What conditions are covered by NDIS?

The NDIS, or National Disability Insurance Scheme, is a government-funded initiative designed to support an estimated 500,000 Australians living with a disability each year. The idea of the scheme is to connect people living with disabilities with the services they need—including doctors, support groups, libraries, schools and sporting clubs. The NDIS also provides eligible participants with access to information about the support provided by each territory and state government.

You may be wondering what conditions are covered by NDIS? In short, the NDIS is intended to support people living with permanent or significant disabilities.

Permanent disability means the condition is likely to last for the rest of your life. Significant disability means the condition has a serious impact on your ability to undertake daily tasks.

The government divides NDIS eligibility into two lists—List A and List B. List A describes conditions that are highly likely to be eligible for NDIS support. List B describes conditions that may require a further assessment before approval.

Conditions falling under List A of the NDIS

A person is likely to be eligible for NDIS support if they live with one or more of the following conditions:

1. Intellectual disability, assessed and diagnosed as profound, severe or moderate according to DSM criteria. For example, an IQ score of 55 points or less and severe adaptive functioning deficits will generally indicate an intellectual disability.
2. Autism, as diagnosed by a multi-disciplinary specialist team, psychiatrist, paediatrician or clinical psychologist with experience in Pervasive Development Disorder assessment. The client must be diagnosed under current DSM-V criteria with Level 2 or Level 3 severity. Level 2 indicates a need for substantial support, while Level 3 indicates a need for highly significant support.
3. Cerebral palsy, as diagnosed by a qualified professional and assessed as Level 3, 4 or 5 on the GMFCS.
4. Several genetic conditions that result in severe or permanent physical and intellectual impairments. See the NDIS website for a full list of conditions.
5. Brain injury or spinal cord injury leading to hemiplegia, tetraplegia, quadriplegia or paraplegia, resulting in severe or complete loss of movement and strength in the affected limbs.
6. Permanent blindness in both eyes, as assessed and diagnosed by an ophthalmologist.
7. Permanent hearing loss (bilateral) of greater than 90 decibels in the better-performing ear.
8. Dead-blindness as diagnosed and assessed by an audiologist and ophthalmologist, resulting in severe or total permanent impairment of hearing and visual function.
9. Congenital absence or amputation of two limbs.

Conditions falling under List B of the NDIS

A person may be eligible for NDIS support after further assessment if they live with one or more of the following conditions (see the NDIS website for more details):

1. Conditions that result in an intellectual or learning impairment, including intellectual disability, Asperger syndrome, atypical autism or childhood autism.
2. Chromosomal abnormalities that result in permanent impairment and unspecified in List A.
3. Conditions are resulting primarily in neurological impairment, including Alzheimer’s disease, Parkinson’s disease, and other disorders affecting the central nervous system.
4. Conditions that result in physical impairment, including amputations, Harlequin type ichthyosis, rheumatoid arthritis, and cerebral palsy or similar conditions, not meeting the criteria of severity in List A.
5. Conditions are resulting in speech or sensory impairment, not including permanent blindness or permanent, severe hearing loss.
6. Conditions that result in multiple impairment types, such as albinism, Menkes disease and other congenital conditions.

Looking for help understanding NDIS eligibility?

The list of conditions covered by the NDIS scheme can be complicated and difficult to understand. At Instacare, we’re dedicated to helping our clients access the NDIS support services and information they need. Contact us today—our friendly team will happily answer any questions you may have.