“Reasonable and necessary” is the set of criteria the NDIA uses when deciding which NDIS supports can be included in a participant’s plan.
A support is not funded simply because it is helpful, linked to a goal or recommended by a provider. The NDIA considers how the support relates to your disability, what it will help you do, whether it is likely to work, its cost and whether the NDIS is the right system to fund it.
In Short
A strong request explains what the support is, how it helps with disability-related needs and why it makes sense for the NDIS to fund it.
Reasonable and necessary is not one simple test
The NDIA considers several criteria together.
A reasonable and necessary support generally needs to:
- Relate to your disability
- Help you work towards your goals
- Support independence, work, study or social participation
- Be value for money
- Be likely to be effective and beneficial
- Work alongside family, community and mainstream supports
- Be an NDIS support or an agreed replacement support
The current NDIA reasonable and necessary guidance explains the criteria used when supports are considered for a plan.
Each support needs to make sense on its own, but the NDIA also looks at how the supports work together across the whole plan.
This is why a single sentence such as “it relates to my goal” is rarely enough to explain the full request.
Start with the disability-related need
The clearest starting point is the problem the support is meant to address.
Ask:
- What is difficult, unsafe or not currently possible?
- How is this connected to the person’s disability?
- What support is needed because of that difficulty?
- What would the support help the person do?
For example, saying someone needs a shower chair is less useful than explaining that balance, fatigue and transfer difficulty make showering unsafe without appropriate equipment.
The item matters, but the functional reason behind it matters more.
In practice, this is where strong requests often begin. They describe the real problem clearly before focusing on the preferred product, provider or solution.
Goals help, but they do not decide the answer
Goals give direction to the plan. They help explain what the person wants to work towards.
A support may connect to a goal about independence, communication, employment, relationships or community participation.
But a goal does not make every related support reasonable and necessary.
A goal to improve community participation does not automatically mean every activity, membership or transport option will be funded. The support still needs to meet the other criteria and fit the role of the NDIS.
What Can NDIS Funding Be Used For? explains the difference between an ordinary cost and the disability-related support needed around it.
Explain the practical benefit
The NDIA considers whether a support is likely to be effective and beneficial.
The explanation should show what the support is expected to change, improve or maintain.
This may include:
- Making a daily task safer
- Reducing the amount of assistance needed
- Maintaining an important skill
- Improving communication
- Supporting access to work or community life
- Preventing a foreseeable decline in function
Avoid vague wording such as:
This would improve quality of life.
That may be true, but it does not explain what the support will actually do.
A clearer explanation might be:
This equipment would allow the participant to transfer onto the toilet with less physical assistance and reduce the current risk of falling.
Evidence should support the explanation
Evidence helps the NDIA understand the person’s needs and whether the proposed support is likely to help.
Depending on the request, useful evidence may include:
- A therapist assessment
- A short supporting letter
- Trial results
- Functional examples
- Incident or care records
- Quotes or product information
- Evidence about current best practice
The current NDIA guidance on gathering evidence explains the types of information that may help with decision-making.
More paperwork is not automatically better.
The most useful evidence is usually current, relevant and clear about:
- The disability-related need
- What has already been tried
- Why the support is suitable
- What result is expected
- Any risks if the need is not addressed
A provider recommendation can be important, but the provider does not approve the funding. The recommendation still needs to explain the reasoning behind it.
Value for money does not always mean cheapest
Value for money looks at the cost of the support compared with the benefit it is expected to provide.
The lowest-cost option is not always the best value.
A more expensive option may be better value if it:
- Lasts longer
- Reduces ongoing support hours
- Prevents repeated replacement
- Works more safely
- Better matches the person’s long-term needs
At the same time, a higher price needs a clear reason. If two options are likely to achieve the same result, the less expensive option may be preferred.
A strong request explains why the proposed option offers reasonable value, rather than simply describing it as the best product.
Check whether the NDIS is the right system
A support may be needed but still be more appropriately funded or provided by another system.
This can include health, education, employment, housing or another community service.
The NDIA also considers what it is reasonable for family, friends and other people in the participant’s network to provide.
This does not mean families are expected to do everything. The answer depends on the person’s age, situation, the type of help involved and whether the expectation is reasonable.
The practical question is:
Is this disability-related support most appropriately provided through the NDIS, or is another person or system responsible?
A simple way to explain a support
Before asking for a support, try explaining it in three parts:
- What is it?
Describe the support, service or item clearly. - How does it help?
Explain the functional, safety, access or participation benefit. - Why is it needed?
Connect the support to the person’s disability-related needs and relevant evidence.
For example:
An adjustable shower chair is needed because reduced balance and fatigue make showering unsafe. It would provide stable seating, reduce falls risk and allow the participant to complete more of the task independently.
That is much clearer than saying:
The participant would benefit from a shower chair.
If the answer is unclear or the support is not included
Ask which part of the request needs more explanation.
Useful questions include:
- Which criterion was not clear?
- Is more evidence needed?
- Is another support being considered instead?
- Is another system expected to provide it?
- Does the issue relate to the support itself, the amount or the evidence?
If your needs or circumstances have changed and the current plan no longer fits, How to Request a Change to Your NDIS Plan will explain how to describe the change and ask what process applies.
The NDIS Funding Plan Guide helps you work through disability-related need, goals, evidence, plan wording and spending decisions without treating reasonable and necessary as a guaranteed approval formula.
