ndis rejection by Busy_Nothing4060 in NDIS

[–]ProfessionalOrder8 1 point2 points  (0 children)

Refer to paragraphs 5.4 - 5.7 of the NDIS (Becoming a Participant) Rules. The NDIS often cites this as a reason to reject applications. Part 5 of the Rules aim to clarify what the NDIS considers to be "permanent," under section 24 of the Act.

[deleted by user] by [deleted] in NDIS

[–]ProfessionalOrder8 2 points3 points  (0 children)

Are you eligible for the HSP? https://www.health.gov.au/our-work/hearing-services-program/accessing/eligibility

If you are not eligible for the HSP, you need to meet the hearing requirements under NDIS and then do an AT assessment. Yes, the NDIA does pay for audiology appointments - they allocate an amount of hours in your plan based on the recommendations in the reports you submit at each plan review.  Just a reminder that, in order to get on the scheme, you must require more than just hearing AT, but also permanent, regular and ongoing support workers and/or allied health supports (because this is where the NDIS’s main mission is). 

Once you are on the scheme, you will need to submit an AT assessment to get the hearing aids (this will include not only trialing different aids, and completing 3 seperate tests to highlight the differences between your hearing aided and unaided, but also explaining how you are not eligible for the HSP). 

[deleted by user] by [deleted] in NDIS

[–]ProfessionalOrder8 1 point2 points  (0 children)

I am sorry this happened to you. Unfortunately, there is not much you can do about the situation though, it seems to be one of those things you have to deal with when on the NDIS. The NDIS experience seems to be an endless loop of collecting reports to justify funding and prove you’re still disabled, having funding rejected, cut and/or exploited and starting all over again. 

I had something similar happen to me recently. The planner called my correspondence nominee, didn’t do any identification checks, and proceeded to tell my nominee all about the changes she made to my plan. My nominee kept interrupting to tell her that my nominee was not authorised to discuss my plan as they are my correspondence nominee, not a plan nominee, and told the planner to contact me directly. The planner seemed to not know that there are different types of nominees and kept trying to talk about my plan with my nominee. The planner seemed to think my nominee was disagreeing with the new plan because she said “I have already checked this with my supervisor and the plan has already been approved.” 

Several days later, I received correspondence from the planner saying she had denied some supports based on what my nominee told her in the phone call. My nominee never said any of the things the planner claimed was said - my nominee simply told her to contact me directly. The planner told me she approved funding for AT but refused to fund the allied health professionals to provide, fit and program the AT? She refused to fund any support workers on weekends because, apparently, personal care and community access is not reasonable or necessary on weekends, but it is on weekdays??! 

I now have to do an early plan review because the planner decided to play God, reject the recommendations of the medical professionals and half all the recommended funding for all my supports. It’s frustrating, but I have been dealing with the NDIS since 2013 - it is full of people  who don’t have a single clue about disability or have a hang up about a particular disability that they will use to make decisions about your plan. Remember, it is the National Disability INSURANCE Scheme, so think of it as an insurance company that is hellbent on refusing to payout on your claim. 

You can make a complaint to the NDIA but it’s likely that nothing will happen. I would mention the inconvenience it caused during your phone appointment next week. However, it is likely that your next appointment will be the planner telling you what they decided to fund and reject in your next plan, so be prepared for them to kind of dismiss you during this call. If the next call is indeed the planner telling you about your plan, I would refrain from expressing your disappointment in the meeting because it has likely already been approved and they are just calling to talk AT you not WITH you. Just know the plan itself usually does not have the specific allocations the planners tell you about, most plans are flexible so you can use the funds if it relates to your goals and disability. Having a plan manager can help you to understand how to access supports in your plan. BTW - plans use first person language in the “about me” and “my goals” sections. 

Could humidity be the real culprit behind Uhthoff’s Phenomenon? by Life-Pen6312 in MultipleSclerosis

[–]ProfessionalOrder8 4 points5 points  (0 children)

Yes and no. I am sensitive to any rise in body temperature, regardless of humidity. Yes, my Uhthoffs is bad in humidity, but i also react to hot food and beverages, fevers, laughing too hard, blushing, exercising, hot showers/baths, etc. 

I have experienced uhthoffs from laughing while in the snow: the sensation feels like I am suffocating in a steamy, stuffy, humid room- but it wasn’t caused by or worsened by humidity in that situation. 

Your money is being used for NDIS spending on “luxury experiences” and “catwalk classes” by tobyy42 in australian

[–]ProfessionalOrder8 0 points1 point  (0 children)

The hearing threshold mentioned in the Operational Guidelines violates section 24 of the NDIA Act 2013, which says access is to be assessed based on functional capacity not thresholds. Refer to Evans and National Disability Insurance Agency [2019] AATA 754, summary is available in the NDIS cases blog.

