If you’re new to the National Disability Insurance Scheme (NDIS), or even if you’ve been in the system for a while, you’ve probably heard the term “reasonable and necessary” more times than you can count. But what does it actually mean? And why is it so important when it comes to getting the right supports under the NDIS?

In this blog, we’ll break it down into simple terms and help you understand how the NDIS uses this concept to determine which supports and services can be funded in your plan.

What Does “Reasonable and Necessary” Mean?

Under the NDIS, supports need to meet certain criteria to be funded. These are known as “reasonable and necessary supports.”

The idea is pretty straightforward: the NDIS will fund supports that are both:

• Reasonable– something that is fair for the NDIS to provide, and
• Necessary– something you actually need because of your disability.

These supports are meant to help you live an ordinary life and achieve your goals – whether that’s becoming more independent, connecting with your community, building skills, working or studying, or simply improving your quality of life.

The Six Criteria for Reasonable and Necessary

To be considered reasonable and necessary, a support must meet six specific criteria under the NDIS Act. The support must:

1. Be related to your disability
   The support must be directly linked to your disability – not just a general life expense.
2. Not include day-to-day living coststhat aren’t related to your support needs
   For example, the NDIS won’t cover things like groceries or rent.
3. Be value for money
   The support must be cost-effective and provide good benefits compared to alternatives.
4. Be likely to be effective and beneficial
   It should be based on evidence or best practice and expected to help you achieve your goals.
5. Take into account informal supports
   The NDIS considers help you already get from family, friends, or community services.
6. Be the responsibility of the NDIS (not another service system)
   It can’t be something that should be provided by education, health, or other mainstream services.

Examples of What Might Be Funded

Here are a few examples of supports that could be considered reasonable and necessary:

• Occupational therapy sessions to improve daily living skills
• A wheelchair or mobility aid to help with movement
• Support worker hours to assist with personal care or community access
• Assistive technology for communication or independence
• Transport funding if public transport isn’t accessible

On the other hand, the following might not be funded:

• A gym membership for general fitness (unless clearly linked to a therapy goal)
• Support for a family member or carer (the NDIS focuses on the participant)
• Holidays or entertainment expenses not directly tied to your goals

How to Make Your Case

If you’re preparing for a planning meeting or a plan review, it’s important to clearly link your requested supports to your goals and your disability. Bring reports from health professionals, quotes, or letters that explain how the support will benefit you.

Using words like “This support will help me achieve my goal of…” or “This is necessary because I need assistance with…” can help your planner see why the support meets the criteria.

Final Thoughts

The “reasonable and necessary” concept is central to how the NDIS works. While it might seem like a bit of a grey area sometimes, understanding the six criteria can help you better advocate for what you need and feel more confident during plan meetings.

If you’re ever unsure, don’t hesitate to ask your Local Area Coordinator (LAC), Support Coordinator, or even reach out to advocacy services. Knowing your rights and understanding how decisions are made puts you in a better position to get the support you deserve.

Need help preparing for your NDIS planning meeting? Or want to learn more about specific supports? Drop your questions in the comments or get in touch – we’re here to help!