NDIS Appeals and Reviews: How to Challenge Decisions About Your Funding

Receiving an NDIS decision that doesn’t align with your needs can feel overwhelming, especially when you’ve spent considerable time and energy preparing for your plan. Perhaps your funding has been reduced, specific supports have been denied, or essential therapies have been removed from your budget. The uncertainty that follows—wondering if you have any recourse, whether you’ll get the support you need, or if challenging the decision is even worth the effort—can leave you feeling powerless at a time when you need certainty most.

The truth is, you have more power than you might realise. The NDIS framework includes formal mechanisms specifically designed to ensure decisions are fair, transparent, and genuinely reflect your disability-related needs. Whether you’re in Cairns, Brisbane, or anywhere across Australia, understanding how to navigate NDIS appeals and reviews can be the difference between accepting inadequate support and securing the funding that enables you to live independently and pursue your goals.

This comprehensive guide will walk you through every stage of the appeals process, from understanding your fundamental rights to preparing compelling evidence for review. You’ll learn when to pursue an internal review, how to escalate to external tribunals when necessary, and most importantly, how to advocate effectively for the support you deserve.

What Are Your Rights When You Disagree with an NDIS Decision?

Every NDIS participant has the legal right to request a review of decisions made by the National Disability Insurance Agency (NDIA). This isn’t a favour or a privilege—it’s a fundamental entitlement embedded within the National Disability Insurance Scheme Act 2013. When you receive a decision letter from the NDIA, it must include information about your review rights, the timeframes for requesting a review, and how to initiate the process.

The types of decisions you can challenge extend far beyond simple funding amounts. Reviewable decisions include access to the NDIS, the supports included in your plan, the amount of funding allocated, how your plan is managed, whether you’re eligible for crisis support, and decisions about plan nominees or supported decision-making arrangements. Essentially, if the NDIA has made a decision that affects your participation in the scheme, you typically have the right to request a review.

Understanding this right is crucial because many participants accept decisions they’re unhappy with simply because they don’t realise challenging them is an option. The appeals and review system exists precisely to address situations where initial decisions may not have fully considered all relevant circumstances, where new information has come to light, or where administrative errors have occurred.

Your right to review is protected regardless of your geographic location. Whether you’re accessing NDIS services in Cairns, Brisbane, or elsewhere in Queensland, the same review rights apply. Time is of the essence, however, as strict timeframes govern when you must lodge your review request to maintain your rights.

How Does the NDIS Internal Review Process Work?

The internal review process represents your first opportunity to challenge an NDIS decision, and it’s conducted by the NDIA itself—but critically, by a different decision-maker from the person who made the original decision. This provides a fresh perspective on your circumstances and ensures that any oversights or misunderstandings can be identified and corrected.

You have three months from the date you receive the decision letter to request an internal review. This timeframe is strictly enforced, though in exceptional circumstances, the NDIA may accept late applications if you can demonstrate reasonable grounds for the delay. Your request should clearly identify the decision you’re challenging, explain why you believe it’s incorrect, and provide any supporting evidence that wasn’t available during the initial decision-making process.

NDIS Review Process Comparison

Review Stage	Timeframe to Apply	Conducted By	Average Resolution Time	Cost to Participant
Internal Review	3 months from decision	NDIA (different decision-maker)	60-90 days	Free
External Review (ART)	28 days from internal review outcome	Administrative Review Tribunal	4-12 months	Free
AAT Review (pre-2024)	28 days	Administrative Appeals Tribunal	8-18 months	Free

During the internal review, the new decision-maker will reconsider all aspects of your case, including any additional information you’ve provided. They’re not bound by the original decision and have the power to affirm it, vary it, or set it aside entirely and substitute a new decision. Importantly, they can only make a decision that’s more favourable or identical to the original—they cannot reduce your supports as a result of the review process.

The internal review process typically takes between 60 to 90 days, though complex cases may take longer. Throughout this period, your existing plan generally continues unless it has already expired. If your plan has ended and you’re awaiting a review outcome, you may be eligible for interim supports to ensure continuity of care whilst the matter is being reconsidered.

Many appeals are successfully resolved at the internal review stage, particularly when participants provide comprehensive supporting evidence from allied health professionals, medical specialists, or other relevant experts who can articulate how the requested supports meet the “reasonable and necessary” criteria under the NDIS Act.

When Should You Consider External Review at the Administrative Review Tribunal?

If the internal review outcome still doesn’t address your needs, you have the right to escalate your case to the Administrative Review Tribunal (ART). The ART is an independent body, separate from the NDIA, that conducts merits reviews of administrative decisions. This means they examine whether the decision was correct based on the law and all available evidence, not just whether the NDIA followed proper procedures.

You must apply to the ART within 28 days of receiving the internal review decision. This is a significantly shorter timeframe than for internal reviews, so acting promptly is essential. The ART process is more formal than internal review but remains relatively accessible—you don’t need a lawyer, though many participants find legal representation or support from disability advocacy organisations extremely valuable.

The ART process typically involves several stages. After you lodge your application, the NDIA prepares a statement of issues explaining their position and provides relevant documents. You’ll then have the opportunity to respond with your own materials and evidence. In many cases, the ART facilitates case conferences—less formal discussions between you (or your representative) and the NDIA to explore whether the matter can be resolved without proceeding to a full hearing.

Case conferences successfully resolve a significant proportion of ART applications. These structured negotiations often result in outcomes that better reflect participants’ needs because both parties have the opportunity to present their positions comprehensively and explore creative solutions that might not have been apparent during the initial decision-making process.

