NDIS Appeals Self-Help Guide

This page is a practical guide for people challenging an NDIS decision. It explains Tribunal language, how to apply, what happens after you apply, how evidence is gathered, and what to expect if your matter proceeds to hearing.

Important starting point

The NDIS is the National Disability Insurance Scheme. The NDIA is the National Disability Insurance Agency, which makes decisions under the scheme.

An NDIS appeal is a request for the Administrative Review Tribunal to take a fresh look at an NDIA decision after the NDIA has completed its internal review. The Tribunal looks again at the facts, the law, and the material before it and decides what the correct or preferable decision should be.

In most NDIS matters, the Tribunal reviews an NDIA internal review decision. That means there is usually an internal review stage first, and the written internal review outcome is the decision then taken to the Administrative Review Tribunal.

After you receive the internal review decision, you usually have 28 days to apply to the Tribunal. If you are out of time, you can still ask for an extension of time.

This page gives general information only. It is not legal advice. Each matter turns on the exact decision, the evidence, and the law that applies to that decision.

ART NDIS review page NDIS Act

Typical path after you apply

  1. Application lodged
  2. T-documents provided
  3. Case conference
  4. Further directions and evidence gathering
  5. Further conferences if needed as the issues narrow and the NDIA position becomes clearer
  6. Sometimes a third conference if more evidence is identified as helpful and still needs to be gathered
  7. Conciliation or further alternative dispute resolution if needed
  8. If unresolved, hearing
Before you apply

Check what decision you are actually challenging

The Tribunal reviews a specific decision, not your entire history with the NDIA. Start by identifying the exact decision and the letter that records it.

Key document

Keep the internal review outcome letter. This is important to use when applying for a review to the Tribunal.

Two common types of review

Access decisions

These usually focus on whether the person meets the access criteria. Evidence often centres on impairment, permanence, and functional impact.

Support decisions

These usually focus on the support itself, what it is for, how it relates to impairment, and why the evidence supports funding that support.

These are common examples only. They are not the full list of reviewable decisions.

How to apply and what to write

Keep the application simple. The first job is to identify the decision, attach additional evidence or documents, and briefly explain why you say the decision should be reviewed.

What you will need

  • your contact details
  • the date you received the decision
  • a copy of the decision letter
  • a very brief reason why you think the decision is wrong
  • details of any representative, if you have one

What the review is about

You do not need to write everything at this stage. A simple explanation is enough. You are asking the Tribunal to look at the decision again because you believe it is wrong.

Sample wording for the application form

“I seek review of the NDIA internal review decision dated [insert date]. I believe the decision did not properly apply the law and did not properly take into account the material before the decision-maker.”

Keep this short. You can explain things in more detail later.

Ways to apply

  • online through the ART application process
  • using the ART NDIS form and emailing it to reviews@art.gov.au

Internal review first

If you are still at the NDIA stage, focus first on the internal review process. The NDIA says requests for internal review usually need to be made within 3 months of receiving the decision in writing.

Tribunal language

Understanding Tribunal language in an NDIS appeal

These are words you are likely to see in Tribunal emails, directions, notices, and documents.

Applicant

The person asking the Tribunal to review the NDIA decision.

Respondent

The person responding to the application, in this case the NDIA, often through a lawyer or other representative.

Member

The Tribunal decision-maker who manages or decides the matter.

Registrar

A Tribunal officer who may manage conferences, directions hearings, and procedural steps.

Representative

A person acting for a party, such as a lawyer, advocate, or other authorised person.

Directions

Formal steps or orders made by the Tribunal about what must happen next, including dates for documents and evidence.

Directions hearing

A case-management event focused on process rather than final outcome and often preparing a timetable of events leading to hearing.

Case conference

An informal and private alternative dispute resolution event used to clarify issues, discuss evidence, and explore resolution options and pathways.

Conciliation

A more focused, usually longer meeting, similar to a case conference but often with decision-makers available to try and resolve the matter on the day. It is usually the last point before hearing becomes necessary.

T-documents

These are the documents the NDIA used to make the decision. They are taken from the NDIA case file and provided to the Tribunal as part of the review process.

Statement of Facts, Issues and Contentions

Often called SOFIC. It sets out the facts relied on, the issues in dispute, and the argument about how the law applies. It is usually a document leading up to hearing.

