Source
r/NDIS•
ryan19944

Worth going for a review early or wait until funds are more exhausted?

Question/self.NDIS

Hi guys I have a client who use to get yearly plans (joubert syndrome) now he has a 3 year plan with an amount that will probably cover 2, maybe 2.5 years of services , currently about 25% spent of what he mainly uses his ndis plan for

From my understanding cat 1 and cat 4 are interchangeable? as cat 4 is getting low but cat 1 still has plenty to go for now

His Mum is wondering if it’s worth going for an early review now or wait until more funding is exhausted, as we are worried if we go for an early plan review at this stage they (the ndia) could make his current plan situation worse somehow by given him a new plan with less funding then we currently have access too at the moment

Thank you for your input , we are unsure of how to proceed right now if we just wait a while or push for an early plan review sooner then later

Posted Sep 22, 2022, 4:01 AM UTC

57
EliteFourFay•

Yes all of the Core budget category is flexible, can flick the funding around as you need. Are you applying for an early review or a change in circumstances? If you haven't spent a hefty amount in a certain category, they may strip that money in the review.

5
Spoonlessdownunder•

Core support budges are flexible and if funds are underutilised on one are (say, social community and civic participation) they can be used to 'top up' another core budget (such as core daily activities).

The exceptions to this flexibility are:

  • where there are Stated supports - the funding assigned for these items is not interchangeable for anything else
  • where there are different management styles in place (e.g. if the majority of the core budget is plan managed, but the consumables budget is self managed these two are not glexible).
  • Transport is only flexible when not being paid as a periodic payment. This then changes the evidence requirements (invoice required for every claims) so isn't ideal for most people.

If the plan funds will not last the entire plan you will need functional capacity evidence to show why (such as an Occupational Therapist functional capacity report from the last 2 years). Without this it is unlikely that the request for reassessment would be granted and if it was, may actually result in less funds again.

4
learnlikelove•

Are you place able to explain what you mean about the invoices for transport? Are you talking about if they have periodic paid payments into bank account?

1
Spoonlessdownunder•

When transport is a periodic payment to the participant, it isn't flexible. The upside of this is that the NDIA aren't expecting the participant to keep records of every bus ticket, uber receipt etc This operates in a really similar manner to the transport allowance from Centrelink, where the person gets a set amount deposited to their bank account each week. How they then use it is theoretically up to them.

If a participant requests for transport to be plan or agency managed (or even self managed but NOT as a periodic payment), the funds can be used as required (so more flexible, particularly for those with fluctuating capacity). The downside is you will only get access to the funds you use and you need tax invoices like you do for all other NDIS spending (unlike periodic self-managed). This is a great option if you need to use higher cost transport supports less frequently, like community transport.

1
ryan19944OP•

Ok thank you we have all reports (doc ot support workers etc ) in place etc for an early review but we will hold off for now

1
qacona•

My OT and SC put in review paperwork for me about 3 months ago and I haven't had an acknowledgement yet, so don't put it in tooo late. They're pretty backed up.

1
Suesquish•

It is not the case that a participant can request a review at any time. There are 2 types of review requests.

Unscheduled review. Once you get a plan you have 3 months to ask for a review if the funding is insufficient. That is all. It is unfortunately a participant's responsibility to request a review in that time frame if their plan doesn't have enough to cover their disability support needs.

Change of Circumstances review. This can be requested at any time during a plan, but most likely would be after the first 3 months and before the last 100 days of their plan. This is because the unscheduled review can happen within 3 months, and an early plan review can be requested within 100 days before the plan ends. A CoC review can be denied by the agency. The participant must have had a change in their circumstances to request this kind of review. That may be moving out of home, transitioning from group to independent living, deterioration in disability, etc. This is not for a plan being underfunded.

So, if the review is because the plan was never sufficient the participant would have to do option A, which is to request a review in the first 3 months of their plan, or ask for an early review 100 days before their plan ends.

It is very common that the NDIA do not adjust plan funding for longer plans. People who go from 1 to 3 years often only get 2 years funding. How much plan funding has been used doesn't necessarily affect future plan funding, especially if evidence has been provided as to why it hasn't been used (such as therapist retiring and not finding a new one).

1