NDIS NAVIGATION 101 • MODULE 4

When Your Plan Isn’t Right

What to do if funding, supports or goals in your NDIS plan are incorrect or insufficient — how to ask for an internal review, prepare evidence, and escalate safely if needed.

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What You’ll Learn in This Module

  • The difference between an internal review, a plan review and external appeal
  • How to request an internal review and what to include
  • How to build an evidence bundle that clearly links to goals and functional impact
  • How to prepare for escalation if the review doesn’t fix the issue
  • Safe wording and a practical template you can use right away

Which Review or Route Do You Need?

There are different ways to challenge a plan decision. Choosing the right route makes a big difference. The common options are:

  • Internal review / review request — ask the NDIA to reconsider a specific decision. This is usually the first step.
  • Plan reassessment — request a new planning meeting if your needs or circumstances have changed.
  • External review (appeal) — if the internal review fails, there are independent review bodies you can approach (for example, an administrative tribunal). External routes are more formal and may have time limits.
Tip: Start with an internal review request and a clear evidence bundle — this resolves many problems without escalation.

How to Request an Internal Review

An internal review asks the NDIA to reconsider a decision. Keep your request focused, factual, and brief. Include:

  1. Reference: the decision you are asking to be reviewed (date, decision title).
  2. Short reason: one paragraph saying why you believe the decision is incorrect.
  3. Evidence summary: a bulleted list of the documents you attach and what each shows.
  4. Requested outcome: exactly what you want changed (e.g., an increase in hours, addition of a support).
  5. Contact details: who should be contacted for further information.
Where to send it: Follow the NDIA instructions in your letter/email, or use the NDIA online review request form. Keep a dated copy of everything you send.

Building a Concise Evidence Bundle

Evidence should be tightly linked to the functional impact and the supports you request. A compact, well-labelled bundle is easier for a reviewer to consider.

Recommended contents:
  • One-page summary (cover sheet) with your requested changes and why.
  • Latest allied health reports (highlight the sections that support your request).
  • Behaviour or function logs (short examples — 1–2 pages).
  • Progress notes showing current need and how supports will help.
  • Quotes/costing for funded supports, if relevant.
  • Any prior NDIA correspondence (letters, emails) referencing the decision.

Label everything. Use filenames or page headers like: “01_Cover_Sheet.pdf”, “02_OT_Report.pdf”, etc. In the cover sheet, state where each piece of evidence is relevant to your request.

Timelines & What to Expect

After you submit a review request, the NDIA will acknowledge receipt. Response times vary, but you should expect a confirmation and a timeframe for review. Keep copies of all communication and note dates.

Practical tip: If you don’t receive an acknowledgement within 7–10 days, follow up in writing. Ask for a named contact and an estimated decision date.

Sample: Internal Review Request (Template)

Subject: Request for internal review — [Decision reference / date]

Dear [NDIA officer name or “NDIA Review Team”],

I am writing to request an internal review of the decision dated [date] regarding [brief description of decision].

Why I am requesting review:
One short paragraph explaining why the decision is incorrect and how it affects daily life.

Requested outcome:
Clear statement of what you want changed (for example, “Increase funded therapy hours to X per week”, or “Add communication therapy”).

Evidence included:
• Cover sheet – summary of request
• Allied health report – [Therapist name, date]
• Examples / logs – dates

Please confirm receipt of this request and advise the expected timeframe for review. Thank you.

Yours sincerely,
[Your name] — [Participant name / NDIS number]
[Contact details]

If the Review Doesn’t Fix It — Escalation Options

If an internal review does not change the decision, you may consider external review or advocacy support. Typical next steps include:

  • Request a second internal review or clarification if new evidence is available.
  • Seek independent advocacy support — an advocate can strengthen submissions and represent you in dispute processes.
  • Consider external review — formal appeal processes exist (for example, tribunal review). External routes are formal and usually have strict time limits; seek advice early.
Important: External review processes can be complex. Consider getting advice from a legal clinic, community advocate or a support organisation experienced with NDIS appeals.

Activity: Draft Your Review Cover Sheet

Use the template below to prepare a one-page cover sheet that summarises your request and points the reviewer to the most relevant evidence.

Cover sheet structure

1. Participant name and NDIS number
2. Decision reference and date
3. Requested change (one sentence)
4. Why the decision is incorrect (3–4 short bullets)
5. Evidence list (with filenames and page numbers)
6. Contact details and request for acknowledgement

Ready for Module 5?

Module 5 covers advocacy and complaints — how to raise concerns safely and where to go for formal review or support.

Continue to Module 5 →