Getting an NDIS decision that doesn't reflect your family member's actual needs is genuinely upsetting. Particularly when you've already spent months preparing evidence and waiting for an outcome.

This is general information only and does not constitute legal or financial advice. For guidance specific to your situation, speak with a disability advocate or your support coordinator.

If you want to challenge an NDIS decision, there are two formal pathways available: an Internal Review through the National Disability Insurance Agency (NDIA), and if needed, an external appeal to the Administrative Review Tribunal (ART). This post explains both. It does not cover complaints about provider conduct (that's handled separately through the NDIS Quality and Safeguards Commission, as explained in our how to make an NDIS complaint guide). It also does not cover routine NDIS plan reviews, which are a different process entirely.

[IMAGE SUGGESTION: A family member sitting with a support coordinator at a table, reviewing printed NDIS documents together. Alt text: "Family member and support coordinator reviewing NDIS plan decision documents to prepare an internal review request"]

What NDIS Decisions Can Be Challenged?

Not every NDIS decision can be formally challenged, but many of the most significant ones can. Under the National Disability Insurance Scheme (NDIS) Act, a defined category of "reviewable decisions" can be disputed through the Internal Review process.

Common examples families actually encounter include: Specialist Disability Accommodation (SDA) funding refused or a design category not approved, plan funding amounts reduced or left unchanged when support needs have clearly changed, access to the NDIS refused or cancelled, and Supported Independent Living (SIL) funding denied or found to be insufficient.

It's worth being clear about terminology. A "review of a decision" is a formal legal process for challenging a specific NDIA determination. It's entirely different from a "plan review" (the routine reassessment that happens when a plan approaches its end date). Families often confuse the two. If you're dealing with an outcome from a plan reassessment that you believe is wrong, a review of that decision is your next step. Our guide on NDIS plan reviews explains the reassessment process separately. For context on your broader rights as an SDA resident, see our SDA rules and regulations guide.

If you're unsure whether your specific decision is reviewable, call the NDIA on 1800 800 110 or speak with a disability advocate before proceeding.

The Internal Review Process: How to Challenge an NDIS Decision

The Internal Review is always the first step. You cannot apply directly to the ART without completing an Internal Review first. There are no exceptions to this.

What happens during an Internal Review? A different NDIA delegate, who was not involved in the original decision, reviews it from scratch. They consider the facts at the time of the review, not just the original decision date. That matters, because it means you can submit new evidence.

To request an Internal Review, you can phone the NDIA on 1800 800 110, write to them directly, or complete the official review of a decision request form available on the NDIS website. The NDIA aims to complete Internal Reviews within 60 days under the Participant Service Guarantee.

There are three possible outcomes: the original decision is affirmed (unchanged), varied (partially changed), or set aside and replaced with a new decision. If the outcome still doesn't meet your family member's needs, the ART is the next step.

What to Include in Your Internal Review Request

The quality of your request matters. Be specific.

• A written statement clearly explaining which decision you are disputing and why you believe it is wrong
• Supporting evidence: occupational therapist (OT) functional assessments, specialist medical letters, physiotherapy reports
• Any new information that was not available at the time of the original decision
• Previous correspondence with the NDIA about the decision

Because the Internal Review considers circumstances at the time of the review, new evidence genuinely changes what's possible. If your family member's situation has changed since the original decision, document it thoroughly.

Time Limits You Must Not Miss

This is where families sometimes find themselves in difficulty. Both deadlines are strict.

You have three months from receiving the NDIA's written decision to request an Internal Review. If the outcome of that Internal Review is still unsatisfactory, you then have 28 days from receiving the Internal Review decision to apply to the ART for an external review.

Extensions can be requested in writing with reasons, but they are not guaranteed. Don't assume an extension will be granted and don't wait until the deadline is close, particularly if you need time to gather supporting evidence.

The NDIA's target under the Participant Service Guarantee is to complete Internal Reviews within 60 days. In practice, timelines vary. We'd encourage you to act promptly rather than wait to see how the process unfolds.

