The National Disability Insurance Scheme (NDIS), rolled out nationally across Australia in 2016, is about providing “choice and control” for people with disabilities. Its self-stated goal is relatively simple to say: “To support a better life for hundreds of thousands of Australians with a significant and permanent disability and their families and carers”.

Achieving this, however, is no easy task. Disabilities are complex – there are countless faculties of the human body and facets of human experience that a disability can impact, along an extremely broad spectrum of severity. Getting it right was never going to be a ‘one size fits all’ proposition. On top of this, the still-fledgling scheme is struggling with major and well-publicised design and implementation problems.

Erin Pavy is the Director of Integrate Rehab, a private rehabilitation company that provides allied health services to people who have experienced significant injury. Integrate Rehab assists clients in completing their application for the NDIS to ensure that what they receive from the scheme is adequate to meet their needs. People who have received compensation payouts via a civil legal process (because they are victims of negligence or an accident) can still claim from the NDIS, although their payout is taken into account. However, many mistakenly believe that a payout means they are ineligible to access the NDIS.

This is why, says Erin, organisations that know the detail and the system can make big differences in real lives: “Extra criteria need to be addressed in these cases and when this is not done accurately or persuasively, the funds granted to the applicant are often lower than they should be. We have seen numerous NDIS plans that fall short of what is reasonable and necessary. Support is available to hold the NDIS accountable by getting a quality plan.”

Erin also emphasizes that “Getting the plan right is just chapter one. After that, we oversee and support the implementation of the plan and monitor that the client is accessing supports.”

In one case that Integrate Rehab consulted on, the mother of a child with a disability had applied for the NDIS and was granted $39,000 per year. That plan did not cover the reasonable and necessary supports for the child, lacked detail and was generally inadequate. The financial administrator for the child got involved and supported the mother by engaging Integrate Rehab to assist. After a full professional reassessment of the child’s needs, the NDIS were required to produce a new plan that more than doubled the initial inadequate plan. The family was able to access the funds and start paying for the supports the child needed.

“In cases of compensation fund clients, the role of a financial administrator should be a great enabler and support,” says Katrina Harper, National  Manager, Health and Personal Injury at Equity Trustees. “Companies like ours have a fiduciary obligation to secure adequate funding for their clients, and while some take a hands-off approach that leaves all of that responsibility with the clients themselves, at Equity Trustees, we take our fiduciary obligation very seriously and actively pursue the best possible outcome in every case.

“For people who receive compensation payouts, we’re talking about money that is there to take care of them often for the rest of their lives. As a financial administrator we need to make sure that money does that – and that they have the services and supports to live as well and as comfortably as possible in their circumstances,” she said.

Katrina and Erin agree that a two-pronged approach is a proven recipe for success.

“It starts with Equity Trustees taking the initiative in identifying clients who don’t receive NDIS funding but maybe should,” Katrina explained. “We then refer those clients to Integrate for a formal assessment and from there, both of us, together with the client, embark on a journey to determine exactly what they’re eligible for and to advocate for them and secure an optimal outcome.”

Persistence and excellent professional skills are important. It’s common, explains Erin, for clients who get a rejection or low funding assessment to think it’s their fault; that their application just wasn’t strong enough and nothing more can be done. “However, commonly it’s the NDIS not getting the right information in the first place, and then not interpreting the information properly,” says Erin.

“The NDIS is still a new scheme and continually evolving. They have big problems and participants should not suffer because of those problems. The support of a professional organisation whose people understand the NDIS is crucial. We ensure that our information provided to the NDIS is thorough and clear, which helps the NDIS get plans to where they need to be legally, with all reasonable and necessary supports properly costed and covered. We do our best to make sure the client doesn’t get short-changed.”

The NDIS, like all government schemes, is legally accountable. Clients whose plans remain inadequate can ask an independent tribunal to review their plans. Integrate has been involved in many such matters, pulling together all the requisite information and providing it as necessary to the client’s legal representative.

While the upfront costs and effort associated with an appeal can be off-putting, Erin says “The vast improvements in the NDIS plans have far outweighed the cost and time involved.” For some clients, a successful appeal has meant as much as hundreds of thousands of additional funding dollars, which translates to a significantly improved quality of life. Happily, to date, all tribunal cases that Integrate Rehab have provided expert evidence on have been decided in the client’s favour.

A financial administrator that takes their job seriously will always ensure their clients are not only receiving the funds they need for the present but are also being set up for the future. This means potentially investing that money or seeking out alternative funding streams that give them greater security and options for down the track.

“Wanting the best for our clients means not just ticking off the NDIS application and calling it a day,” says Katrina. “We’re always thinking about and – where opportunities presents themselves – finding ways to grow our clients’ financial means and security. The welfare of our clients is our number one priority, and knowing that the NDIS promises much, we have systems in place to make sure they deliver what they should for our clients.”

Equity Trustees Limited (ABN 46 004 031 298) AFSL 240975 and Equity Trustees Wealth Services Limited (ABN 33 006 132 332) AFSL 234528 are part of the EQT Holdings Limited (ABN 22 607 797 615) group of companies, listed on the Australian Securities Exchange (ASX:EQT).
This communication is intended as a source of information only. No reader should act on any matter without first obtaining professional advice which takes into account an individual’s specific objectives, financial situation and needs. 
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