DOCUMENT 14
FOI 22/23-1539
Fact Sheet - Free Text ‘reason for our decision’
The content of this document is OFFICIAL.
Introduction
We need to make sure we are making good, evidence-based decisions. The most important
part of this is to communicate these decisions clearly – if we do this in a way that is clear and
meaningful, this improves the participant experience.
Being clear about the reasons for our decisions:
• Reflects the principles outlined in the NDIS Participant Service Charter, particularly the
principle of transparency.
• Delivers the ‘communicating with us’ promises in the NDIS Participant Service
Improvement Plan 2020-21.
• Is a requirement of the legislation.
Guidelines
Follow these guidelines when drafting free text in ‘Justification for the plan approval letter’:
• Ensure you are entering your reason for decision in the correct free text box
Note: information entered in this box will print on the plan.
• Ensure comments are objective, include facts based on evidence, and avoid personal
opinions or feelings.
• Reference all information the participant has provided in your decision. This includes any
documents or material relied on such as medical reports, comments, conversations,
emails and participant submissions.
• Keep the text short, simple and in plain conversational English.
• Avoid jargon.
• Introduce all acronyms before using them. For example, ‘Assistive Technology (AT)’.
• Cross-check your decision against the statutory criteria to ensure you meet all necessary
sections. Do not include considerations that are not required by the criteria in the
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legislation. For example, do not include considerations around whether the participant
can or cannot afford a support.
• Provide the basis for how you reached your decision against each criteria in the
legislation. For example, if a support does not meet two of the reasonable and necessary
criteria, explain your decision about both criteria.
• Provide the reasoning you used to reach your outcome on the overall matter. For
example, explain what supports you have not included in the participant’s plan.
Examples
Example 1 - Section 34(1)(a) Support will not assist the participant to pursue
the goals in their plan
Example
You asked us for help to be able to cook breakfast in the morning. We haven’t received any
information which indicates you need help in preparing your meals and this request wouldn’t
help you to pursue your goals. You can if you would like to, fund cooking lessons yourself.
I have included 2 hours of support each month for you to go to your local community house.
This will help you to pursue the goal in your plan to ‘be able to attend your local community
house’.
Example 2 - Section 34(1)(b) Support will not assist the participant to
undertake activities to facilitate their social and/or economic participation
Example
In your request you asked us to include funding for a new microwave so you would be able to
heat up food when your friends visit you. The information we received from your occupational
therapist doesn’t provide us with any evidence you need a microwave because of your
disability. A microwave is considered to be a household item that most people have in their
homes so I have not included funding for this in your plan. You can buy this yourself though if
you would like.
Or
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You asked to have funding for a personal trainer included in your plan. We did not receive
enough information from your allied health professional telling us you need a personal trainer to
safely participate in exercise classes. I have included funding for 8 sessions of group exercise
therapy classes in your plan. This will help you pursue your goal of meeting new people and
improving your general fitness and mobility. If you would like a personal trainer you could pay
for this yourself.
Example 3 - Section 34(1)(c) Does not represent value for money
Example
I have included funding in your plan for a new wheelchair which was recommended in the report
you gave us from your Occupational Therapist. However, there were some additional features
for the wheelchair you asked for that your OT did not recommend. I have not included funding in
your plan for these additional features. If you would like to buy the wheelchair you requested
which has the additional features, you can pay the difference in cost between the 2.
Or
Following your recent plan check-in I have included weekly hydrotherapy sessions to help you
to improve your mobility. You did ask for funding in your plan for a swimming pool to be put into
your backyard. Unfortunately, I cannot fund a swimming pool as this does not represent value
for money as your occupational therapist has recommended you attend weekly hydrotherapy
sessions.
Example 4 - Section 34(1)(d) Support is not likely to be effective or beneficial
to the participant
Example
You requested we fund fortnightly massage sessions in your plan as you think this might help
you better manage your mobility.
I have looked at the evidence you provided alongside best practice and cannot find any
supportive evidence that including funding for massage therapy will assist you in improving your
mobility.
