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What does Reasonable and Necessary mean in the NDIS?

In your NDIS plan meetings, you’ve probably heard the phrase “reasonable and necessary” a lot, but what does it actually mean?

The Bright Plan Management team is explaining everything you need to know about this term and how it impacts your NDIS plan. Read on for more.

What does Reasonable and Necessary mean in the NDIS?
What does Reasonable and Necessary mean in the NDIS?

Within the NDIS context, reasonable and necessary refers to whether a support is needed due to your disability alongside whether it is an appropriate use of your NDIS funding.

For a support to be deemed reasonable and necessary, it has to fill in the gap between your disability and achieving your goals set out in your NDIS plan. They don’t include everyday living expenses that aren’t directly related to your disability.

For example, a reasonable or necessary support may be having a support person accompany you to the supermarket. However, the purchasing of your groceries wouldn’t be considered reasonable and necessary, as this is a day-to-day expense encountered by everyone.

It’s key to remember that what is reasonable and necessary varies between individuals - it all depends on your own needs.

How is it decided if a support is reasonable or necessary?

To determine whether a support is reasonable and necessary in order to be included in your NDIS plan, the NDIA will look at various factors during the planning phase. They’ll consider how the support relates to your disability as well as figuring out whether it is required to assist you in moving towards your goals. They’ll also evaluate how likely the support is to achieve your goals and live independently.

They also consider the value for money of the support, and what other supports you may already have such as family and community supports.

What happens if a support isn’t deemed reasonable or necessary?

If a support is denied however you believe it will help you achieve your goals, you have the option to appeal. There are internal and external review processes in place. You can start the appeal process by phone or letter.

Before you appeal, review your application and think about the key points that are considered when determining if a support is reasonable and necessary. Create a clear outline of how the support is related to your disability and will play a key role in helping you achieve the goals you’ve set out in your NDIS plan.

Looking for assistance in managing your NDIS plan? We can help - get in contact today to chat to a plan manager.



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