Statement of Issues

A document used during the alternative dispute resolution stage that helps outline the history, the issues in dispute, and the evidence that may still be needed. It can be updated as further evidence is sought and provided and is used to help case conference discussion.

Hearing bundle

The organised set of documents used for the hearing.

Summons

A formal Tribunal process requiring a person to produce documents or attend.

Interlocutory hearing

A procedural hearing held before the final hearing. It deals with issues of contention which may need to be resolved before final hearing.

Independent Medical Examination (IME)

An assessment by a medical or allied health professional arranged during the case. This may include an occupational therapist assessing functional capacity or another specialist assessing impairment, treatment, or the appropriateness of supports.

NDIA case manager

A person within the NDIA who manages the matter from the NDIA side. They are the person instructing the lawyers. These are the decision-makers on the NDIA side.

Solicitor, barrister, or counsel

Lawyers representing a party. In NDIS matters, the NDIA will usually engage solicitors, and sometimes barristers, to act on its behalf. Once engaged, the solicitor is often the main point of contact, but the NDIA case manager is still the instructing party.

Hearing

The substantive Tribunal event where evidence and arguments are presented. It is the final opportunity to put forward your case to a Tribunal member.

After you apply

Alternative dispute resolution and case management

Once the application is lodged, the NDIA will become involved through an NDIA case manager and, in many matters, through lawyers acting for the NDIA. The NDIA is required to act under a model litigant obligation. In practical terms, that means it should assist the Tribunal to reach the correct or preferable decision while properly setting out its position.

This is why the NDIA may produce documents such as a Statement of Issues or a Statement of Facts, Issues and Contentions. These documents help explain what the NDIA says the case is really about and what you may need to respond to.

T-documents

These are the documents the NDIA used to make the decision. They are taken from the NDIA case file and provided to the Tribunal as part of the review process. They often include the decision letter, reasons, reports, assessments, plans, and correspondence.

NDIA legal representatives

In many matters, the NDIA will engage lawyers after the application is lodged. Once engaged, the NDIA’s solicitor is usually the main point of contact for the process.

Statement of Issues during alternative dispute resolution

The Statement of Issues is usually provided during the alternative dispute resolution stage and often closer to conference dates. It helps set out the history, the issues in dispute, and the evidence the NDIA says may still be needed.

It can be updated as new evidence is sought and provided by the applicant or by professionals involved in the matter. It is used to help case conference discussion.

Requests for documents and medical information

As part of the process, the NDIA may seek additional documents, including reports or records from doctors, psychologists, occupational therapists, or other professionals.

This may involve asking you to provide the documents, or seeking a summons requiring a third party to produce them.

You can agree to these requests or you can challenge them. If a request is challenged, the Tribunal may need to decide the issue at an interlocutory hearing.

In some cases, documents may be produced for viewing first. You may have the opportunity to object to parts of the material before it is relied on in the case.

If you are unsure whether to agree or challenge a request for documents, you should consider seeking legal advice.

Case conference

Usually informal and private. It helps identify the decision under review, clarify what is in dispute, discuss evidence, and explore whether the matter can resolve early.

Directions hearing

A procedural case-management event. It may set dates for evidence, witness material, responses, and hearing preparation.

Independent assessments and reports

During the process, the NDIA may request or arrange further assessments. This can include an independent medical examination or reports from medical or allied health professionals.

These assessments may look at functional capacity, impairment, treatment, or whether a support is appropriate. You can consider these requests and decide how to respond. It is important that any assessment clearly reflects your actual day-to-day experience.

Case conference and evidence gathering

A case conference is a discussion about the current request, whether that is access, supports, or another reviewable decision. Two common areas are access and support requests.

In access matters, the focus is often on impairment, treatment history, and functional impact. In support matters, the focus is often on what support is being requested, why it is recommended, what it would achieve, and what happens if it is not provided or is provided at a lower level.

The purpose of the conference is to work out what is agreed, what is still in dispute, and what evidence would be most useful next.

Building your evidence

Evidence should clearly explain what your impairment is, what you are trying to do, what goes wrong, and what support is needed. Detail matters. It is important to explain what happens when the support is not there.

