Operational Guideline – Access – Disability
Requirements
What is the purpose of this Operational Guideline?
1.
This Operational Guideline provides guidance to delegates in assessing whether a person meets
the disability requirements, which are part of the access criteria that must be met for a person to
become a participant.
Legislation
2.
Read s.24 of the National Disability Insurance Scheme Act 2013 (NDIS Act) and Parts 5 and 7 of
the National Disability Insurance Scheme (Becoming a Participant) Rules 2013 (Becoming a
Participant Rules).
Becoming a participant
3.
To become a participant a person must meet the age and residence requirements and either the
disability or early intervention requirements.
See s.21 of the NDIS Act.
4.
For further guidance, refer to the following Operational Guidelines:
a.
Operational Guideline – Access – Age Requirements
b.
Operational Guideline – Access – Residence Requirements
c.
Operational Guideline – Access – Early Intervention Requirements
See sections 21, 22, 23 and 25 of the NDIS Act and Parts 3, 4 and 6 of the Becoming a Participant Rules.
The disability requirements
5.
There are five separate factual matters that must be established when a delegate is determining
whether a person meets the disability requirements set out in s.24 of the NDIS Act.
6.
A person meets the disability requirements if:
a.
The person has a disability that is attributable to one or more intellectual, cognitive,
neurological, sensory or physical impairments or to one or more impairments attributable to a
psychiatric condition, and
b.
The impairment or impairments are, or are likely to be, permanent, and
c.
The impairment or impairments result in substantially reduced functional capacity to
undertake, or psychosocial functioning in undertaking, one or more of the following activities:
i.
Communication
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ii.
Social interaction
iii.
Learning
iv.
Mobility
v.
Self-care
vi.
Self-management, and
d.
The impairment or impairments affect the person’s capacity for social and economic
participation, and
e.
The person is likely to require support under the National Disability Insurance Scheme (NDIS)
for the person’s lifetime.
See s.24 of the NDIS Act.
7.
If a person is found not to meet one or more of the above criteria, the delegate should consider
whether the person could meet the early intervention requirements as an alternative.
8.
For children under 7 years of age (except where diagnosed with a condition on ‘List A at Appendix
A’ of this Operational Guideline) a delegate should first consider whether the child meets the early
intervention requirements, before considering the disability requirements.
Streamlined process where a delegate may be
satisfied that a person meets one or more parts of
the disability requirements
9.
This section gives guidance on the circumstances in which a delegate may generally be satisfied
that a person meets one or more parts of the disability requirements by reference to one of the lists
appended to this Operational Guideline.
10. For the avoidance of doubt, a person does not need to have a condition on List A or List B to
become a participant in the NDIS. These lists have been developed to streamline the access
process for people with a condition on one of these lists. The lists are not exhaustive and in no way
suggest that a person with a condition not on a list is excluded from the NDIS.
11. Where a person has a diagnosed condition that appears on ‘List A at Appendix A – Permanent
impairment/functional capacity – no further assessment required’, a delegate may generally be
satisfied that the person meets all elements of the disability requirements in s.24 of the NDIS Act
without requiring additional evidence. This is because the nature of the conditions on List A at
Appendix A is such that these conditions are considered to result in a disability that is attributable to
a permanent impairment that results in substantially reduced functional capacity. List A at
Appendix A is not exhaustive and in no way suggests that a person with a condition different to
those listed would not have a permanent impairment that results in substantially reduced functional
capacity.
12. Where a person has a diagnosed condition that appears on ‘List B at Appendix B – Permanent
impairment/functional capacity variable – further assessment of functional capacity required’, a
delegate may generally be satisfied that the person’s disability is attributable to a permanent
impairment without requiring additional evidence. This is because the nature of the conditions on
List B at Appendix B is such that they are generally considered to result in a disability that is
attributable to a permanent impairment. However, the severity of the resulting disability is variable
and people with these conditions will not necessarily have substantially reduced functional capacity.
Accordingly, a delegate would require further evidence to be satisfied that the person, as a result of
that impairment:
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
has substantially reduced functional capacity or psychosocial functioning;

