The NDIS widely covers a range of conditions that impact an individual’s physical, intellectual, cognitive, sensory, neurological, social, and psychological functioning. From physical impairments, neurological disorders, and sensory limitations to intellectual challenges and more, the NDIS leaves no stone unturned in its mission to enhance the quality of life for those it serves.
Understanding the range of disabilities covered by the NDIS is essential for anyone seeking support through this groundbreaking scheme. This wholesome guide will provide you with detailed insights into the diverse disabilities catered to by the NDIS, helping you make informed decisions about your support needs.
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Now, we provide a simplified breakdown of the conditions covered by the NDIS Guidelines under different lists and categories. Let’s dive right into it!
List A: Conditions Meeting NDIS Disability Requirements
The following List A by the NDIS Guidelines shows the conditions that are likely to meet the disability requirements. It encompasses health conditions often characterised by permanent impairment and psychosocial disability. These conditions, recognised as primary disabilities, typically qualify Australians for NDIS assistance. Health professionals and early intervention may play crucial roles in ensuring individuals with these conditions receive the necessary support and services.
- Intellectual Disability
- Cerebral Palsy
- Genetic Conditions
- Mucopolysaccharidoses (MPS)
- Osteogenesis Imperfecta
- Spinal Muscular Atrophies
- Spinal Cord or Brain Injury
- Permanent Blindness
- Permanent Bilateral Hearing Loss
- Amputation or Congenital Absence of Two Limbs
List B: Permanent Conditions Requiring Further Assessment
List B of the NDIS Guideline outlines conditions that may result in a permanent impairment and require more assessment. These conditions include intellectual disabilities, chromosomal abnormalities, neurodegenerative diseases like Alzheimer’s and Parkinson’s, physical impairments e.g. amputations and congenital absence of limbs, sensory disorders leading to blindness and hearing loss, as well as conditions that result in permanent types of impairment. These conditions cannot be corrected by surgery and are typically covered by the NDIS. They are essential to assess eligibility and access requirements for NDIS support, including global developmental delays.
These conditions encompass a wide range of disabilities, such as:
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Intellectual and Learning Impairments
- Intellectual Disability: Diagnosed and assessed as moderate, severe, or profound in accordance with the current DSM criteria.
- Pervasive Developmental Disorders: Includes autism, Asperger syndrome, and atypical autism.
- Chromosomal Abnormalities: Conditions such as Down syndrome (Trisomy 21), Fragile X syndrome, and Williams syndrome are covered.
- Alzheimer’s Dementia: Covered under neurological impairments.
- Motor Neuron Diseases: Including Amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease.
- Demyelinating Diseases: Multiple sclerosis and related conditions are eligible for NDIS support.
- Epilepsy: NDIS supports epilepsy management with funding for medication, seizure alarms, and epilepsy clinics.
- Multiple Sclerosis: Individuals with multiple sclerosis can access NDIS assistance for physiotherapy, mobility aids, and home modifications.
Resulting in Physical Impairments
- Amputation: Permanent loss of limbs or parts thereof.
- Mobility Impairments: This category includes conditions like paralysis, amputations, and muscular dystrophy.
- Congenital Absence of Limbs: Conditions where individuals are born without limbs.
- Spinal Cord Injuries: Assistance for assistive technology, personal care, and home modifications.
- Diseases of Myoneural Junction and Muscle: Including muscular dystrophies like Duchenne and Becker muscular dystrophy.
- Cerebral Palsy and Paralytic Syndromes: Conditions such as cerebral palsy, hemiplegia, and quadriplegia are covered.
Sensory and Speech Impairments
- Permanent Blindness: Individuals with corrected visual acuity less than or equal to 6/60 in both eyes or with significant visual field constrictions.
- Permanent Bilateral Hearing Loss: Greater than 90 decibels in the better ear.
- Disorders of the Choroid and Retina: Conditions like Retinitis Pigmentosa and Kearns-Sayre syndrome, resulting in blindness when not meeting severity criteria on List A, are included.