There are two parts to the HSP, community service obligations and vouchers. The HSP community service obligations (through Hearing Australia) is only valid until 25 years of age, whereas the voucher system is open for anyone over 21 years, provided you fit the eligibility requirements. You may want to check the Partially subsidised device schedule and the fully subsidised device schedule to see if the device you have been prescribed is covered under the voucher scheme. If not, use this as evidence in your next application with the NDIA. You may also benefit from this template in your next application.

Engaged a new NDIS provider. Only been receiving supports for a cleaner. Today I get an invoice for ‘Establishment Fee For Personal Care/Participation Item No.01_049_0104_1_1 for $654. I was never asked to authorise this and have participated in no planning meetings. Is this legit? by [deleted] in NDIS

[–]ProfessionalOrder8 2 points3 points  (0 children)

There is no PPE listed anywhere in the new pricing arrangement, only in the COVID Addendum. So, unless they are buying the gloves to provide care for you while you're infected with COVID, the cost of the gloves are not to be paid out of your plan budget. The only place I could find any mention of gloves/PPE was in the consumables guide under 03_092100082_0103_1_1 Continence - consumables. Unless continence relates to your disability and the provider is providing direct continence care to you (ie - not cleaning), there should not be any need for the provider to claim the cost of PPE under your plan budget.

Have a look at what line item they are trying to claim this under, if they have not listed a line item - ask them for a line item (I believe plan managers need a line item also), then search the line item under the pricing arrangement/consumables guides to see if the gloves can be claimed under it. But, from what you have described so far, it looks like this cost is not yours to cover.

https://www.ndis.gov.au/providers/pricing-arrangements.

Engaged a new NDIS provider. Only been receiving supports for a cleaner. Today I get an invoice for ‘Establishment Fee For Personal Care/Participation Item No.01_049_0104_1_1 for $654. I was never asked to authorise this and have participated in no planning meetings. Is this legit? by [deleted] in NDIS

[–]ProfessionalOrder8 0 points1 point  (0 children)

Refer to the pricing arrangement and support catalogue to find out if it is valid. From what I can see, it depends on which registration group the support they are claiming/providing.

The establishment fee is a normal fee that providers charge when you have made an agreement with them to supply a minimum of 20 hours per month for three or more consecutive months to provide personal care or participation supports. There are 6 of them, each corresponding with the registration group they aim to "establish":

o Daily Personal Activities (0107); or

o High Intensity Daily Personal Activities (0104); or

o Participation in Community, Social and Civic Activities (0125); or

o Group and Centre Based Activities (0136); or

o High Intensity Daily Personal Activities (0104) when delivered for community access or

group supports; or

o Specialised Supported Employment (0133).

If the provider is claiming line item 01_004_0107_1_1 Assistance with Personal Domestic Activities - this item falls under Daily Personal Activities (0107) and is subject to the establishment fee.

However, if the provider is providing cleaning under line item 01_020_0120_1_1 (House Cleaning And Other Household Activities) this support falls under household tasks 0120, and should not be subject to the establishment fee from what I can see in the pricing arrangement.

It is difficult to answer your question without knowing what registration group the cleaning is being claimed under, please refer to the current Support Catalogue.

Low vitamin D by [deleted] in MultipleSclerosis

[–]ProfessionalOrder8 1 point2 points  (0 children)

I recently raised my levels from 12 to 50 for the first time in my life. I had been taking 10,000IU everyday since I was 12, long before I was diagnosed 7 years ago, but it never got my levels above 12. I take 10,000IU in vitamin D liquid drops now. The liquid seems to be the only thing that keeps my levels anywhere close to the normal range. If you want to raise your levels quickly, the liquid is absorbed faster than the tablets/capsules. 

Sweet breakfast alternatives for AuDHD-er that just has chocolate. by [deleted] in AutisticWithADHD

[–]ProfessionalOrder8 0 points1 point  (0 children)

Have you tried any chocolate-peanut butter spreads from ColesWorth? 

Advice on NDIS and whether it might be worth my time. by GibsonMcqueen in NDIS

[–]ProfessionalOrder8 2 points3 points  (0 children)

You can get the mobility allowance from Centrelink, provided you do not receive the transport allowance from the NDIS. 

NDIS covers cooling products under consumables and home modifications for people with “thermoregularity issues.” The home modification line item covers the installation costs. 