their capacity for social or economic participation is affected; and

is likely to require support under the NDIS for the person’s lifetime.
13. List B at Appendix B is not exhaustive and in no way suggests that a person with a condition
different to those listed would not have a permanent impairment.
14. Where a person has already been considered eligible for certain state or territory schemes (listed in
Appendix C), the delegate would generally be satisfied that the person meets the Disability
Requirement. This is because some state and territory schemes have been assessed as having
eligibility requirements equivalent to the NDIS disability requirements and therefore the relevant
state or territory has already assessed that the person has a disability that is attributable to a
permanent impairment that results in substantially reduced functional capacity. The list at
Appendix C is not exhaustive and in no way suggests that a person who has not been found
eligible for a listed program or who is receiving supports from a program that is not listed would not
meet the disability requirement.
What is a disability attributable to impairment?
15. Under s.24(1)(a) of the NDIS Act a delegate is required to determine whether a person has a
disability and whether that disability is attributable to one or more intellectual, cognitive,
neurological, sensory or physical impairments, or to one or more impairments attributable to a
psychiatric condition. This is essentially a question of fact and a delegate should consider all of the
available evidence, including diagnostic evidence.
16. The Administrative Appeals Tribunal (AAT) considered the meaning of “disability” and “impairment”
in Mulligan and National Disability Insurance Agency [2014] AATA 374 (Mulligan). The AAT stated
that “disability” takes its meaning from the United Nations Convention on the Rights of Persons with
Disabilities Article 1 which refers to a:
“long term physical, mental, intellectual or sensory impairments which in interactions
with various barriers may hinder their full and effective participation in society on an
equal basis with others,”
17. The AAT also referred to the Explanatory Statement to the Becoming a Participant Rules which
explains that the focus of “disability” is on the reduction or loss of an ability to perform an activity
resulting from an impairment. The Explanatory Statement notes the NDIS “will be open to people
with a permanent disability which results in substantially reduced functional capacity” and explains:
“Although the definition of “disability” under these Rules does not precisely correspond
with that of the CRPD, the eligibility and assessment of need has been based on the
World Health Organisation’s International Classification of Functioning, Disability and
Health (ICF). The narrower definition of “disability” employed by the [NDIS] is aimed at
achieving a legitimate purpose by targeting those people with disability who have a
significant impairment to their functional capacity. This functional definition of disability
focuses on outcomes for the segment of the disability population that has the most
unmet need.”
18. The AAT also noted that a person may have a disability without necessarily meeting all, or even
any, of the disability requirements in s.24(1)(b), (c), (d) and (e). For example, a person might have a
temporary disability, or a permanent disability that has only minimal effect on functioning, or no
effect on his or her social or economic participation.
19. An “impairment” is a recognised intellectual, cognitive, neurological, sensory, physical or psychiatric
condition identified by a qualified professional as affecting a person. The AAT noted that
“impairment” commonly refers to a loss of, or damage to, a physical, sensory or mental function.
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20. The Access Request Form requires a prospective participant to provide information in relation to all
of the access criteria to support their request. Diagnostic information will generally be required to
determine whether a person has a disability attributable to an impairment. In relation to the
impairments listed in s.24(1)(a) of the NDIS Act, information about the person’s diagnosis may be
supplemented with other information about the person’s reduced functioning. It is expected that this
information will generally be provided in the form set out in the ‘Evidence of Disability’ form. The
NDIA can assist people to gather the necessary information if needed.
21. A delegate may refer people for a specialist assessment. If a person has made an access request a
delegate can request, within the limitations of s.26 of the NDIS Act, information that is reasonably
necessary, such as information on previously completed assessments or examinations. A referral
for an assessment or examination would only be expected to occur in limited circumstances, such
as where other sources of information have been exhausted or there is inconsistent information, the
information is outdated or a matter needs to be resolved to enable a decision to be made.
What is a permanent impairment?
22. The test in the NDIS Act is whether the impairment or impairments ‘are, or are likely to be
permanent’.
23. In some cases the available information will need to be assessed very carefully to determine
whether the impairments are, or are likely to be, permanent. The Becoming a Participant Rules set
out in legislation some circumstances in which an impairment is not permanent and also some
