Whether you’ve been with the NDIS for a while or are just getting started, chances are that you’ve come across the term ‘reasonable and necessary’. It’s often used when discussing whether the NDIS would fund a certain support or service.
It’s also one of the most challenging NDIS concepts to get your head around. But once you break it down, it becomes much clearer.
Having a good understanding of reasonable and necessary helps you use your NDIS funds in a way that meets the NDIS guidelines.
What is reasonable and necessary?
Reasonable and necessary is the funding criteria used by the NDIS. Simply put, reasonable is something that is fair and necessary is something you need because of your disability.
The NDIS funds reasonable and necessary supports connected to your disability to help you:
- Pursue goals and aspirations
- Increase independence
- Participate in the community, work or study
- Develop capacity to connect with and be part of the community.
Every item purchased with NDIS funds must meet all of the reasonable and necessary funding criteria. See our handy checklist below.
NDIS reasonable and necessary checklist.
To be considered reasonable and necessary, a support must:
o Be related to your disability needs
o Help you pursue your goals and aspirations
o Help you do activities that will improve your social and economic participation (like social activities and work or study)
o Be value for money (see below)
o Be likely to be effective and beneficial (considered best practice and will likely work for you)
o Complement (not replace) other informal supports including those provided by family and the community; and formal supports like health and education
o Be the responsibility of the NDIS to fund (not another organisation or government service).
By checking these off each time you prepare to purchase an item with your NDIS funds, you will be on track to ensuring you meet the criteria.
Every person is different so it’s important that you are prepared to demonstrate why a request should be deemed reasonable and necessary in your situation.
[Image: A man in a wheelchair sits at a desk in an office environment, using a computer.]
Value for money and the NDIS.
You might be wondering how the NDIS determines whether something is “value for money”. It’s a tricky concept because value can mean something different to everyone.
The NDIS considers the cost of a support relative to the benefits that it could achieve. For example, will providing a support worker to teach you cooking skills now improve your independence and reduce future costs?
It’s also important to consider the cost of alternative supports. Can the same effect be achieved with less money? For example, renting versus buying assistive technology.
The NDIS will only usually fund the minimum requirement. If a cheaper option meets your needs and delivers an equal result, you will be unable to purchase a more expensive option with NDIS funds. However, you may be able to pay the difference yourself.
Things that your NDIS Plan won’t cover.
NDIS funding doesn’t cover general day-to-day living costs that people without disability would be required to pay, such as train travel, rent, groceries, mobile phone or movie tickets.
The NDIS won’t pay for items that are likely to cause harm to you or other people, supports that are against the law or those that should be funded by another service such as Medicare or Centrelink.
Navigating the NDIS can be tricky. Let us help you prepare for your first meeting or plan reassessment meeting to ensure you’re prepared, confident and relaxed.
If you have any questions or would like to talk to one of our Crew about the unique benefits of Leap in! plan management please call us on 1300 05 78 78, email email@example.com or chat with us online.
Originally published 14 November 2018, updated 10 October 2022.