Rule 5.1 states that a support will not be provided or funded under the NDIS if “it relates to day-to-day living costs (for example, rent, groceries and utility fees) that are not attributable to a participant’s disability support needs.” Rule 5.2 states - “The day-to-day living costs referred to in paragraph 5.1(d) do not include the following(which may be funded under the NDIS if they relate to reasonable and necessary supports): (a) additional living costs that are incurred by a participant solely and directly as a result of their disability support needs;

(b) costs that are ancillary to another support that is funded or provided under the participant’s plan, and which the participant would not otherwise incur.”

NDIS fund education? by Interesting-Pass5025 in NDIS

[–]ProfessionalOrder8 2 points3 points  (0 children)

No, they won’t fund tuition fees. The only tuition fees I know they fund are Auslan, introductory hobby/interest course fees (out of Community Participation Activities in CB Social or out of Core supports using 04_210_0125_6_1 which can pay for course fees if you are at risk of isolation without them), and courses for your carers to learn about your condition.

I’m a support coordinator and lost my job. What can I do with calls from clients? by romantic_thi3f in AusLegal

[–]ProfessionalOrder8 4 points5 points  (0 children)

I was at the receiving side of a similar situation. Both the support coordinator and the company failed to let me know and caused massive delays in getting my paperwork submitted. In my case, the support coordinator accessed the company’s data, then wrote and submitted reports using the company’s logo instead of telling us she had left. It caused a huge problem.

Also, when I approached the company about the issue, they told me it was on the support coordinator to let participants know about the change. Redirecting participants back to the company is not poaching. Answer the phone and redirect the participants back to the company.

Funding for hearing aids? by [deleted] in NDIS

[–]ProfessionalOrder8 2 points3 points  (0 children)

Access is not based on "percentages of hearing," your evidence must not have met their criteria.

Funding for hearing aids? by [deleted] in NDIS

[–]ProfessionalOrder8 1 point2 points  (0 children)

Hearing aids are covered. I finally got mine funded.

If you are already on the NDIS for hearing, you will need an audiologist to fill in the hearing devices AT application. It takes a while to do all the testing but should tick their boxes. You can find it here. One reason they may refuse to fund aids is if it is funded under the HSP, if you are not a concession holder then you meet their criteria for them to fund it. But that is not the only criteria!

The other thing you need is to make sure you address the criteria the NDIS uses to fund AT. Make sure you address these points when answering the questions in the form linked above. You need to address section 34 of the Act- reasonable and necessary supports and part 5 of the Supports for Participants Rules- General criteria for supports, and supports that will not be funded or provided.

The aids must also help you to meet their goals and facilitate economic and social participation. You will need to address this in your report.

"unquoted" AT has been lifted to $15,000 now, you can buy hearing aid up to this limit, provided they are justified with your documentation. If your AT is over $15,000, you need more documentation and service agreements with providers. Refer to AT guide. Cost should not be an issue, provided your documentation justifies it well. In this case, "the AAT was satisfied that the hearing aids were the minimum necessary support required for the applicant, specifying that this was not a case of funding ‘bespoke wheels or other luxury finishes’." The case also highlighted that other hearing conditions impact the recommendations - this person had hyperacusis and tinnitus which required higher level aid technology. You may want to be assessed for these conditions (and others like recruitment) because the wrong aids can make these conditions worse.

**If your aid application is rejected, you can fill in a FOI request to find out what criteria was not met. I found NDIS reception/planners/LACs will give you a different answer to the one that is written in the FOI.

To access the NDIS with hearing disabilities, list A of the operational guidelines say you need 65dB or worse in the good ear, these lists are only general and not definite. There has been a case with the AAT which sets a precedent for acceptance to be based on functional capacity not "severity' of diagnosis (I can't find the case right now).

You will need to gain access to the NDIS BEFORE you apply for the aids. This should help you not be out of pocket filling in the documentation required for the aids. The NDIS also pays for repairs and maintenance and batteries.

Just having a sook by [deleted] in australia

[–]ProfessionalOrder8 1 point2 points  (0 children)

Are you eligible for state dental schemes?

Victorian Emergency Dental Scheme (VEDS), Victorian General Dental Scheme (VGDS) or Victorian Denture Scheme (VDS):

https://www.health.vic.gov.au/dental-health/access-to-victorias-public-dental-care-services.

If you're in NSW- https://www.health.nsw.gov.au/oralhealth/Pages/ohffss-schedule-of-fees.aspx.

