NDIS Plan Review Evidence Checklist

Section 48 of the NDIS Act 2013 establishes your right to request a plan review when your circumstances change or your current plan doesn't meet your needs. The NDIA must review your plan if you can demonstrate that your disability support requirements have changed, your goals have evolved, or your current funding is inadequate.

Under the Act, all supports must meet the 'reasonable and necessary' criteria outlined in Section 34. This means your evidence must clearly show how requested supports relate to your disability, help you pursue your goals, represent value for money, and are likely to be effective. The NDIA received over 89,000 plan review requests in the 2024-25 financial year, with participants who provided comprehensive evidence achieving significantly better outcomes.

Your plan review evidence must address three key areas: functional capacity changes, progress towards existing goals, and new support needs. The NDIA's planners use this evidence to determine funding across all support categories, from Category 1 (Assistance with Daily Personal Activities) through to Category 15 (Improved Daily Living Skills).

Medical evidence forms the foundation of your plan review submission. Recent reports from your treating team carry the most weight, particularly when they specifically address functional impacts and support recommendations. Your GP should provide a comprehensive health summary covering any changes in your condition, new diagnoses, or medication impacts on your daily functioning.

Allied health professionals play a crucial role in demonstrating support needs. Occupational therapy assessments are particularly valuable as they directly address daily living skills, home modifications, and assistive technology needs. Speech pathology reports support communication-related funding, whilst physiotherapy assessments justify exercise physiology and mobility supports. Psychology reports are essential for mental health supports and behaviour intervention funding.

Ensure all professional reports are dated within six months of your review request and include specific recommendations with costings. For example, if your occupational therapist recommends 2 hours per week of daily living support, this should be clearly stated with reference to current NDIS pricing. The current support worker rate ranges from $54.48 to $81.88 per hour depending on timing and location.

Functional assessments provide objective evidence of your support needs across different life domains. The most recognised assessment tools include the Supports Intensity Scale (SIS), WHODAS 2.0, and the Adaptive Behaviour Assessment System. These assessments must be conducted by qualified professionals and clearly demonstrate how your disability impacts your functional capacity.

Your functional assessment should cover six key life areas: home living, community living, learning, employment, health and safety, and social activities. Each area should be scored and compared to age-appropriate norms, with clear recommendations for support levels. For participants with intellectual disability, cognitive assessments using tools like the WISC-V or WAIS-IV provide additional evidence for support intensity requirements.

Physical function assessments are crucial for participants with physical disabilities. These should include mobility assessments, activities of daily living evaluations, and environmental access reviews. The assessment should specify support hours needed and link directly to NDIS support categories and pricing schedules.

Demonstrating progress towards your current goals whilst identifying new aspirations is crucial for plan review success. Your evidence should show both achievements and remaining gaps that require ongoing or increased support. Support coordinators play a vital role in documenting goal progress, particularly for Category 7 (Support Coordination) and Category 8 (Improved Life Choices) outcomes.

Document specific examples of goal achievement with measurable outcomes. For instance, if your goal was independent grocery shopping, provide evidence of current capacity, frequency of successful trips, and remaining support needs. Include photos, receipts, or diary entries that demonstrate real-world functioning improvements.

New goals should align with NDIS outcome domains and demonstrate reasonable and necessary support requirements. Employment goals might require vocational assessments and workplace support recommendations. Independent living goals need occupational therapy input and potentially Supported Independent Living (SIL) assessments for Category 1 supports.

Different support categories require specific types of evidence to justify funding increases. Understanding these requirements helps you gather targeted documentation for your review. Each category has distinct evidence standards and pricing structures that must be addressed in your submission.

Category 1 (Core Supports - Assistance with Daily Personal Activities) requires functional assessments demonstrating support needs in personal care, domestic assistance, and community access. Category 6 (Capacity Building - Support Coordination) needs evidence of coordination complexity and participant goals requiring professional navigation support.

Significant life changes trigger plan review rights under Section 48 and require comprehensive documentation. These changes might include housing transitions, relationship changes, employment status shifts, health deterioration, or family circumstance variations. Each change type requires specific evidence to demonstrate impact on support needs.

Housing changes need tenancy agreements, support worker assessments of new environments, and potential home modification reports. Relationship changes affecting informal supports require statutory declarations and updated carer assessments. Health changes need recent medical reports with functional impact statements and updated medication lists.

Employment circumstance changes require vocational assessments and workplace support evaluations. Starting work might increase transport and support coordination needs, whilst job loss might trigger mental health support requirements. Document these impacts with specific examples and professional recommendations linking to NDIS support categories.

The NDIS plan review process follows strict timelines that affect your funding continuity. Submit your review request and evidence at least 60 days before your current plan expires to avoid funding gaps. The NDIA has 49 days on average to process reviews, but complex cases can take longer.

Contact the NDIA on 1800 800 110 to initiate your review request. You'll receive a review form to complete alongside your evidence submission. Organise your evidence into clear categories matching NDIS support areas, and include a cover letter summarising key changes and requests.

If you're dissatisfied with your review outcome, you have rights under Section 100 of the NDIS Act 2013 to request an internal review within three months. This process requires additional evidence addressing the NDIA's decision reasons, so keep detailed records of all communications and decisions.