guidance on when an impairment may be permanent. A delegate must apply the criteria below in
assessing whether the impairments are, or are likely to be, permanent for the purpsoes of
s.24(1)(b) of the NDIS Act.
24. An impairment is, or is likely to be, permanent only if there are no known, available and appropriate
evidence-based clinical, medical or other treatments that would be likely to remedy the impairment.
See r.5.4 of the Becoming a Participant Rules.
25. An impairment that varies in intensity (for example, because the impairment is of a chronic episodic
nature) may be permanent despite the variation.
See r.5.2 of the Becoming a Participant Rules.
26. An impairment may be permanent notwithstanding that the severity of its impact on the functional
capacity of the person, may fluctuate or there are prospects that the severity of the impact of the
impairment on the person's functional capacity, including their psychosocial functioning, may
improve.
See r.5.5 of the Becoming a Participant Rules.
27. Under the Becoming a Participant Rules an impairment is, or is likely to be, permanent only if the
impairment does not require further medical treatment or review in order for its permanency or likely
permanency to be demonstrated (even though the impairment may continue to be treated and
reviewed after this has been demonstrated). In relation to this requirement:
a.
What is required is information that is sufficient to demonstrate to a delegate that the
impairment is permanent or likely to be permanent. This is matter of judgment but what the
Becoming a Participant Rules are trying to do is rule out cases where the permanency or likely
permanency has not been established because the person requires further medical treatment
or review before the permanency or likely permanency can be demonstrated.
b.
This does not mean that an impairment will not be permanent or likely to be permanent if it
requires further medical treatment or review. In addition to that described in paragraph 15a
above, in some cases an impairment may continue to be treated and reviewed after it has
been demonstrated that is permanent or likely to be permanent.
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See r.5.6 of the Becoming a Participant Rules.
28. If an impairment is of a degenerative nature, the impairment is, or is likely to be, permanent if
medical or other treatment would not, or would be unlikely to, improve it.
See r.5.7 of the Becoming a Participant Rules.
What is an impairment that results in substantially
reduced functional capacity or psychosocial
functioning?
29. The test in the NDIS Act is that the impairment or impairments result in substantially reduced
functional capacity to undertake, or psychosocial functioning in undertaking, one or more of the
activities listed in s.24(1)(c) of the NDIS Act.
30. An impairment results in substantially reduced functional capacity of a person to undertake one or
more of the relevant activities – communication, social interaction, learning, mobility, self-care, selfmanagement (see paragraph 4c above) – if its result is that:
a.
The person is unable to participate effectively in the activity, or perform tasks or actions
required to undertake or participate effectively in the relevant activity due to their
impairment, without assistive technology, equipment (other than commonly used items such
as glasses) or home modifications.
See r. 5.8(a) of the Becoming a Participant Rules.
For the purpose of paragraph 18a, commonly used items could include glasses, walking
sticks, non-slip bath mats, simple adapted kitchen utensils and dressing aids.
Commonly used items also include items such as bathroom grab rails, hand rails
installed at stairs and age-appropriate child safety locks.
In considering the role played by assistive technology, home modifications and
equipment, the delegate should usually only consider needs specific to the impact from
the person’s impairment and that are specifically designed to assist in increasing the
functional capacity and participation of people with disability. Such items would usually
be assessed and prescribed by a qualified practitioner such as an occupational
therapist, physiotherapist, speech therapist or continence nurse and may traditionally be
supplied through a specialist disability aids and equipment service or multidisciplinary
team.
A person is usually considered to be unable to undertake an activity effectively due to
their impairment if they cannot safely complete a task within an acceptable time period.
The person may complete the task more slowly or in a different manner to others and
still be considered to be effective in the task.
Or:
b.
the person usually requires assistance (including physical assistance, guidance, supervision
or prompting), from other people to participate in the activity or to perform tasks or actions
required to undertake or participate effectively in the activity. Delegates may also take into
account the person’s age and whether they are able to perform tasks that they would normally
be expected to perform independently at their age.
See r. 5.8(b) of the Becoming a Participant Rules.
For example, the need for assistance from other people on most days is inconsistent
with expectations of tasks or activities that would normally be performed independently
by a person of their age in one or more of these areas:
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





