NDIS Eligibility and How to Apply: The Access Criteria, the Evidence and the Process

The access requirements

To become an NDIS participant you must meet all of the following:

• Age: under 65 on the day you apply.
• Residence: live in Australia and be an Australian citizen, permanent resident or Protected Special Category Visa holder.
• Disability or early intervention: meet either the disability requirements or the early intervention requirements below.

Most adults enter under the disability requirements. Most young children enter under early intervention.

The disability requirements

You must have an impairment (intellectual, cognitive, neurological, sensory, physical or psychosocial) that:

• is permanent, or likely to be permanent;
• substantially reduces your functional capacity in at least one of: mobility, communication, social interaction, learning, self-care or self-management;
• affects your ability to take part in work, study or community life; and
• means you are likely to need NDIS support for your lifetime.

The word doing the work is substantially. A diagnosis alone does not qualify anyone. Two people with the same condition can get different decisions because the NDIA is assessing what the impairment stops you doing, not what it is called.

The early intervention requirements

Early intervention is for people whose impairment is permanent (or, for children younger than 6, who have a developmental delay) and where getting support now is likely to reduce the support they need later, build capacity, or stop the impairment getting worse. Most children enter the scheme this way through the early childhood approach. Adults can too, particularly with psychosocial disability.

Note the change coming in 2028: from 1 January 2028, children aged 8 and under with developmental delay or autism and low to moderate support needs will be supported through the new Thriving Kids program rather than individual NDIS plans. Children already in the scheme keep their current eligibility until then. Our NDIS changes in 2026 guide has the detail.

Conditions that qualify automatically

The NDIA keeps lists of conditions that are likely to meet the disability requirements without further functional evidence (List A) and conditions that are permanent but need evidence of functional impact (List B). List A includes, for example, intellectual disability with a full-scale IQ below 70, cerebral palsy at GMFCS level III to V, autism at level 2 or 3, and permanent blindness or profound deafness. If your condition is on List A, the application is largely about proving the diagnosis. If it is not, the application is about proving the impact.

Evidence that works

The strongest applications contain reports from treating professionals that answer three questions in plain terms: what is the impairment, is it permanent, and what can the person not do because of it. Practical guidance:

• Use the NDIA's Access Request Form and Supporting Evidence Form; they prompt clinicians for exactly what the assessor needs.
• Get evidence from the professional most relevant to the impairment - a psychiatrist or psychologist for psychosocial disability, a paediatrician or developmental team for children, a neurologist for neurological conditions.
• Ask clinicians to describe function on a bad day, and to use words like "requires assistance with", "unable to" and "requires prompting", rather than "manages with difficulty".
• Include functional assessments where available - occupational therapy functional capacity assessments, WHODAS or Vineland scores, speech pathology reports.
• State clearly that treatment options have been explored and the impairment remains, because "likely to be permanent" is where many applications stall.

How to apply

1. Call the NDIS on 1800 800 110 or contact your local area coordinator or early childhood partner. You can make a verbal access request over the phone; the NDIA sends the forms to complete.
2. Complete the Access Request Form and gather your evidence. Your LAC can help you understand what is needed but does not make the decision.
3. Submit by email, post or through the NDIS portal.
4. Wait for the decision. The NDIA aims to decide within 21 days of a complete request. If it asks for more information you have 90 days to provide it (extended from 28 days under the October 2024 reforms).
5. If approved, you move to planning. Since October 2024, new plans are for 12 months with a total funding amount and 12-month funding periods.

Eligibility reassessments

The NDIA can check whether you still meet the access requirements, and does so more often since 2024, particularly for people who entered under early intervention. You will be asked for updated evidence and have 90 days to provide it. Not responding is treated as no longer meeting the requirements, so take the letter seriously and involve your support coordinator or LAC.

If you are not eligible

You can request an internal review within three months, then go to the Administrative Review Tribunal. Many people find that reapplying with better functional evidence is faster than reviewing a decision made on thin evidence. Outside the NDIS, foundational supports are being expanded through 2026 to 2028 for people with disability who are not participants, and people over 65 are supported through aged care - for in-home help that means the Support at Home program.

After approval

Your first decisions are how the plan is managed (self, plan or agency) and whether you need a support coordinator. Then you choose providers. The AusCareGuide NDIS directory lists every registered provider in Australia by state, suburb and support category.

Price limits on this page are from the NDIS Pricing Arrangements and Price Limits published by the NDIA and are current as at August 2026. Limits are usually updated each 1 July, and the NDIA can change them mid-year. Always check the current document on ndis.gov.au before relying on a figure. This guide is general information, not financial or legal advice.