Accessing NDIS funding can be extremely challenging for those living with a disability and their family members. If you’ve tried to access NDIS funding, or are in the process of having your funding approved, it’s almost a guarantee you’ve heard the term ‘reasonable & necessary’ before. So what can actually be deemed as a service that fits these criteria?
If you’re looking to be more prepared during your next planning meeting and want to have a better idea of the kinds of support you or your loved ones are entitled to, this is a must-read.
Reasonable and Necessary: What’s the Deal?
As a first, for a service to be deemed ‘reasonable & necessary’ it must be related to assisting you in bridging the gap between having a disability and living a more independent life. To break down the two terms.
Reasonable:
Your need for the service is fair. The NDIS doesn’t fund ‘nice to haves’, but they do recognise that everyone’s needs are different and there are things you may need to live an independent life. The need also has to be fairly priced (more on this below).
Necessary:
This means this is something that you need to meet your independence goals and milestones. For something to be deemed necessary, it must be linked to your disability.
Some of the key criteria that fall under a task or service that will be deemed reasonable & necessary include the following:
The task will assist you in pursuing your future goals and aspirations
One of the key missions of the NDIS is to assist you in reaching your future goals and aspirations, whatever they may be. For example, a reasonable goal could be becoming more healthy. This means you may be eligible for funding to participate in a sports team or see a nutritionist should a Doctor think you could benefit from an improved diet.
A criterion for a goal is it needs to be impactful and improve your overall quality of life, not just make things easier for those around you. This is an important distinction to make as the NDIS is about building your capacity and independence, not necessarily making things easier for carers or those in your support network.
The task or service should assist you in living a more independent and normal/ordinary life
The primary goal of the NDIS is to help participants to live more independent and ordinary lives. This means that any task or service that can help you to do this is likely to be reasonable & necessary and eligible for funding.
Some examples of this could be things like funding for a Disability Support Worker to help you with the activities of daily living in the form of personal care or domestic assistance. This is care where you may need help with getting dressed, bathing, cleaning around the house or meal prepping. For example, home modifications are covered by the NDIS because they can help you to be more independent in your everyday life. If you have a disability that affects your mobility, paying a professional to widen doorways, install handrails or modify a bathroom can all be funded by the NDIS if it can be demonstrated that these changes will increase your independence.
The NDIS is also there to help people with disabilities to prevent their symptoms or functional decline from deteriorating further. This could include things like funding for allied health services such as physiotherapy, occupational therapy or speech therapy.
It may help you develop confidence in participating in social activities and become a more active member of the community
For anyone that may be living with a disability to become more independent, becoming an active member of the community is highly important. The NDIS funds Community Participation programs which are a great way to help people with disabilities develop skills and confidence in social situations, as well as make friends.
These programs can be things like supported holidays or group outings, day programs or even just regular catch-ups with friends. If you’re looking for ways to get more involved in your community, the NDIS may be able to help you.
It could benefit you in entering the workforce
The NDIS participant employment strategy is a strategy outlined by the NDIA to help NDIS participants work towards becoming active members of the workforce and contribute to the Australian economy. Having a job can help provide a purpose and can assist in having a sense of achievement, social well-being and independence. It also means you may require less support from a personal Carer, having your day filled with engaging and challenging tasks while at work.
The Australian government understands that NDIS participants can have a range of barriers that make work more difficult, which is why they can provide funding for job coaches, work experience placements or even support to find and maintain employment. You may also be able to get funding for workplace modifications, mobility equipment or transport to and from work.
It’s also important that the service is great value for money
This falls under the term reasonable. The NDIS is not there to fund luxuries or necessities for day to day living that fall outside your disability. For example, the NDIS would not fund a new TV for someone with a disability or necessities like groceries that those with or without a disability need. It’s important to remember that your NDIS funding is there to help you live a more independent and normal life, not to make your life easier in general. For example, the NDIS would not be willing to fund paying for a Disability Support Worker to do tasks that you are able to do yourself with a little bit of effort. This would go against the criteria for helping you achieve a more independent life.
Reasonable & Necessary Explained
We hope you’ve found this blog informative. “Reasonable & Necessary” is very often a misunderstood term, however a little more understanding of the terminology and knowledge of the NDIS guidelines, you’ll be more prepared for your Planning Meetings and have a better idea of what kinds of support you or your loved ones are entitled to. If you have any questions or are on the lookout for an NDIS provider, get in touch with OSAN Ability Assist on 1300 799 941 to talk to a real person 24 Hrs/Day & 7 Days/Week. Alternatively, click here to see more about our mission and the range of services we offer NDIS participants.