Communication (understanding and being understood by others)
Social interaction (making and keeping friends and relationships, behaving
within limits accepted by others, and/or coping with feelings and emotions)
Learning (understanding and remembering information, learning new things,
practicing and using new skills and ideas)
Mobility (moving around their home and community and/or performing other
tasks involving movement, e.g. using hands and arms)
Self-care (e.g. daily showering, bathing, dressing, eating, toileting and
grooming; and/or special health care needs attended to by self, family members
or carers)
Self-management (planning and organising daily life and managing household
personal finances)
In Mulligan the AAT considered the case of a person with chronic ischaemic heart
disease, cardiomyopathy, Conn’s Syndrome, and sciatica from two ruptured discs in their
lower back. The AAT accepted that the person performs most activities with difficulty,
often with a great deal of pain, and more slowly than they would without impairments.
However, the AAT considered that in the areas of mobility and self-care, the person
participates effectively, if not efficiently, and can complete tasks within a reasonable time,
for the most part without aids of any sort, and that the aids that the person does use
(being handrails, a grab rail, and an Easi-reacher), are commonly used by many people.
On this basis, the AAT was not satisfied that the person’s capacity in those areas is
substantially reduced.
Or:
c.
The person is unable to participate in the activity or to perform tasks or actions required to
undertake or participate in the activity, even with assistive technology, equipment, home
modifications or assistance from another person.
See r. 5.8(c) of the Becoming a Participant Rules.
For example, a person may require complete assistance as they are not at all able to
perform one or more essential daily activities or tasks appropriate to their age (e.g. a
person over the age of 3 years cannot stand, use their hands or arms to perform tasks,
communicate their needs in any way, and/or interact with others).
In Mulligan the AAT held that a person’s inability to mow a lawn for the purpose of
maintaining a tenancy did not amount to substantially reduced functional capacity.
31. For NDIS purposes, where the person’s impairment is fluctuating or episodic (e.g. due to a mental
illness or a condition such as epilepsy), substantially reduced functional capacity is determined
when the person’s impairment is fully treated and stabilised, (i.e. the person’s level of functional
capacity due to residual and long term impairment is determined in the periods between acute
episodes).
See r. 5.8 of the Becoming a Participant Rules.
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Substantially reduced functional capacity and
children – matters to consider
32. The above criteria are to be applied in a way that is appropriate to the child.
33. In particular with children under 7 years of age, and noting that for this group the recent diagnosis
and resulting impairment may not be fully resolved, a delegate may first consider the early
intervention requirements in preference to the disability requirements in determining whether a child
meets the access criteria.
34. When considering access in accordance with s.24(1)(c) of the NDIS Act and as described in r.5.8 of
the Becoming a Participant Rules, a delegate is to consider the impact on functional impairment for
the child relative to the result for other children of the same age. For example:
a.
The child requires more assistive technology, equipment (other than commonly used items
such as glasses) or home modifications to participate in one or more of the activities listed in
s.24(1)(c) of the NDIS Act than most other children of the same age, or
b.
The child usually requires more assistance than most other children of the same age to
participate in one or more of the activities listed in s.24(1)(c) of the NDIS Act ,or
c.
The child is unable to participate in the activities listed in s.24(1)(c) of the NDIS Act that would
usually be expected of most other children of the same age.
35. If a child’s impairment does not currently result in substantially reduced functional capacity but
could in the future, the delegate should consider whether the child meets the early intervention
requirements.
What is an impairment that affects a person’s
capacity for social and economic participation?
36. Under s.24(1)(d) of the NDIS Act, a delegate needs to be satisfied that the person’s impairment or
impairments is affecting their capacity for social and economic participation to meet this disability
requirement. For example, the impairment may be affecting the person’s capacity to look for and
maintain employment.
37. A delegate does not need to be satisfied that a person’s capacity for social and economic
participation is reduced or substantially reduced. It is enough for the person’s capacity for social
and economic participation to be merely affected by their impairment, which is a relatively low
threshold.
See Mulligan and National Disability Insurance Agency [2014] AAT 374.
When is a person likely to require support under the
NDIS for their lifetime?
38. The test in s.24(1)(e) is whether a person is likely to require support under the NDIS for their
lifetime. This requires a delegate to consider whether:
a.
the person is likely to require support of a kind that is funded or provided under the NDIS, and
b.
the support is likely to be required for the rest of the person’s lifetime.
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39. It is important to note that this test can include consideration of a person’s likely need for both
general supports provided under the NDIS and reasonable and necessary supports funded through
the NDIS.
40. In Mulligan the AAT held that the test in s.24(1)(e) does not require a delegate to be satisfied that
the supports likely to be required for the person’s lifetime meet all of the criteria for reasonable and
necessary supports specified in s.34 of the NDIS Act. At the same time, where the supports likely to
be required for a person’s lifetime clearly would be better met by other service systems, then the
person would generally not be considered to require support under the NDIS for their lifetime. The
National Disability Insurance Scheme (Supports for Participants) Rules 2013 provides guidance as
to what supports the NDIS will provide.
41. If an impairment varies in intensity (for example, because the impairment is of a chronic episodic
nature) the person may still be assessed as likely to require support under the NDIS for the
person’s lifetime, despite the variation.
See r.5.2 of the Becoming a Participant Rules and s.24(1)(e) of the NDIS Act.
Use of information
42. In considering whether a person meets the disability requirements a delegate should develop a
comprehensive view of the person’s circumstances including by:
a.
Examining all relevant available information provided by the participant (such as the selfassessment in My Access Checker and any diagnostic or assessment information provided),
and
b.
Talking with the person and (with the person’s consent) the person’s family, or carers.
43. Diagnostic information will generally be required to determine whether a person has a disability
attributable to an impairment and whether that impairment is permanent. Information about the
person’s level of functioning will generally be required to determine whether the person has
substantially reduced functional capacity or psychosocial functioning.
44. Information about the person’s level of functioning may be informed by a support needs
assessment, usually undertaken by a suitably qualified health practitioner, to assist with the access
decision.
45. Where the available information is not sufficient for a sound decision, the NDIA may request, within
the limitations of s.26 of the NDIS Act, information reasonably necessary to decide whether a
person meets the access criteria. Delegates can also request a prospective participant to undergo
an assessment or examination.
46. Where further information is being sought from the participant the request should clearly identify
what information is being sought and by when it must be provided, which must be at least 28 days
after the request date. If the request is to a third party, the delegate should inform the prospective
participant of the reason for the delay in making the decision.
See s.26 of the NDIS Act and
Operational Guideline – Information Handling –Collecting, Accessing and Recording Protected Information.
General considerations for delegates
47. A decision tree designed to assist decision makers in making and recording their decisions has
been developed and is attached. The decision tree should be completed for each prospective
participant, except a prospective participant who:
a.
Has a condition listed in List A at Appendix A of this Operational Guideline, or
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b.
Has been found eligible for a program at Appendix C of this Operational Guideline, or
c.
Is a child under 6 years of age who has developmental delay, or
d.
Is a child under 7 years of age who has a condition listed in List C at Appendix A to
Operational Guideline – Access – Early Intervention Requirement.
See Operational Guideline – Access – Decision Tree Disability Requirements and Early Intervention Requirements.
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Appendix A
List A – Conditions which are likely to meet the disability
requirements in s.24 of the NDIS Act
1. Intellectual disability diagnosed and assessed as moderate, severe or profound in accordance
with current DSM criteria (e.g. IQ 55 points or less and severe deficits in adaptive functioning)
2. Autism diagnosed by a specialist multi-disciplinary team, pediatrician, psychiatrist or clinical
psychologist experienced in the assessment of Pervasive Developmental Disorders, and
assessed using the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V)
diagnostic criteria as having severity of Level 2 (Requiring substantial support) or Level 3
(Requiring very substantial support)
3. Cerebral palsy diagnosed and assessed as severe (e.g. assessed as Level 3, 4 or 5 on the
Gross Motor Function Classification System - GMFCS)
4. Genetic conditions that consistently result in permanent and severe intellectual and physical
impairments:

