Goodbye plan reviews and hello plan reassessments! The NDIS recently updated their terminology to replace the term ‘plan review’ with ‘plan reassessment’. The plan reassessment process, especially when participant initiated, is reportedly much smoother and simpler. However, like with any change made by the NDIS, knowledge is key – get to know the steps for NDIS initiated and participant-initiated plan reassessments.
Understanding Plan Reassessments
Every participant has their NDIS plan reevaluated by the NDIA after a period (typically ranging from 12 months to three years) to ensure the NDIS funding they receive is providing the necessary support. This process, which was formerly known as a plan review, is now called a plan reassessment. A NDIS initiated reassessment happens towards the end of a plan period. However, a participant can also request a plan reassessment at any time during their plan period.
Although the change from plan review to plan reassessment is mostly just a name change for better clarification around the process, there is one minor difference – the default plan period duration has changed from 12 months to 24 months. Which means participants can expect fewer NDIS initiated plan reassessments as a result.
If a plan reassessment has not been completed or the new plan is not finalised in the allotted 21-day response period, your plan will be automatically varied to extend the current plan for another 12 months. This ensures there is no gap in your funding and support services, while allowing time to complete the reassessment (if necessary) or finalise your new plan.
There are two way a plan reassessment can occur – NDIA initiated, or participant initiated.
Steps for a NDIA initiated plan reassessment
Step 1: Participant check-in
A plan reassessment initiated by the NDIA typically follows a participant check-in. Participant check-ins normally occur approximately three months before the end of current your plan period. However, it’s important to be aware that they can occur at any time, not just near the end of the plan period. If you’re uncertain when a participant check-in may occur, you can contact the NDIA to confirm a date. This will allow you to be better prepared for the check-in.
During your scheduled participant check-in, your Local Area Coordinator (LAC) or NDIA planner will discuss your situation to determine whether your current plan can continue, if variations need to be made or if you need a reassessment.
If you need a reassessment, this must be scheduled for a later date. A reassessment should not occur during a participant check in. You need time to collect evidence, supporting letters, and reports to ensure your reassessment and new NDIS plan accurately reflect your needs.
During the check-in, the LAC or NDIA planner should also advise you on what information you need to bring to the reassessment.
Step 2: Reassessment date
On the plan reassessment date, you can discuss your current plan, supports, goals, and any changes in circumstances that are relevant for creating a new plan. This is your opportunity to provide evidence that supports and reflects your needs.
This reassessment can take place in person, over the phone or via video call, and you can have a support person present with you.
Step 3: Outcome
Following your reassessment, the NDIA have 21 days to respond with their decision. If you’re unhappy with the decision they’ve made, you can request an internal review (more on this in the ‘steps for a participant-initiated plan reassessment’ below).
Steps for a participant-initiated plan reassessment
A plan reassessment can also be initiated by a participant at any time during your plan period.
Step 1: Gather evidence
The funding you receive in your NDIS plan is influenced by the evidence you provide. Which means if you want a reassessment - evidence is key. Before making your plan change request to the NDIA, you should start the process in collecting evidence including assessments, reports, or other supporting documentation.
If you need assistance collecting evidence for your request, you can speak with your support coordinator, LAC, or a disability advocate.
Step 2: Request a change
There actually isn’t a specific option to request a reassessment on the NDIS website. If you would like a reassessment, then you need to request a change to your plan.
There are three ways you can request a change:
* To fill out the form go to Part C on page 3, select the 5th checkbox to identify that your situation has changed, then proceed to page 5 and complete Part H
During your request to change your plan, you will need to provide information to help the NDIA understand the reasons for the change request Which will inform their decision on whether they do a plan variation or reassessment. For this reason, if you would like the NDIA to consider a reassessment over a variation, it is important to have evidence to back up your request. This information helps the NDIA better understand your situation and reasons for a reassessment.
Please note, for participants just seeking a plan variation, for example if they want to change from agency management to plan management, providing evidence like this may not be necessary.
The NDIA have 21 days to respond to your plan change request. If you have been approved for a reassessment, they will discuss a suitable date with you as well as your preference for either an in-person, over the phone or video call reassessment. Remember, you can have a support person with you during your reassessment.
Step 3: Reassessment date
During your reassessment, you can present all the evidence you have collected in support of a new plan. It is also a good opportunity to discuss in more detail:
· What is working well & what isn’t working well in your current plan
Any achieved goals
New goals or changes to previous goals
How you would like your plan to be managed (agency, self, or plan management)
Changes to your situation or needs
Length of your next plan (if you aren’t expecting any changes to your situation, you may be able to extend your plan period)
Step 4: Receive the outcome
Following the reassessment, the NDIA is required to respond within 21 days. As mentioned above in the ‘steps for a NDIA initiated reassessment’, if you are unhappy with the outcome, you can request an internal review. The internal review process is completed by someone within the NDIA who was not linked to the original outcome. It is up to them to determine whether the NDIA supports the original outcome or if changes need to be made. If they support the original outcome but you are still unhappy with this decision, then you can request an external review by the Administrative Appeals Tribunal (AAT), who are a separate entity to the NDIS.
An internal review must be completed before you can request an external review.
Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.