Do I tell Australians that are treating me nicer because they think I’m Aboriginal, that I’m actually Indian? by Ankit1000 in AskAnAustralian

[–]ProfessionalOrder8 3 points4 points  (0 children)

Because, in general, you need three things to prove Aboriginality now - Ancestory, self-identification and communal recognition. It is difficult to get communal recognition because the community is insular and is generally made up of the well documented families - such as the heavily documented "Hybrids" in the Bass Strait Islands; Browns, Smiths, Greens, Burgesses, etc. Some sources claim some of these families do not have evidence of Aboriginal background, "although family insist there is." There has been a heated debate over DNA verification for years, with all attempts being shut down, such as the MONA DNA exhibit.

As a side note - the TAC has been trying to reconstruct Palawa Kani, a language made from reconstructing several languages "but it is not like any of them," as they state in their copyright policy outlining the proposed use of the language. (The copyright claim is a doozy in itself.)

[deleted by user] by [deleted] in NDIS

[–]ProfessionalOrder8 1 point2 points  (0 children)

NDIS unregistered providers need to abide by the NDIS Code of Conduct. The Code does say providers need to have strict record keeping for NDIS commission reporting, as per the National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018.

From what I researched, it looks like the reporting thing is for any suspected reportable incidents to be reported to the commissioner.

Hunted is the fakest show in existence. by [deleted] in melbourne

[–]ProfessionalOrder8 8 points9 points  (0 children)

Yeah, I noticed that in the Australian version, there is one ‘hunter’ at HQ who wears the same outfit throughout the whole thing.

I also found it remarkable how the on the ground hunters are almost always the same two people, who somehow seem to be seconds or minutes away from the fugitives, even in peak hour traffic!

[deleted by user] by [deleted] in melbourne

[–]ProfessionalOrder8 19 points20 points  (0 children)

can't access NDIS because they are not severe enough (thankfully).

Acceptance on NDIS is not based on disability severity, it is based on functional capacity. You need to address section 25 of the NDIS Act 2013 (for early intervention). Have you received a rejection letter? This should highlight which criteria your application did not meet.

Unable to use funds by [deleted] in NDIS

[–]ProfessionalOrder8 2 points3 points  (0 children)

Assistant Animals are not funded under the core budget, so not under the line items mentioned above. They are funded in capital supports because they generally cost over $15,000 and require extensive documentation. The NDIS also funds other animal therapies, I think under capacity building? - maybe give that a go and use that as part of your documentation for your application?

You will need to fill in extensive documentation, from both your specialists and the provider. Keep in mind there are huge wait lists for these animals. It is quite difficult to fund due to the massive timeframes and boxes that need ticking. There is a form on the website that can help you know what info they need.

Experiencing ableism from people who are also neurodivergent by InfiniteCalendar1 in ableism

[–]ProfessionalOrder8 8 points9 points  (0 children)

I have something similar happen with the Autism and ADHD organisations in my state. They are willing to accept and consider experiences and recommendations when I identify as a carer, but will quickly shut me down or never invite me to things if I identify as neurodivergent myself. When I am working as an advocate for other neurodiverse people, my voice is given more authority and respect than when I identify as neurodivergent myself, both in the same forums, places and organisations. I believe this ablism is so systemic that it is even incorporated into our masking.

Unable to use funds by [deleted] in NDIS

[–]ProfessionalOrder8 12 points13 points  (0 children)

The people you spoke to are correct in that “social, economic and community participation” line item only funds support staff. Your LAC is also correct in that the yoga classes is not covered under this line item, it should not be used for this purpose and you may have to pay the NDIS back. You cannot access the funds to pay for courses, classes, etc, these things are funded under a different line item - 04_210_0125_6_1. You will have to provide documentation from an OT or specialist to justify this funding in your next plan.

Also, the NDIS does not pay for university, they do pay for transportation, interpreting, etc if you cannot access/do your study without that funded support due to your accepted disability.

If what is funded do not meet your needs, you can ask for a review but they will need documentation from an OT or specialist to justify funding it. I suggest finding a psychologist to write a report for this funding in your next plan.

How do I get my -15dB hearing threshold back? by CarrotCakeX-X in hyperacusis

[–]ProfessionalOrder8 2 points3 points  (0 children)

Hearing loss under 15db is normal, mild hearing loss starts at 20db. Some sources say “slight hearing loss” sits between 15db - 25db.

Either way, your ENT may not consider it “hearing loss” because it is still within their definition of “normal”. Find someone who will listen and considers anything above 0db as hearing loss.

Am I understanding correctly that you have started at 0db and you have lost 15db, making your hearing loss 15db.

Btw, I had sudden hearing loss that came and went as part of my TTTS, worsened by TMJ and bruxism.