Angelman syndrome

Coffin-Lowry syndrome in males

Cornelia de Lange syndrome

Cri du Chat syndrome

Edwards syndrome (Trisomy 18 – full form)

Epidermolysis Bullosa (severe forms):
o
Autosomal recessive dystrophic epidermolysis bullosa
o
Hallopeau-Siemens type
o
Herlitz Junctional Epidermolysis Dystrophica

Lesch-Nyhan syndrome

Leigh syndrome

Leukodystrophies:

o
Alexander disease (infantile and neonatal forms)
o
Canavan disease
o
Krabbe disease (globoid cell leukodystrophy) – Infantile form
o
Pelizaeus-Merzbacher Disease (Connatal form)
Lysosomal storage disorders resulting in severe intellectual and physical
impairments:
o
Gaucher disease Types 2 and 3
o
Niemann-Pick disease (Types A and C)
o
Pompe disease
o
Sandhoff disease (infantile form)
o
Schindler disease (Type 1)
o
Tay-Sachs disease (infantile form)
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

Mucopolysaccharidoses – the following forms:
o
MPS 1-H (Hurler syndrome)
o
MPS III (San Fillipo syndrome)
Osteogenesis Imperfecta (severe forms):
o
Type II - with two or more fractures per year and significant deformities severely
limiting ability to perform activities of daily living