However, I have included 6 physiotherapy sessions in your plan. Your physiotherapist is going
to develop an exercise programme with you to improve your balance and has suggested you
join a local walking group.
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Example 5 - Section 34(1)(e) Support can reasonably be expected to be
provided by families, carers, informal networks OR the community
Example
In Sam’s recent plan check-in you asked us to include funding for a carer to look after him while
you attend a family wedding. Providing care and safe supervision to children is the role of
parents and other family members or informal supports.
As Sam is only 6 years old, I haven’t included funding in his plan for someone else to care for
him while you attend a wedding. Parents would usually arrange supervision for their child if they
were unable to provide care for their child because of work or other commitments.
I have included 8 speech therapy sessions in Sam’s plan to help him improve his social skills.
Example 6 - Section 34(1)(f) Support is most appropriately funded or
provided through mainstream or other general service systems, not the
NDIS
Example
At Nishka’s recent plan check-in you asked for funding to be included in her plan to help her to
improve her reading ability. As we discussed, you will need to talk to Nishka’s school as they
can provide this support for her. Support for Nishka in the classroom is the responsibility of the
Education department. You can ask Niska’s paediatrician to provide evidence and
recommendations to the school to assist her to improve her reading level.
I have included 8 occupational therapy sessions in Niska’s plan to help improve her fine motor
skills so she can learn to tie her shoelaces by herself.
Example 7 - Rule 5.1(a) Support is likely to cause harm to the participant or
pose a risk to other people
Example
You asked me to include funding in your plan for a walking stick as you are sometimes feeling a
bit unstable when you are accessing the community. The report I have from your occupational
therapist suggest you might be at risk of falls using a walking stick in the community.
Instead, I have included funding in your plan for you to purchase a mobility walking device
which has been recommended by your occupational therapist so you can safely access the
community.
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Example 8 - Rule 5.1(b) Support does not relate to participant's disability
Example
You requested we include funding for house cleaning and garden maintenance in Elanora’s
plan. A 7 year child would not usually be expected to clean the house and look after the garden
and lawns but they might help with some of these jobs. I have not included funding for domestic
assistance in Elanora’s plan. This request isn’t related to her disability and would not be
expected by someone of her age.
I have included funding in Elanora’s plan for 10 hours of occupational therapy sessions to
improve her gross motor skills to help her pursue her goal of learning to ride her bike.
Example 9 - Rule 5.1(c) Support duplicates other supports delivered under
alternative funding through the NDIS
Example
You asked for transport funding to be included in your plan to help you get to work. In your most
recent plan, we paid for your car to be modified so you could drive to work. You confirmed you
are still able to drive your car which was been modified and was paid for from your plan. I have
not included any funding for transport in this plan as this is a duplication of NDIS funding.
Example 10 - Rule 5.1(d) Support is related to day-to-day living costs
Example
At your recent check in you asked us to include funding to pay for your water bill in your plan.
The cost of water is a day-to-day living cost which everyone has to pay for and is not specific to
your disability. The NDIS can fund reasonable and necessary supports to help you with things
you might not be able to do because of your disability. I have not included funding for your water
bill in your plan, as this is not something the NDIS is able to fund.
Example 11 - Rule 5.3 (a) Support is contrary to Commonwealth, Territory or
State laws in which the support would be provided
Example
I have including funding in your plan for an electric wheelchair as recommended by your
occupational therapist. This model meets the standards and requirements of the state of
Victoria. The model of wheelchair you requested does not comply with these regulations in
Victoria due to the terrain of the roads in the area you live. Our rules prevent the NDIS from
funding a request for supports if it is against the law of the Commonwealth, State or Territory.
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Feedback
If you have any feedback about this fact sheet, please complete our Feedback Form.
Version Control
Version
Amended
Brief Description of Change
Status
Date
by
1.0
GO0002
Class 3 Approval
APPROVED
2022-08-18
SM0075
Created in response to legislation changes
2.0
JS0082
Class 1 Approval
APPROVED
2022-09-08
Updates made to remove reference to
content appearing in CRM.
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