Conditions Resulting in Multiple Types of Impairment
- Various congenital conditions: Leading to permanent impairment with variable severity.
- Rett Syndrome: NDIS provides specialised support, including communication devices, respite care, and adaptive equipment for individuals with Rett syndrome.
- Prader-Willi Syndrome: Those with Prader-Willi syndrome can access funding for behavioural interventions, dietary plans, and accommodation support.
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List C: What if you’re receiving disability support in Western Australia?
As per List C by the NDIS Guidelines, an agreement exists between the NDIS and the Western Australian government to facilitate access to the NDIS for individuals in Western Australia who are already receiving disability support for medical conditions. This agreement allows a smoother transition to the NDIS.
- Age: You must be under 65 years of age when you apply.
- Residency: You should live in Australia permanently.
- Citizenship/Permanent Residency: You must be either an Australian citizen or a permanent resident.
Western Australian Programs for Eligibility
If you are part of a Western Australian-defined program, which includes various services like Supported Community Living, Day Options, and more, you might already meet most of the criteria to be eligible for the NDIS.
- WA state-administered NDIS covered
- Supported Community Living
- Community Residential
- Day Options
- Disability Professional Services
- Emergency Accommodation
- Local Area Coordinator Coordination
To establish your eligibility, you will need to provide specific evidence that you meet the above requirements. The evidence requirements will be outlined when you apply for the NDIS.
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List D: Permanent impairment/Early intervention under 7 years
These conditions from LIST D of the NDIS Guidelines can significantly affect an individual’s daily life activities and their ability to perform tasks. Examples of these conditions range from intellectual disabilities, chromosomal abnormalities, and global developmental delay to conditions like muscular dystrophies, cerebral palsy, and sensory impairments such as permanent blindness or deafblindness.
Conditions primarily resulting in Intellectual/ learning impairment:
- Global Developmental Delay
- Various syndromes and chromosomal abnormalities, such as Down syndrome, Fragile X syndrome, and more.
Conditions primarily resulting in neurological impairment:
- Various conditions like Friedrich’s ataxia, Niemann-Pick disease, and spinal muscular atrophies.
Extrapyramidal and movement disorders:
- Conditions like Parkinson’s disease, Shy-Drager syndrome, and more.
Diseases of myoneural junction and muscle:
- Conditions like Duchenne muscular dystrophy, Myotubular myopathy, and Paramyotonia Congenita.
Cerebral palsy and other paralytic syndromes:
- Various forms of cerebral palsy, including quadriplegia and hemiplegia.
Conditions resulting in sensory and/or speech impairment:
- Visual impairment and deafblindness.
Conditions resulting in multiple types of impairment:
- A wide range of genetic and congenital conditions, such as Gaucher disease, Pompe disease, and others.
- Conditions like Chiari malformation, Spina bifida, and VATER syndrome.
What types of Support are not funded by the NDIS?
The NDIS evaluates support requests to ensure they align with specific criteria and are directly related to your disability, excluding supports that may cause harm, replicate existing benefits, or cover unrelated daily living expenses or income replacement.
The NDIS may decline to fund a requested support under several circumstances. Firstly, if the support is likely to pose a risk of harm to you or others, it would not be considered for funding. Additionally, if the requested support is not directly related to your disability, the NDIS may choose not to provide funding. Moreover, if the requested support offers the same benefit as another support that is already funded in your NDIS plan, it may not be funded again.
The NDIS also refrains from funding supports that relate to day-to-day living costs, such as expenses like rent, groceries, or utility bills (e.g., water bills), which are not directly associated with your disability support needs. These living costs typically fall outside the scope of NDIS funding. Furthermore, the NDIS does not provide funding for supports that serve as income replacements.
These are some of the complexities you might encounter when navigating the NDIS funding process. But there’s no need to worry. Auspire Care is right here to guide and support you through it all. Our dedicated team of experienced professionals is well-versed in the NDIS landscape. We will help you understand what’s covered and how to make the most of your plan.
Contact Us today, and let’s embark on this journey together!