Patau syndrome

Rett syndrome

Spinal Muscular Atrophies of the following types:
o
Werdnig-Hoffmann disease (SMA Type 1- Infantile form)
o
Dubowitz disease (SMA Type II – Intermediate form)
o
X-linked spinal muscular atrophy
5. Spinal cord injury or brain injury resulting in paraplegia, quadriplegia or tetraplegia, or
hemiplegia where there is severe or total loss of strength and movement in the affected limbs of
the body
6. Permanent blindness in both eyes, diagnosed and assessed by an ophthalmologist as follows:
a.
Corrected visual acuity (extent to which an object can be brought into focus) on the
Snellen Scale must be less than or equal to 6/60 in both eyes; or
b.
Constriction to within 10 degrees or less of arc of central fixation in the better eye,
irrespective of corrected visual acuity (i.e. visual fields are reduced to a measured
arc of 10 degrees or less); or
c.
A combination of visual defects resulting in the same degree of visual impairment as
that occurring in the above points.
(An optometrist report is not sufficient for NDIS purposes.)
7. Deafblindness confirmed by ophthalmologist and audiologist and assessed as resulting in
permanent and severe to total impairment of visual function and hearing
8. Amputation or congenital absence of two limbs
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Appendix B
List B – Conditions for which permanent impairment/functional
capacity are variable and further assessment of functional capacity
generally is required
Note: Synonyms for conditions are also shown e.g. condition/ synonym/ synonym
1. Conditions primarily resulting in Intellectual/ learning impairment


Intellectual disability
Pervasive developmental disorders not meeting severity criteria in List A of this Operational
Guideline or List C of Operational Guideline – Access – Early Intervention Requirements:
 Asperger syndrome
 Atypical autism
 Childhood autism
Chromosomal abnormalities resulting in permanent impairment and not specified on List A:





















Aicardi-Goutières syndrome
CHARGE syndrome
Cockayne syndrome Types I and Type II/Cerebro-oculo-faciao-skeletal (COFS) syndrome /Pena
Shokeir syndrome Type II/Weber-Cockayne syndrome/Neill-Dingwall syndrome)
Cohen syndrome
Dandy-Walker syndrome
DiGeorge syndrome /22q11.2 deletion syndrome/Velocardiofacial syndrome/ Shprintzen
syndrome/Conotruncal anomaly face syndrome
Down syndrome
Fragile X syndrome
Kabuki syndrome
Menkes disease
Prader-Willi syndrome
Seckel syndrome /microcephalic primordial dwarfism/Harper’s syndrome/Virchow-Seckel
dwarfism
Smith-Lemli-Optiz syndrome
Smith-Magenis syndrome
Spinal muscular atrophy Types III and IV
Sturge-Weber syndrome
Trisomy 9
Tuberous sclerosis
Turner syndrome
Williams syndrome
Wolf-Hirschhorn syndrome
2. Conditions primarily resulting in Neurological impairment
 Alzheimer’s dementia
 Creutzfeldt-Jakob disease
 HIV dementia
 Huntington’s disease
 Multi-infarct dementia
 Parkinson’s disease
 Post polio syndrome
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
Vascular dementia
Systemic atrophies primarily affecting the central nervous system:











