What should you do after an SDA refusal?
An SDA refusal does not have to be the final outcome. This article explains how to request a review, prepare supporting evidence and take further action if the NDIA does not change its decision.
An SDA funding appeal starts with reading the written decision carefully. Check whether the NDIA refused SDA entirely, approved a different design category, or changed the dwelling type or location in your plan.
Take these first steps:
- Record the date you received the decision.
- Ask for a copy of the reasons and any evidence used.
- Mark the deadline for requesting a review.
- Tell your support coordinator, occupational therapist and housing provider.
- Keep the decision letter, reports and emails together.
SDA is generally for people with extreme functional impairment or very high support needs. Review SDA eligibility requirements before deciding which parts of the NDIA’s reasoning you need to challenge.
How do you request an internal review?
An internal review of a decision asks an NDIA staff member who was not involved in the original decision to reconsider it. This is often called an SDA decision review or review of a reviewable decision.
You generally need to request the review within three months of receiving the written decision. Follow the instructions in your decision letter and clearly identify each outcome you want changed.
Your request should state:
- The date and details of the decision
- Why you believe the decision is incorrect
- The SDA design category, dwelling type or location you are seeking
- How the requested SDA relates to your disability support needs
- What evidence you are providing
Focus on facts rather than describing the decision as unfair. Explain what assistance you need at home, why ordinary housing or home modifications would not meet those needs, and what risks arise without suitable accommodation.
For a closer look at the review process, read how to review or appeal an NDIS decision.
What evidence supports an SDA funding appeal?
Strong supporting evidence connects your disability, daily support needs and housing requirements. A diagnosis by itself will rarely explain why SDA is reasonable and necessary.
An occupational therapist’s housing assessment may cover transfers, personal care, mobility, overnight support, access, safety and assistive technology. It should also explain why the requested SDA design category meets your needs better than other options.
Useful evidence may include:
- A functional capacity or housing assessment
- Reports from treating professionals
- Incident, falls or hospital records
- Statements from support workers or family
- Details of unsuccessful housing arrangements
- Evidence about available properties in Perth or regional Western Australia
- Quotes or information about alternative home modifications
Ask each professional to respond directly to the reasons in the refusal letter. An OT should explain your functional needs in plain terms and link their recommendations to everyday activities. You can also read what to expect from NDIS OT assessments before arranging an updated report.
What happens if the internal review is unsuccessful?
If the internal review confirms the original decision, you may apply to the Administrative Review Tribunal, known as the ART. The ART is independent of the NDIA and can review eligible NDIS decisions.
The usual application period is 28 days from receiving the internal review outcome. Extensions may be available in some circumstances, but you should act quickly and seek advice if the deadline has passed.
Before applying, check that you are challenging the latest internal review decision. Gather the review outcome, your NDIS plan, professional reports and all correspondence with the NDIA.
Legal assistance may be available through community legal centres or disability advocacy services in Western Australia. Your support coordinator can help organise records, but they cannot provide legal advice unless appropriately qualified.
If your needs have changed since the decision, a plan reassessment may also be relevant. That is different from arguing that the original SDA decision was wrong, so consider which process fits your situation.
Preparing your next step
An SDA funding appeal is easier to manage when you act within the deadline, respond to the NDIA’s reasons and provide evidence tied to your daily housing needs. Keep copies of every document and ask professionals to be specific about why the requested SDA option is required.
If you need help understanding SDA options in Perth or preparing housing information for your treating team, contact Innogreen. You can also review SDA design categories before discussing your preferred housing outcome.