Change of circumstances

What is a change of circumstances in the NDIS?

A change of circumstances is any event or change in a participant's life that affects, or might affect, their NDIS access, their status as a participant or their plan. The NDIS Act requires participants and people applying for the NDIS to tell the NDIA about these changes as soon as reasonably practicable. Reporting a change doesn't automatically change funding, but it can lead to a plan variation or reassessment.

The duty is in section 51 of the NDIS Act. It applies to participants and prospective participants, and covers both changes that have already happened and changes the person becomes aware are likely to happen. Under section 52, the NDIA must approve the way changes are to be reported and tell each person in writing how to do it.

The phrase is used in two related ways:

• The reporting duty — telling the NDIA about something that may affect your access, status or plan.
• A reason to change the plan — a change in personal or environmental circumstances is one of the grounds for asking for a plan reassessment.

What counts as a change of circumstances

The Act doesn't give an exhaustive list. The test is whether the change affects, or might affect, the person's access request, participant status or plan. Changes that commonly meet that test include:

Smaller administrative changes, such as new contact details or bank details for self-managed funding, also need updating with the NDIA so letters and payments reach the right place. If the change affects how you pay for supports, the NDIA's guide to using your funding explains the rules for each way of managing a plan.

How to report a change of circumstances

Report the change in the way the NDIA has told you in writing, because the Act requires that manner to be used. The NDIA's website lists current contact options. A local area coordinator, support coordinator or nominee can help.

Overseas travel

Section 40 of the Act gives participants a 6-week grace period when temporarily absent from Australia. If you stay away longer, your plan is suspended from the end of the grace period until you return, unless the NDIA has agreed to a longer grace period. A decision not to extend the grace period is reviewable.

Change of circumstances vs plan variation vs reassessment

Reporting a change and changing the plan are separate steps. Telling the NDIA something meets your reporting duty; if you also want your supports to change, ask for a plan variation or a reassessment.

Under the current Act, a participant-requested reassessment must meet the conditions in section 48A: a significant change in the participant's ongoing disability support needs, caused by a significant and ongoing change in functional capacity or by a change in personal or environmental circumstances. The NDIA's summary of legislation changes explains how variations and reassessments work since the NDIS Act amendments, so check it before relying on a change of circumstances as grounds for reassessment.

What the NDIA can do after you report a change

Once the NDIA knows about a change, it has several options under the Act:

• Do nothing if the plan still fits.
• Vary the plan, either at your request or on its own initiative, for changes the Act allows without a full reassessment.
• Reassess the plan on its own initiative, which it can do at any time.
• Ask for information or documents where it has reasonable grounds to believe you hold information relevant to matters such as monitoring supports or other supports you receive.

Decisions to vary or not vary a plan, or not to reassess it, can be reviewed if you disagree.

What providers should know

The section 51 duty sits with the participant, not the provider. But providers often notice changes first, and their records become the evidence for a variation or reassessment. Good practice includes:

• Recording changes in support needs factually in progress notes and incident reports, with dates.
• Telling the participant, nominee or support coordinator when the support you deliver no longer matches the plan.
• Reviewing the service agreement when a participant moves, changes plan or changes management type.
• Getting consent before sharing information with the NDIA or others.

Don't report a participant's circumstances to the NDIA on their behalf without authority. Help them report it themselves or through their nominee.

Common mistakes

• Assuming reporting a change will change funding. It won't on its own; ask for a variation or reassessment as well.
• Waiting for the plan reassessment date. The Act says report as soon as reasonably practicable, including changes that are likely to happen.
• Forgetting overseas trips. Absences longer than 6 weeks can suspend the plan.
• Not reporting compensation claims. Compensation has specific consequences for NDIS funding.
• Using the wrong channel. Use the manner the NDIA has approved and told you about in writing.