  • What is the impairment?
  • What exact task are you trying to do?
  • What happens when you try to do it?
  • What support is needed?
  • How often is it needed and for how long?
  • What does that support cost, where relevant?
  • What happens if the support is not provided?

Information the NDIA may ask from you

This can include a clearer explanation of your daily function, what happens when you try certain tasks, how often help is needed, how long it is needed for, and what happens when the support is not there.

Information the NDIA may ask from professionals

This can include reports from an occupational therapist, doctor, psychologist, physiotherapist, speech pathologist, or another professional relevant to your function, treatment, impairment impact, or support needs.

Access evidence

In access matters, it helps if the medical or allied health evidence is clear about the impairment, how it affects function, what treatment has been tried, why the impairment is ongoing, and what further treatment is recommended or not recommended.

The difference between a condition and an impairment matters. The condition or diagnosis is not the whole question. The focus is on impairment, meaning the loss of, or damage to, how the body or mind functions, and what that means in daily life.

Treatment evidence should explain what has been tried, what happened, why something was not tried if that is relevant, what else could help, and what the outcome of past treatment has been.

Support evidence

In support matters, be clear about what you are asking for. The evidence should come from the right professional, explain what they recommend, what the support would achieve, and what happens if it is not provided or is only provided at a lower level.

Where it makes sense, include quote or price detail so the recommendation is practical and specific.

Lived experience statement

A lived experience statement is often one of the most useful documents you can prepare. It is your practical day-to-day account of how your impairments affect you in real life.

What it should do

Show what a normal day looks like. Explain what you can do, what you cannot do, what takes longer, what breaks down, and what help, equipment, or supervision is needed.

What to include

Morning routine, showering, dressing, meals, medication, transport, communication, appointments, fatigue, regulation, mobility, pain, supervision, and what happens at night.

Other useful detail

Equipment, car modifications, home changes, rails, ramps, communication aids, alarms, routines, informal supports, and paid supports.

Simple structure you can follow

  1. What impairments affect you.
  2. What your day looks like from waking until sleep.
  3. Who helps you, when, and with what tasks.
  4. What happens if that help is not there.
  5. What equipment, modifications, or strategies you rely on.
  6. What risks, shutdowns, overwhelm, falls, distress, or deterioration occur.
  7. Why the support you seek is linked to actual daily function.

Conciliation

Conciliation is often the last opportunity to resolve the matter before hearing. It is a structured discussion aimed at reaching agreement.

The NDIA may put forward a proposed outcome. You are able to respond, negotiate, and propose a different resolution for consideration.

Not all matters resolve at conciliation, but it can narrow the issues or result in an agreed outcome without the need for a hearing.

Hearing

Preparing for hearing and what to expect

If the matter does not resolve through alternative dispute resolution, it may proceed to hearing. As the case moves toward hearing, there is usually a further exchange of documents and preparation steps before the hearing itself.

Lead up to hearing

Preparing for hearing

As the matter moves toward hearing, documents are exchanged and prepared. This often includes the NDIA providing a Statement of Facts, Issues and Contentions, which sets out their position.

You will have the opportunity to respond to this document and provide any additional material addressing the issues in dispute and supporting your arguments.

The Tribunal may also require a hearing certificate. This helps the Tribunal work out the likely length and dates of hearing by finding out how many witnesses there are and the availability of everyone involved.

Before hearing, the relevant documents are often organised into a hearing bundle so the member and parties can work from the same material.

Responding to the Statement of Facts, Issues and Contentions

Facts

Check dates, diagnoses, history, assessments, supports, and daily function. Correct anything wrong or incomplete.

Issues

These are the questions the Tribunal must decide. Keep bringing your material back to these issues.

Contentions

These are the NDIA’s arguments about the law and the evidence. Answer them directly and point to supporting material.

Creating Your Response

This is general guidance only. It is not legal advice.

Work through the Respondent’s document in order. Be precise. Use page and paragraph numbers. Check what they actually say and go back to the original evidence.

  1. State what you agree with.
  2. State what you disagree with.
  3. Explain why in short numbered paragraphs.
  4. Refer to exact evidence (report, page, paragraph).
  5. Link it to the legislation or rules where relevant.
  6. Check their claims carefully. They may get things wrong or present things selectively.
  7. Understand what the NDIA is saying and why, then respond to that directly.