One practical note: the clock starts from the date you receive the written decision, not the date you became aware of the outcome. Keep a record of when you received it.

What Evidence Should You Prepare?

This is often where families have the most influence over the outcome. Targeted, specific evidence is more useful than a large volume of general paperwork.

Evidence that typically strengthens an Internal Review includes:

• Allied health professional reports: OT functional assessments, physiotherapist assessments, specialist medical letters
• Documentation of what supports are needed and why existing funding is inadequate for your family member's actual situation
• A written statement explaining the gap between what was approved and what is realistically needed
• Assessments or reports that were not available at the time of the original decision

For SDA-specific decisions, the most relevant evidence includes a housing assessment from an OT, functional capacity evidence, and a documented statement of housing goals. Our SDA assessment guide explains what the NDIA typically looks for in this evidence.

Gathering this takes time and energy, and we're aware that families are often managing everything else at the same time. Start with what you have. A clear written account and one or two professional reports are a legitimate starting point.

[IMAGE SUGGESTION: A desk with an occupational therapist's assessment report, handwritten notes, and a folder of medical letters. Alt text: "Evidence gathered for an NDIS internal review including OT assessment and medical reports"]

The Administrative Review Tribunal (ART): External Review

If the Internal Review outcome is still unsatisfactory, the ART is your next option.

The ART replaced the Administrative Appeals Tribunal (AAT) on 14 October 2024. It is independent of the NDIA and has the authority to affirm, vary, or set aside NDIA decisions. You can only apply to the ART after completing an Internal Review.

You can apply online via the Administrative Review Tribunal website, by phone on 1800 228 333, or by mail. Remember: you have 28 days from receiving the Internal Review decision to apply. Extensions are possible in writing, but not guaranteed.

What happens at the ART? In most cases, a conciliation process is attempted first. Many matters are resolved at this stage without proceeding to a formal hearing. If conciliation does not resolve the dispute, a formal hearing follows.

We won't pretend the ART process is quick. It can take months. That's genuinely hard when your family member's housing or funding situation is the thing on hold. Legal representation is not required, but it can be beneficial for complex matters. Victoria Legal Aid may be able to assist eligible participants (see Victoria Legal Aid's NDIS review page). There is also a federally funded NDIS Appeals Program through the Department of Health that provides free legal advice and representation for eligible participants at the ART stage.

How Advocates and Support Coordinators Can Help

Most families who successfully challenge an NDIS decision had help doing so. That's not a sign of weakness. The system is genuinely complex, and navigating it alone while also managing your family member's day-to-day situation is a lot to ask.

Disability advocates are free, completely independent of the NDIA and all providers, and can help prepare your review request, gather evidence, and attend meetings on your behalf. Find a local advocate using the Disability Advocacy Finder on the NDIS Commission website.

Support coordinators can also play an important role in the appeals process, identifying what went wrong in the plan, helping gather and organise evidence, and advising on what to include in the review request. If your family member has a support coordinator, involve them early. If they don't, this is a good reason to consider it. Our support coordination guide explains what support coordinators can do and how to access one.

A support person, family member, or advocate can also formally challenge a decision on behalf of a participant with appropriate authorisation. You do not need to be the participant yourself to be involved in the process.

Conclusion

Challenging an NDIS plan or funding decision follows two steps: an Internal Review through the NDIA first, then the ART if the Internal Review outcome is still not right. The process exists because NDIA decisions are not always correct, and your family has a legal right to challenge them.

A reminder that this is general information only, not legal advice. For guidance specific to your family member's situation, speak with a disability advocate, support coordinator, or Victoria Legal Aid.

As a housing provider, Paramount Disability Homes doesn't provide legal advice or advocacy services. Our role is to help your family member find the right SDA home once funding is confirmed. If your family is working toward SDA housing and you have questions about what's available in Melbourne, we're happy to talk through your situation.

Call us on (03) 9999 7418 or email admin@paramounthomes.com.au. We know how to challenge an NDIS decision can feel like a long road. We're here when your family is ready for the next step.