If the NDIA says no to a robotic pet: internal review and tribunal

If the NDIA has made a reviewable decision that leaves out funding for a robotic pet, you have 3 months from the day you received the decision to ask for an internal review. If you still disagree after the internal review, you have 28 days to ask the Administrative Review Tribunal for an external review. Before any of that, check who actually said no, because a plan manager declining an invoice is not an NDIA decision and needs a different response.

Step 1: Who said no?

Low-risk assistive technology costing less than $1,500 does not need NDIA approval before you buy it, so a refusal can come from several places.

Who said no	NDIA decision?	Where to go
The NDIA approved a plan without the funding you asked for	Yes	Steps 2 and 3
The NDIA decided not to vary your plan	Yes	Steps 2 and 3
Your plan manager will not pay the invoice	No	Step 7
A supplier will not sell or invoice the way your plan needs	No	Another supplier
An LAC, planner or coordinator said it would not be funded	Not on its own	Ask the NDIA whether a decision has been made

The NDIS asks participants to tell it which types of low-cost assistive technology they might need, so they can be included in the plan. If a robotic pet was never raised, the gap may be in the plan rather than in a decision. Our guide to talking to your LAC or planner about a robotic pet covers how to raise it.

Step 2: Is the decision reviewable?

The NDIS page on how to request a review of a decision lists common reviewable decisions, including when the NDIA decides:

• to approve your plan, which includes approving the NDIS supports it funds
• not to do a plan reassessment
• not to do a plan variation
• to vary your plan.

Some decisions cannot be reviewed. Budget reductions are the example the NDIS gives, and a participant with high support needs whose budget has been reduced can ask for a variation instead. The NDIA’s reviewing our decisions guideline has the full list. If the reasons for a decision are unclear, contact the NDIA and ask it to explain them before you go further.

Step 3: Internal review and the 3 month deadline

1. Note the day you received the decision and the date 3 months later.
2. Write down the decision you expected, why a different decision should be made, anything already sent that you want looked at again, and any new evidence you will provide.
3. Send the request using the NDIA’s request for a review of a decision form (PDF or Word), an enquiry through its service hub with supporting evidence, a letter with your evidence, a visit to a local office, or a call.
4. If the NDIA asks for more information, send it within 28 days or ask for more time.

Family, friends, your local area coordinator, your my NDIS contact or your nominee can help you ask for a review, as long as you tell the NDIA they have your permission. The review is done by a different person from the one who made the original decision.

Step 4: Evidence to add for a robotic pet

The evidence needs to show the pet is a disability support and not a pet or a toy, which are two of the things the NDIS supports lists exclude.

• A recommendation from an OT or other therapist that names the disability-related need and the plan goal. Our goal link and OT recommendation checklist sets out 10 points to cover.
• The plan goal in the participant’s own words, with a sentence on how the pet supports it.
• A product description that presents the pet as assistive technology and gives a price under the low-cost limit.
• Notes from any trial: when the pet was used, for how long and what changed.
• Safety points, such as secured battery covers.
• The rules that apply: our page on robotic pets and the NDIS supports lists explains the rows that matter.

Do not call the pet a toy, a gift or animal therapy anywhere in the request.

Step 5: External review at the Administrative Review Tribunal

You can go to the Administrative Review Tribunal only after the internal review is finished and you have its decision. The NDIS page on decision reviews says you must apply within 28 days of the internal review decision, and the Tribunal might give you longer depending on your circumstances. The Tribunal is separate from the NDIA and reviews decisions made by Australian Government agencies, departments and ministers.

During Tribunal hearings, a participant can use NDIS funding for disability-related supports such as personal care or communication support.

Step 6: Free help with a review

• NDIS Appeals Program. The Department of Health, Disability and Ageing funds this program for people seeking a Tribunal review of most NDIA decisions. Its support is free of charge, and its support persons are disability advocates available in every state and territory. You can use it once an internal review is complete and you have the outcome. An advocate can explain the process, help prepare documents and attend Tribunal conferences and hearings with you.
• Legal help. Legal Aid Commissions assess applications for NDIS Appeals legal services funding, with a 30-day processing period. In Victoria that is Victoria Legal Aid. Victorian organisations on the program’s provider list include Disability Justice Australia, Villamanta Disability Rights Legal Service, Leadership Plus and the Rights Information and Advocacy Centre.
• Finding someone near you. The Disability Advocacy Finder on Ask Izzy lets you filter by postcode or suburb, including for NDIS Appeals services. From Williamstown, search 3016.

Step 7: When a plan manager or supplier says no

If a plan manager manages your plan, you give them the invoice and any required documents and they handle payment and claims. A plan manager declining an invoice is not an NDIA decision you can take to internal review.

1. Ask for the reason in writing.
2. If the problem is the description, ask the supplier to reissue the invoice with an accurate product description, and send the therapist’s note with it.
3. If the Consumables budget is short, the NDIS says core funding can be used flexibly for low-cost AT, and that where there is no flexible funding it can discuss other options with you, which might include a plan variation.
4. If a provider does not deal with your concern properly, the NDIS Quality and Safeguards Commission takes reports about providers that do not respond to complaints effectively. It does not offer individual dispute resolution, and it refers questions about providers getting paid to the NDIA.

Our page on claiming a robotic pet from Consumables covers the payment steps. If the supplier was the problem, send us a new robotic pet enquiry for a different supplier and mention how your plan is managed.

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