Every support and service that is approved for funding through your NDIS plan needs to meet the ‘reasonable and necessary’ criteria.
It is important to understand the specific criteria the NDIS uses to decide whether a support or service does – or does not – get approved to be funded through your NDIS plan. We have broken down the criteria so that you can use them when motivating why you need a particular support or service. You should especially bear these criteria in mind during your annual NDIS review meeting.
The NDIS was established to give people living with disability more control and flexibility in making decisions about how they use their NDIS funding. However, a basic framework was needed to give the NDIS decision maker a basic framework to determine whether a support or service should be funded through a participant’s NDIS plan. This framework is the ‘reasonable and necessary’ criteria.
What does ‘reasonable and necessary’ mean?
There are two main factors that both need to be true for a support to be considered reasonable and necessary:
- The support is directly related to your disability
- The support provides value for money
Additionally, a reasonable and necessary supports should:
- Help you reach your goals and aspirations established in your NDIS plan
- Help you to be more independent
- Help you take part in the community, social activities, or work
- Be likely to be effective and work for you
Your NDIS funding also takes into account informal supports you receive, such as support given to you by your family and the community.
Below are examples of the type of supports the NDIS funds:
- Assistance with personal care activities
- Day to day general transport
- Help at work to help you get or keep a job
- Therapeutic supports, such as occupational therapy, speech therapy, and behaviour support
- Help with home maintenance, such as cleaning and cooking
- Aides or equipment that helps you do things more independently
- Home modifications that allow you to live at home
- Mobility equipment
- Vehicle modifications that make your car easier for you to use
Below are examples of the type of supports the NDIS does not fund:
- Supports that are not related to your disability
- Supports that are (or are more suited to be) funded through other areas of government, for example, school teacher aides, GP and hospital visits
- Day to day costs that are not related to your disability support needs, such as groceries
- Is likely to cause you or others harm
Once a support is approved for funding through your NDIS plan, remember that you have choice and control about how your supports are given and which service providers you use in your plan.