If your case proceeds to a full hearing, you’ll present your evidence before an ART member who has expertise in administrative law. Hearings can be conducted in person, by telephone, or through video conferencing, making them accessible for participants across Cairns, Brisbane, and regional Queensland. The ART member considers all evidence afresh and has the power to affirm, vary, or set aside the NDIA’s decision and substitute their own.

What Evidence and Documentation Do You Need for a Successful Appeal?

The strength of your appeal fundamentally depends on the quality and relevance of the evidence you provide. Successful appeals typically share common characteristics: they clearly articulate how the requested supports meet NDIS criteria, they’re supported by objective professional assessments, and they demonstrate how the supports will help you pursue your goals and live independently.

Start by gathering all documentation related to your NDIS journey. This includes your current and previous NDIS plans, all correspondence with the NDIA, planning meeting notes, and any assessments conducted during your planning process. Understanding exactly what was considered in the original decision helps you identify gaps or misunderstandings that need addressing.

Professional reports form the backbone of compelling appeals evidence. Reports from occupational therapists, physiotherapists, psychologists, speech pathologists, or other relevant allied health professionals should clearly explain your functional capacity, how your disability impacts your daily life, and why specific supports are necessary to address disability-related barriers. The most effective reports avoid clinical jargon and instead focus on practical examples of how your disability affects everyday activities and participation.

Medical evidence from specialists can be particularly powerful, especially when it addresses the permanency of your condition, expected progression or stability, and why certain therapeutic interventions or supports are clinically indicated. However, medical reports alone are rarely sufficient—the NDIS focuses on functional impact and participation, so combining medical evidence with allied health assessments creates the most comprehensive picture.

Document your lived experience thoughtfully. While personal statements alone won’t win an appeal, your firsthand account of how inadequate supports affect your daily life, safety, independence, and wellbeing provides essential context for professional assessments. Specific examples are far more compelling than general statements: describe particular situations where you needed support that wasn’t available, or explain how previous funding enabled specific achievements.

Keep detailed records of your current support usage and any gaps you’re experiencing. If you’ve been purchasing supports privately because NDIS funding was insufficient, maintain receipts and explain why these supports were necessary. If you’ve been unable to access needed supports due to funding constraints, document how this has impacted your health, independence, or ability to engage in employment, education, or community life.

How Can You Access Support Throughout the Appeals Process?

Navigating NDIS appeals and reviews doesn’t need to be a solitary endeavour. Multiple support pathways exist to help you prepare compelling applications, understand your rights, and present your case effectively. In Cairns and Brisbane, as throughout Queensland, disability advocacy organisations provide free, independent support specifically designed to assist people through the review process.

Advocacy services can help you understand which review pathway is most appropriate for your circumstances, assist with gathering and organising evidence, help you articulate your position clearly in written submissions, support you during case conferences, and even attend hearings with you if your matter proceeds to the ART. These services are funded separately from the NDIS, so accessing advocacy support doesn’t impact your NDIS funding or plan budget.

The NDIS Appeals Support Service provides free assistance to participants pursuing reviews at the ART level. This programme offers practical support including help understanding ART processes, assistance preparing applications and submissions, and support during case conferences and hearings. Access to this service is available regardless of your geographic location, with remote support options ensuring equitable access for participants across regional Queensland.

Many allied health professionals who provide NDIS services are experienced in supporting participants through the review process. Your existing therapy team may be willing to provide updated assessments or reports specifically tailored to support your appeal. When engaging professionals for this purpose, clearly communicate what you’re appealing and why, so their reports address the specific decision points in your case.

Support coordinators, if included in your current plan, can also play a valuable role in the appeals process. While they can’t act as formal advocates, they can help you coordinate assessment appointments, liaise with service providers to gather supporting information, and ensure all necessary documentation is organised effectively.

Consider whether you need a plan nominee or support person to assist with the appeals process itself. If understanding complex information, articulating your position in writing, or navigating administrative processes is challenging due to your disability, formalising support arrangements ensures you can participate fully in the review without being disadvantaged by communication barriers.

Understanding Your Path Forward After a Review Decision

Once you receive the outcome of your review—whether through internal review or the ART—you’ll need to understand what happens next and what further options exist if you remain dissatisfied. If your appeal is successful and you receive increased or additional supports, your plan will be updated to reflect the new decision. Implementation timelines vary, but the NDIA is generally required to give effect to review outcomes promptly.

In cases where your internal review is partially successful but doesn’t fully address your needs, you retain the right to escalate the remaining issues to the ART. You’re not required to accept the internal review outcome as final—your review rights extend to challenging any aspect of the decision that you believe remains incorrect, even if other elements were decided in your favour.

If the ART decides against you, limited further appeal options exist. The ART’s decisions can only be appealed to the Federal Court on questions of law—meaning you must demonstrate the ART made a legal error in how it interpreted or applied legislation, not simply that you disagree with the outcome. These appeals require legal representation and should only be pursued after careful consideration of the prospects of success.

Regardless of the outcome, your experience through the appeals process provides valuable learning that can strengthen future planning conversations. Understanding how decisions are made, what evidence carries weight, and how to articulate your needs effectively positions you to engage more successfully in subsequent plan reviews and reassessments.

The broader NDIS landscape continues evolving, with legislative amendments and policy refinements shaping how decisions are made and reviewed. Staying informed about these changes—particularly those affecting the “reasonable and necessary” criteria that underpin funding decisions—helps you understand the framework within which your supports are assessed and funded.