Abetalipoproteinaemia
Adult-onset spinal muscular atrophy/late-onset SMA type III)
Fazio-Londe disease/Progressive bulbar palsy of childhood
Friedrich’s ataxia
Hereditary spastic paraplegia/ Infantile-onset ascending hereditary spastic paralysis/ L1
syndrome/ spastic paraplegias types 2 and 11Huntington’s disease/Huntington’s chorea
Louis-Bar syndrome/Ataxia-telangiectasia
Motor neuron disease/Motor neurone disease/ Lou Gehrig’s disease /Amyotrophic lateral
sclerosis
Primary lateral sclerosis
Progressive bulbar palsy
Spinal muscular atrophy – all types
Spinocerebellar Ataxia – all types, including Machado-Joseph disease
Extrapyramidal and movement disorders
 Hallervorden-Spatz syndrome /Pantothenate kinase-associated neurodegeneration
(PKAN)/neurodegeneration with brain iron accumulation 1 (NBIA 1)
 Parkinson’s disease
 Shy-Drager syndrome /Multiple System Atrophy /Striatonigral degeneration (MSA-P)/ Sporadic
olivopontocerebellar atrophy (MSA-C)
 Steele-Richardson-Olszewski syndrome/Progressive supranuclear ophthalmoplegia
 Stiff-man syndrome /Stiff-person syndrome
Other degenerative diseases of the nervous system
 Alzheimer’s disease
 Alpers disease/Grey-matter degeneration/Alpers syndrome/progressive sclerosing
poliodystrophy/progressive infantile poliodystrophy
 Lewy body dementia
 Pick’s disease
Demyelinating diseases of the central nervous system
 Adrenoleukodystrophy
 Multiple sclerosis
 Schilder’s disease /Diffuse myelinoclastic sclerosis – non-remitting
Episodic and paroxysmal disorders
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Brain stem stroke syndrome
Cerebellar stroke syndrome
Motor and sensory lacunar syndromes
Lennox syndrome /Lennox-Gastaut syndrome
West’s syndrome
Polyneuropathies and other disorders of the peripheral nervous system
 Adult Refsum disease
 Charcot-Marie-Tooth disease/Hereditary motor and sensory neuropathy/ peroneal muscular
atrophy
 Dejerine-Sottas disease /Dejerine-Sottas syndrome/Dejerine-Sottas neuropathy/progressive
hypertrophic interstitial polyneuropathy of childhood/onion bulb neuropathy
 Infantile Refsum disease
Operational Guideline – Access – Disability Requirements (v 3.2)
Publication date: 1 September 2014; appendix C updated December 2015
Page 13 of 19
Other disorders of the nervous system
 Hydrocephalus
 Multiple system atrophy
3. Conditions resulting in Physical impairment
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Amputations
Congenital absence of limb or part thereof
Epidermolysis bullosa
Harlequin type icthyosis
Juvenile arthritis / Stills Disease (excluding monocyclic/self-limited Adult Onset Stills disease)
Rheumatoid arthritis
Diseases of myoneural junction and muscle
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Andersen-Tawil syndrome/ Periodic paralysis /myoplegia paroxysmalis familiaris
Becker muscular dystrophy
Congenital muscular dystrophy
Distal muscular dystrophy
Duchenne muscular dystrophy
Emery-Dreifuss muscular dystrophy
Facioscapulohumeral muscular dystrophy
Limb-girdle muscular dystrophy
Mitochondrial myopathy
Myotonic dystrophy /dystrophia myotonica
Myotonic muscular dystrophy
Myotubular myopathy
Oculopharyngeal muscular dystrophy
Paramyotonia Congenita
Thomsens disease /Congenital myotonia/ Becker myotonia)
Cerebral palsy and other paralytic syndromes not meeting severity criteria on List A
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Cerebral palsy
Diplegia
Hemiplegia
Monoplegia
Paraplegia
Quadriplegia
Tetraplegia
4. Conditions resulting in Sensory and/or Speech impairment
Disorders of the choroid and retina where permanent blindness diagnostic and severity
criteria on List A are not met:
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Behr’s syndrome
Kearns-Sayre syndrome
Optic atrophy
Retinitis pigmentosa
Retinoschisis (degenerative and hereditary types/juvenile retinoschisis)
Stargardt disease
Usher syndrome
Operational Guideline – Access – Disability Requirements (v 3.2)
Publication date: 1 September 2014; appendix C updated December 2015
Page 14 of 19
Disorders resulting in hearing loss
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Cortical deafness
Pendred syndrome
Sensorineural hearing loss
Stickler syndrome
Usher syndrome
Waardenburg syndrome
5. Conditions resulting in multiple types of impairment
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Aceruloplasminemia
Addison-Schilder disease /Adrenoleukodystrophy
Albinism
Arginosuccinic aciduria
Aspartylglucosaminuria
Cerebrotendinous xanthomatosis /cerebral cholesterosis
Congenital cytomegalovirus infection
Congenital iodine-deficiency syndrome /cretinism
Congenital rubella syndrome
Glycine encephalopathy /non-ketotic hyperglycinaemia
GM1 gangliosidosis
Hartnup disease
Homocystinuria
Lowe syndrome/ Oculocerebrorenal syndrome
Mannosidosis
Menkes disease
Mucolipidosis II /I-cell disease
Mucolipidosis III /pseudo-Hurler polydystrophy
Mucolipidosis IV
Neuronal ceroid lipofuscinosis (NCL)/ Adult type (Kuf’s or Parry’s disease)/ Juvenile (Batten
disease)/ Late infantile (Jansky-Bielschowsky)
Niemann-Pick disease
Pyruvate carboxylase deficiency
Pyruvate dehydrogenase deficiency
Sialidosis
Sulfite oxidase deficiency
The following mucopolysaccharidoses:
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Scheie syndrome /MPS 1-H
Hurler-Scheie syndrome /MPS 1 H-S
Hunter syndrome /MPS II
Morquio syndrome /MPS IVA
Maroteaux-Lamy syndrome /MPS VI
Sly syndrome /MPS VII
Congenital conditions – cases where malformations cannot be corrected by surgery or other
treatment and result in permanent impairment but with variable severity:
 Arnold-Chiari Types 2 and 3/Chiari malformation
 Microcephaly
 Fetal alcohol syndrome
 Fetal hydantoin syndrome
 Spina bifida
 VATER syndrome /VACTERL association
Operational Guideline – Access – Disability Requirements (v 3.2)
Publication date: 1 September 2014; appendix C updated December 2015
Page 15 of 19
Appendix C
People who are eligible for certain state, territory or Commonwealth
schemes
Note: Where a prospective participant falls within one of the following schemes the delegate is not
required to refer to the Operational Guideline - Access - Decision Tree for Disability and Early
Intervention Requirements in relation to their assessment of that prospective participant.
a. Victoria
Clients of the following Victorian schemes will generally be considered to satisfy the disability
requirements without further evidence being required:

