It’s understandable that navigating NDIS processes can be confusing at times. Just to clarify, NDIS Plan Managers don’t have authority to make decisions about what the NDIS will or won't fund, those decisions are the responsibility of the NDIA (National Disability Insurance Agency).
NDIS References
🌐NDIS Frequently Asked Questions
🌐 NDIA Determining Reasonable and Necessary
What is the Plan Manager's Role?
✅ A Plan Manager can support you in understanding the supports which have been included in your NDIS plan.
✅ Explain the process of requesting the support to be available if the support is not clear, these may include:
- Requesting approval through 'My NDIS Contact': My NDIS Contact has the ability to communicate supports which have and have not been included in your NDIS plan.
- Requesting the support be built into an upcoming plan: This process will vary depending on if there has been a change in circumstances or if the NDIS plan is due for renewal.
- Request a mid-cost or high-cost Assistive Technology support: This process will vary depending on the cost and risk of the assistive technology being requested.
- Replacement Support Application: A replacement support is an item, service, or piece of equipment that you use instead of one or more supports already approved in your NDIS plan. It’s not something extra – it’s a substitute that must meet specific rules to be approved. There are guidelines to determine what supports can be submitted via this process to the NDIS.
What is the NDIS Delegate's Role?
✅ An NDIS Delegate is a person who has the legal authority to make decisions on behalf of the NDIS CEO under the NDIS Act 2013. This authority is formally given through a legal process known as delegation.
Key Points About an NDIS Delegate:
- Appointed by the NDIS CEO: The CEO of the National Disability Insurance Agency (NDIA) can delegate powers and functions to staff within the NDIA.
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Decision-Making Authority: Delegates are responsible for making a wide range of decisions under the NDIS legislation — for example:
- Approving or varying participant plans
- Determining what supports are “reasonable and necessary”
- Deciding on internal reviews
- Managing funding approvals for assistive technology or home modifications
- Bound by NDIS Guidelines: Delegates must apply the law, NDIA operational guidelines, and any internal procedures or policies when making decisions.
- Legally Accountable: Their decisions must be lawful, fair, and in line with the NDIS Act and principles such as natural justice.
- Not a Participant Representative: An NDIS Delegate is not the same as a participant’s nominee, guardian, or support coordinator. A delegate acts on behalf of the NDIS, not the participant.
Example:
If a participant applies for funding for a high-cost assistive technology item, the request will be assessed by an NDIS Delegate. The delegate reviews the evidence and makes the final determination on whether the item will be funded in the participant's plan.
❌ Who is not an NDIS Delegate?
These individuals may be involved in supporting participants but do not have legal decision-making authority under the NDIS Act:
| Role | Why They Are Not NDIS Delegates |
|---|---|
| NDIS Participants | They receive supports but do not make funding or plan decisions on behalf of the NDIA. |
| Nominees (Plan or Correspondence) | They can act on behalf of the participant, not the NDIA. They do not make decisions about what the NDIS will fund. |
| Support Coordinators | They help implement plans and connect participants with services but cannot approve or vary NDIS plans or funding. |
| Plan Managers | They manage funding and process invoices but have no authority to decide what supports are funded by the NDIS. |
| Allied Health Providers | They can recommend supports, but they don't make funding or eligibility decisions. |
| LACs (Local Area Coordinators) | They support access and planning processes but are not legally authorised to make funding decisions unless they are also formally delegated as NDIA staff. |
| NDIS Contact Centre Staff | They provide information but are not authorised to make formal decisions. |
✅ Only NDIA staff with formal delegation from the CEO (typically through a legal instrument under section 9 of the NDIS Act) can be considered NDIS Delegates.