important first step.
Step 1: Understand Your NDIS Plan and the Decision
Review the funded supports and any written explanation provided by the NDIA.
Consider whether the concern relates to:
Understanding exactly what is missing helps identify the most appropriate next action.
- Insufficient assistance with daily living.
- Inadequate community participation support.
- Missing assistive technology.
- Changes in housing or support arrangements.
- Increased overnight support needs.
- Therapy funding that does not reflect current goals and needs.
Step 2: Identify Your Unmet Functional Needs
Rather than focusing solely on the amount of funding requested, document what assistance is actually required.
For example, instead of stating that a participant needs more support hours, explain which activities cannot be completed safely or consistently without assistance.
This may include personal care, meals, household tasks, community access, communication or disability-related risk management.
Record how frequently assistance is required, how long tasks take and what happens when support is unavailable.
Step 3: Gather Relevant Clinical Evidence
Evidence may include occupational therapy reports, medical information, behaviour support documentation, support worker records or other relevant assessments.
A Functional Capacity Assessment can help explain the relationship between a participant’s disability and their everyday support requirements.
Strong evidence should identify functional limitations, existing supports, unmet needs and the rationale for recommended assistance.
Step 4: Understand the Difference Between a Plan Reassessment and a Decision Review
These processes serve different purposes.
Plan Reassessment
A plan reassessment may be appropriate where a participant’s circumstances or disability-related support needs have changed.
Under current NDIA guidance, a participant, nominee or child representative can request a reassessment using the required form and supporting information.
A support coordinator or clinician can assist with preparing evidence, but cannot independently make the request unless they hold the relevant authorised role.
For urgent, minor or short-term changes, a plan variation may be another option.
Internal Review of a Decision
If you disagree with an NDIA decision, you may be able to request an internal review.
For a reviewable decision, the request generally needs to be made within three months of receiving the written decision.
An internal review examines whether the original decision was correct.
If you remain dissatisfied after the internal review, an external review through the Administrative Review Tribunal may be available.
It is important to identify the correct pathway and meet the relevant deadlines.
Step 5: Explain the Consequences of Unmet Needs
Clinical evidence should clearly describe the practical implications of insufficient support.
Depending on the participant’s circumstances, these may include increased risk of falls, reduced personal care, carer fatigue, social isolation, missed appointments or difficulties maintaining safe living arrangements.
Recommendations should be proportionate, individualised and supported by evidence.
How Can an Occupational Therapist Help?
An occupational therapist can assess functional capacity and provide recommendations about disability-related assistance, assistive technology and environmental supports.
The resulting report may help clarify the type, frequency and intensity of assistance required.
However, an occupational therapist cannot guarantee a particular funding outcome.
Functional Capacity Assessments for NDIS Planning
Today & Tomorrow Allied Health Services provides detailed occupational therapy assessments to help participants and their representatives understand current functional support requirements.
Our services include Australia-wide telehealth assessments where clinically appropriate, with a 10-business-day report turnaround offering following completion of the assessment and receipt of the necessary information.
Does your NDIS plan no longer reflect your needs?
Contact Today & Tomorrow Allied Health Services to discuss whether an updated occupational therapy assessment would be appropriate.
Frequently Asked Questions
Can I request more NDIS funding?
You may be able to request a plan reassessment or variation, depending on your circumstances and the applicable requirements.
How long do I have to request an internal review?
For a reviewable NDIA decision, the usual deadline is three months from receiving the written decision.
Will an FCA guarantee increased funding?
No. An FCA provides clinical evidence for consideration, while funding decisions remain with the NDIA.
Official sources
This article provides general information only. NDIS rules and individual circumstances can change; check current official guidance or seek advice about your situation.