The NDIS supports the independence and social and economic participation of people with permanent and significant disabilities and provides reasonable and necessary support needs for participants.
To become a participant of the NDIS a person with a disability must apply to the National Disability Insurance Agency (NDIA) and must:
- Be over the age of 7 and under the age of 65 years at the time of applying;
- Reside in Australia;
- Be an Australian citizen or permanent resident (or special category visa holder); and
- Meet the disability requirements.
A person will meet the disability requirements if:
- The person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or to one or more impairments attributable to a psychiatric condition; and
- The impairment/s are or likely to be permanent; and
- The impairment/s result in substantially reduced physical functional capacity or psychosocial capacity to undertake one or more of the following:
- Social interaction;
- Self-care; or
- Self-management; and
- a. The impairment/s affect the person’s capacity for social and economic participation; and
- The person is likely to require support under the NDIS for the person’s lifetime.
For participants accepted into the NDIS, the NDIA will fund reasonable and necessary supports which include:
- Aids and equipment (ie: wheelchair)
- Vehicle modifications
- Continence aids
- Occupational therapy
- House cleaning
- Daily personal activities
- Therapeutic supports including behaviour support
- Home modifications
- Personal care and attendance
- Transport assistance
- Speech therapy
- Work placement assistance
- Mobility equipment
The NDIS does not fund treatment costs or the costs of medication.
The purpose of the NDIS is to compliment and not replace compensation. An injured person can be a participant in the NDIS and also pursue a personal injury compensation claim (ie compensation for personal injury caused by the negligence of someone else, whether they were injured on the road, at work or in a public place) for the same injury. In fact, the legislation places an obligation on the participant to pursue a compensation claim if they are entitled to do so.
One cannot ‘double dip’ (ie receive compensation / funding for the same support services from more than one source). The participant has a duty to notify the NDIS of any past, existing or potential compensation claims relating to their injury/disability. The NDIS is entitled to a refund of any supports that they have funded for the injury/disability that forms part of the compensation claim and will also consider aspects of the compensation sum by applying it to a formula to discount/offset any future NDIS payments (also known as a Compensation Reduction Amount “CRA”).
The principle behind the CRA is that compensation for NDIS type supports (paid for by the insurer in a personal injury claim) should be used first and then be topped up by the NDIS funding to ensure the longevity of the (NDIS) scheme. The CRA takes into account any reduction in compensation in the personal injury claim for contributory negligence and submissions can be made on special hardship grounds.
Please note that payments for income protection, property damage, total and permanent disability or victims of crime payments are not included in the definition of relevant compensation.
An injured person can be a participant in the NDIS and the National Injury Insurance Scheme (NIIS) at the same time, provided there is no ‘double dipping’, and can still proceed with a personal injury claim for compensation (provided negligence can be established), although the NIIS only applies to motor vehicle accident injury claims and work injury claims.
It is important that appropriate legal advice is sought from specialist personal injury lawyers about these issues, as they are very complex and involved. There are also strict time limits that must be adhered to.