The National Disability Insurance Scheme (NDIS) is designed to support Australians living with a permanent and significant disability. However, one of the most common questions is: What disabilities does the NDIS cover? Understanding whether you or someone you care for is eligible can be confusing, especially when dealing with complex conditions or symptoms that don’t always fit neatly into a box.
Understanding NDIS Eligibility
The NDIS doesn’t cover every health condition or medical issue. To be eligible, a person must have a permanent and significant disability that affects their ability to participate in everyday activities without support.
To qualify for the NDIS, you must meet the following criteria:
- Be aged under 65 at the time of application
- Be an Australian citizen, permanent resident, or hold a Protected Special Category Visa
- Live in an area where the NDIS is available
- Have a permanent disability that significantly impacts daily living
- Show that you need ongoing support or access to early intervention services
The disability can be intellectual, physical, sensory, cognitive, neurological, or psychosocial (mental health-related).
What Does “Permanent and Significant” Mean?
Permanent means the condition is likely to be lifelong.
It significantly affects managing tasks like communication, mobility, self-care, learning, social interaction, or self-management.
The NDIS does not fund treatment or diagnosis for temporary conditions or illnesses. Instead, it focuses on long-term functional support to help people with disabilities achieve greater independence and quality of life.
List of Disabilities Covered by the NDIS
The NDIS uses a system called the NDIS Operational Guidelines to assess eligibility. While each application is considered individually, the NDIS groups conditions into three main categories.
1. Conditions that Almost Always Meet the Criteria
These disabilities are typically accepted as meeting the permanence and functional impact requirements. You will likely be approved if you have a condition listed here and meet the other general eligibility rules.
Some examples include:
- Intellectual Disability
- Autism Spectrum Disorder – Level 2 or 3
- Cerebral Palsy
- Down Syndrome
- Spinal Cord Injury – Permanent
- Multiple Sclerosis (progressive forms)
- Motor Neurone Disease
- Blindness – from birth or early life
- Deafblindness
- Muscular Dystrophy
- Patau Syndrome
- Friedreich’s Ataxia
- Rett Syndrome
These conditions are known to have a lifelong impact on a person’s ability to function without ongoing support.
2. Conditions Likely to Result in Permanent Impairment
These include conditions that may not always meet the criteria but where the NDIS assumes a likelihood of permanent impairment. If you’re applying with a condition from this list, you’ll need to provide extra evidence showing the impact of your condition on daily life.
Examples include:
- Autism Spectrum Disorder – Level 1
- Epilepsy (uncontrolled)
- Hearing Loss (moderate to severe)
- Cystic Fibrosis
- Brain injury (acquired)
- Cleft Palate with associated developmental delay
- Dysphagia (chronic swallowing difficulties)
- Spina Bifida
- Congenital conditions affecting mobility or cognition
Approval depends on how the condition affects daily functioning. The NDIS often requests supporting documents from your doctor, allied health professional, or therapist.
3. Psychosocial Disabilities (Mental Health Conditions)
The NDIS recognises that mental health conditions can be disabling when they are severe and long-term and impact daily life. This is known as a psychosocial disability.
Conditions may include:
- Schizophrenia
- Bipolar Disorder
- Severe Depression
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive Compulsive Disorder (OCD)
- Anxiety Disorders (in some cases)
To qualify, you must show that your condition is ongoing, treatment is not resolving the impairment, and it significantly affects your ability to function independently.
What About Children?
Children under 7 years old with developmental delay or disability can receive support through the NDIS Early Childhood Approach.
- Global developmental delay
- Delayed speech and language
- Delayed motor skills
- Autism spectrum disorder
- Genetic conditions
Early support can significantly affect a child’s learning and interaction with others. Parents and guardians can seek help without needing a formal diagnosis to start the process.
Conditions That May Not Be Covered
It’s important to know that not every condition is eligible. The NDIS does not typically cover the following.
- Short-term injuries (e.g., broken limbs)
- Acute medical illnesses
- Health conditions that are treatable or not significantly disabling
- Chronic pain (unless it causes a disability-level functional impact)
- Age-related conditions (unless they existed before age 65)
NDIS funding is also not used for general medical treatment, medications, or rehabilitation, which are already available through other health systems.
The Importance of Functional Impact
One of the most important aspects of your NDIS application is showing how your disability affects your daily life.
- Needing help to shower, dress, or eat
- Difficulty communicating with others
- Needing someone to assist with mobility or transport
- Trouble with planning, organising, or remembering tasks
- Being unable to take part in work, school, or community activities
Even if your condition isn’t on a list, you may still qualify if you can show a permanent and significant impact. Supporting letters from your GP, therapist, psychologist, or specialist will help strengthen your application.
Conclusion
The NDIS covers a wide range of disabilities, from intellectual and physical to psychosocial and sensory. However, eligibility is not just about having a diagnosis; it’s about how the condition impacts your daily life.
If you or someone you care for is living with a disability and wants to know more, don’t hesitate to seek advice or speak to a local NDIS provider. Alliance Multicare Services can help guide you through the NDIS application process and ensure you receive the proper support. Contact us today at 1800 448 449 to help you move toward a more supported and independent future.