Individual Support Package (ISP)

Disability Support Register (DSR)

Futures for Young Adults

Supported Accommodation

Residential Institutions

Community Respite

Facility Based Respite

Therapy (complex therapy meeting guidelines under the Disability Act 2006 (Vic)

Behaviour Intervention Services

Flexible Support Packages

Outreach Support

Independent Living Training

Case Management (Case Management meeting guidelines under the Disability Act
2006 (Vic)

ECIS

ECIS Waitlist

MHCSS – Adult Residential Rehab Services

MHCSS – Individualised Client Support Packages

MHCSS – Supported Accommodation Services

Program for Students with Disability (PSD) – Vision Impairment

Program for Students with Disability (PSD) – Students enrolled in special schools for
students with moderate to profound intellectual disability
Operational Guideline – Access – Disability Requirements (v 3.2)
Publication date: 1 September 2014; appendix C updated December 2015
Page 16 of 19
b. Queensland
Clients of the following Queensland schemes will generally be considered to satisfy the disability
requirements without further evidence being required:

Service Access Team Assessed

Individual Funding

AS and RS (Accommodation Support and Respite Support)

Supported Accommodation (large/small residential, group homes, attendant
care/personal care, in home accommodation support and other accommodation
support)

Centre Based Respite

Registration of Need Database
c. Northern Territory
Clients of the following Northern Territory schemes will generally be considered to satisfy the
disability requirements without further evidence being required:

Supported Accommodation

Respite

Accommodation Support

Community Access
d. South Australia
Clients of the following South Australian schemes will generally be considered to satisfy the
disability requirements without further evidence being required:

SA Child and Youth Services

Individual Support Packages RCR Stage 1
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Individual Support Packages RCR Stage 2
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Individual Support Packages RCR Stage 3
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Individual Support Packages RCR Stage 3 - Sensory

Supported Residential Facilities (SRF)

Unmet Needs Register
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Supported Accommodation – Residential Institutions
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Supported Accommodation – Group Homes
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Therapy Services – Therapy Support
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Positive Behaviour Support
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Community Access
Operational Guideline – Access – Disability Requirements (v 3.2)
Publication date: 1 September 2014; appendix C updated December 2015
Page 17 of 19
e. Tasmania
Clients of the following Tasmanian schemes will generally be considered to satisfy the disability
requirements without further evidence being required:
f.

Individual Support Program
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Young People in Residential Aged Care

Self directed funding
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Accommodation Support – Group Home

Accommodation Support – Small/Large Resi/Hostel

Centre Based Respite

Community Access (including Recreation Programs)

Disability Assessment Advisory Teams

Severe Disability Register (Department of Education)
New South Wales
People currently accessing the following New South Wales schemes will generally be
considered to satisfy the disability requirements without further evidence being required:

Large Residential / Institution
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Small Residential / Institution
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Group Homes
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Hostels
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Attendant Care
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In-home Accommodation Support
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Alternative Family Placement
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Other Accommodation Support
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Therapy Services for Individuals
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Early Childhood Intervention
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Behaviour / Specialist Intervention
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Counselling
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Regional Resource and Support Teams
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Case Management, Local Coordination and Development
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Other Community Support
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Learning and Life Skills Development
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Recreation / Holiday Programs
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Other Community Access
Operational Guideline – Access – Disability Requirements (v 3.2)
Publication date: 1 September 2014; appendix C updated December 2015
Page 18 of 19

Own Home Respite
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Centre-based Respite/Respite Homes
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Host Family Respite/Peer Support Respite

Flexible / Combination Respite
g. Commonwealth
Clients of the following Commonwealth schemes will generally be considered to satisfy the
disability requirements without further evidence being required:
 Better Start for Children with Disability
 Disability Employment Assistance : Australian Disability Enterprises
 Helping Children with Autism
 Younger Onset Dementia Key Worker Program
 Outside School Hours Care for Teenagers with Disability
 Remote Vision and Hearing Services
Operational Guideline – Access – Disability Requirements (v 3.2)
Publication date: 1 September 2014; appendix C updated December 2015
Page 19 of 19