If you are trying to work out whether you or your child may be eligible for the NDIS, the starting point is the NDIS access criteria.
The biggest part of eligibility is usually not the diagnosis itself. It is whether there is a permanent impairment and whether that impairment has a substantial impact on functional capacity.
What is the NDIS?
The NDIS is the National Disability Insurance Scheme. It provides funding to eligible people with disability for supports that are related to their impairment and help with everyday life, independence and participation.
The scheme is designed to support people with disability over the long term, with funding based on their individual circumstances and support needs.
Who can access the NDIS?
To access the NDIS, you generally need to meet the basic access criteria. You must:
- be under 65 when you apply
- live in Australia
- be an Australian citizen, permanent resident, or Protected Special Category Visa holder
- meet either the disability requirements or the early intervention requirements
For most adults, the main question is whether the disability requirements are met.
What does the NDIS look at when deciding eligibility?
The NDIS looks at whether you have a disability caused by a permanent impairment.
That impairment may be intellectual, cognitive, neurological, sensory, physical or psychosocial.
It then looks at how that impairment affects your functional capacity in daily life.
What is functional capacity?
Functional capacity means how well you can manage ordinary daily activities.
The NDIS looks at whether your impairment substantially reduces your ability to do one or more of these things on most days:
- mobility
- communication
- social interaction
- learning
- self-care
- self-management
This is why eligibility is not just about having a condition. It is about how much that condition affects day-to-day functioning.
What does “permanent impairment” mean?
For NDIS access, the impairment needs to be likely to be permanent.
That means the NDIS needs evidence that the impairment is lifelong, or likely to be lifelong, even if the impact changes over time.
Some conditions fluctuate. Some are episodic. Some are degenerative. A person can still meet the permanence requirement if the overall impairment is likely to remain across their lifetime.
Do you need support with daily life activities?
One of the current NDIS eligibility questions is whether you usually need disability-specific supports to complete daily life activities.
If the answer is yes, and the other access criteria are met, that can support eligibility under the disability requirements.
What if you do not meet the disability requirements?
You may still be eligible under the early intervention requirements.
The NDIS may consider whether supports now could reduce your future need for support, or whether supports now could help your family or carers build the skills to support you.
What about children?
Children have a slightly different pathway.
The early childhood approach supports children younger than 9 with disability, and children younger than 6 with developmental delay.
If your child is under 9, an early childhood partner can help you understand the right pathway, gather evidence, and work out whether an NDIS access request is the right next step.
For children, the focus is still on functioning in everyday life. Evidence should explain the impact on areas like mobility, communication, learning, social interaction, self-care and self-management.
Do you need to be born with a disability?
No. The impairment may be present from birth, or it may happen later because of illness, injury, accident or another health condition.
What matters is whether the impairment is likely to be permanent and whether it substantially affects functional capacity.
What if you have a psychosocial disability?
You may still be eligible if your mental health condition results in a psychosocial disability that has a substantial impact on daily functioning and is likely to be permanent.
What are List A and List B conditions?
Some conditions appear on NDIS condition lists used in the access process.
List A conditions are usually accepted as likely to meet the disability requirements because they are associated with permanent impairment and substantially reduced functional capacity.
List B conditions are usually accepted as permanent impairments, but you still need to show how the impairment affects functional capacity, participation and your need for lifetime support.
Next steps
If you think you or your child may be eligible, focus on the evidence that explains functional capacity. This is often the part that makes the biggest difference.
- Check the access criteria
Make sure the age, residency and visa requirements are met. - Gather supporting evidence
Ask your GP, specialist or allied health professional to clearly explain the impairment, whether it is likely to be permanent, and how it affects daily life. - Submit your access request
You can apply through the NDIS, or get help from an early childhood partner or local area coordinator depending on your situation. - Wait for the access decision
If your application is approved, the NDIS will confirm whether access was met under the disability requirements, the early intervention requirements, or both.
Helpful resources:
Frequently asked questions
Do I need a diagnosis to access the NDIS?
A diagnosis can help, but the NDIS also needs evidence about impairment, permanence and functional capacity. The diagnosis alone is usually not enough.
Can I access the NDIS if my disability was caused by an accident or illness?
Yes. It does not matter how the impairment started. What matters is whether it is likely to be permanent and whether it substantially affects daily functioning.
Can I get the NDIS for mental health?
You may be eligible if your mental health condition results in a psychosocial disability that significantly affects everyday life over the long term.
What if my condition changes over time?
You may still be eligible if the impairment is likely to be permanent overall, even if symptoms fluctuate or become worse over time.
What if my child is younger than 9?
Your child may be supported through the early childhood approach. An early childhood partner can help you understand whether the NDIS is the right pathway and what evidence is needed.
What should my reports include?
Your reports should explain the diagnosis or condition, whether the impairment is likely to be permanent, and how it affects mobility, communication, social interaction, learning, self-care or self-management.
What changed after 1 January 2025?
For new participants, the NDIS now gives clearer information about how access was met, including the category of impairment used in the access decision.