Witnesses

You may need witnesses such as an occupational therapist, doctor, or other professional who understands your daily function and support needs.

There is Tribunal guidance for expert and opinion evidence, and an expert report cover sheet that can help professionals prepare their material. Experts should know the material they have provided, and it may be useful to show them the criticisms that have been made of their written evidence so they can be ready to address them.

Sometimes a written report is enough. Sometimes you may want the witness there to explain or clarify what they have written. In some matters, the NDIA may also ask that you provide a witness.

Let your witness know early that they may be required. In many cases, they may only need to attend for a short period, often around one to two hours.

It is usually better if witnesses are willing to attend. Relying on formal processes to require attendance can be more difficult, may upset your witness, and may make them less helpful.

The NDIA will generally be required to make its witnesses available for cross-examination. These could include IME professionals they sought during the alternative dispute resolution process. Focus your questions on the evidence they have provided and on anything that seems incorrect, inconsistent, or unclear.

Hearing day

How the hearing runs

Tribunal hearings are intended to be more accessible and less formal than a court. The Tribunal Member will usually explain the process at the start. Hearings are often conducted by video conference, though they can also be held in person if required. The NDIA will usually make a short opening. The Applicant may also make an opening if they wish, but this is generally not mandatory. The Tribunal Member controls how the hearing operates, so the exact order may vary.

Who goes first

The Applicant usually puts their case forward first because they are asking the Tribunal to change the decision. This means the Applicant will usually call their own witnesses first, often starting with themselves. A hearing schedule is often agreed in advance, though the Tribunal Member may change the order if needed.

Asking questions

The way questions are asked will change depending on the stage of the hearing. In general, there are two types of questions. Leading questions suggest the answer (for example, “You were there at 3pm, weren’t you?”). Non-leading questions allow the witness to explain in their own words (for example, “What time were you there?”).

In examination-in-chief, questions are generally non-leading so the witness can give their own evidence. In cross-examination, leading questions are usually allowed and commonly used to test or challenge the evidence. In re-examination, questions are generally non-leading again, unless the Tribunal allows otherwise. The Tribunal Member may allow or limit questions depending on how the hearing is conducted.

Examination-in-chief

This is where the party who called the witness asks them questions first. If the Applicant is the witness, they (or their representative) will lead their own evidence first. This is how the witness gives their main evidence and explains what they know and the key facts they rely on.

Cross-examination

This is where the other party asks questions of the witness. If the Applicant is the witness, the NDIA will usually ask these questions. If the NDIA calls a witness, the Applicant may ask questions. The purpose is to test the evidence and suggest a different view. The Tribunal Member may also ask questions at any time and controls how this process runs.

Important (Browne v Dunn rule): If you say a witness is wrong, mistaken, or incomplete, you should put that to them directly so they have a chance to respond. If you do not, the Tribunal may give that point less weight.

Re-examination

This is a chance to clarify issues that came up in cross-examination. It is not usually used to introduce new evidence, but to clear up confusion and bring the evidence back to the key points.

Using documents

Use the hearing bundle where possible and take the Tribunal to the exact page. If you cannot, refer to the page number of the individual document. You may rely on your own statement when giving evidence, but when questioning witnesses and in closing it is best to direct the Tribunal to specific documents.

Note (Jones v Dunkel): If a party does not call a witness who would reasonably be expected to give important evidence, the Tribunal may draw conclusions from that.

Taking notes

Take notes during the hearing, especially of important answers given by witnesses. Note anything that supports your case or seems inconsistent. These notes can be used in your closing submissions to refer back to what was said.

Closing submissions

This is where you bring everything together. Refer to your evidence, the bundle, and what was said during the hearing. Focus on the key issues and clearly state the decision you want the Tribunal to make.

Practical matters

Take your time. Ask for questions to be repeated if needed. You can request a break. If you need an interpreter, ask well in advance so it can be arranged. While less formal than a court, preparation and clear evidence are still important.

Need help with an NDIS appeal?

Self-help can take you a long way, but some matters become too complex to manage alone. If you are unsure what evidence is missing, struggling with documents, or preparing for hearing, get support early.

Contact MDAA