What Is Reasonable and Necessary in the NDIS?
Understand what reasonable and necessary means in the NDIS and how it affects your funding, supports, and plan decisions.
9/3/20264 min read
What Does Reasonable and Necessary Mean in the NDIS?
If you’ve ever heard the phrase “reasonable and necessary” and felt unsure what it actually means, you’re not alone.
It is one of the most important parts of the NDIS, but also one of the most confusing. Many participants and families feel unsure about what it includes, what it excludes, and how it affects their funding.
You might be asking yourself:
Why was something funded and something else not?
Why does the NDIS say no to certain supports?
How do I know what I can request?
The good news is this. Once you understand what “reasonable and necessary” really means, everything becomes much clearer.
Let’s break it down in a way that makes sense for your everyday life.
What “Reasonable and Necessary” Really Means
At its simplest, “reasonable and necessary” is the rule the NDIS uses to decide what supports they will fund.
For a support to be funded, it must:
• Be related to your disability
• Help you work towards your goals
• Support your independence
• Be effective and beneficial
• Represent value for money
It is not about what would be helpful in general. It is about what is appropriate for your specific situation.
It Always Starts With Your Goals
Your goals are the foundation of your NDIS plan.
Every support that is funded needs to connect back to what you want to achieve.
This might include:
• Living more independently
• Building social confidence
• Improving daily routines
• Accessing work or education
If a support does not clearly link to your goals, it may not be considered reasonable and necessary.
A simple way to think about it is:
If it helps you move forward, it matters.
Supports Must Be Related to Your Disability
The NDIS is designed to fund supports that are directly connected to your disability.
This means:
• The support addresses a limitation caused by your disability
• It helps you manage daily life
• It improves your ability to function independently
For example:
Support with personal care may be funded if you cannot complete these tasks independently due to your disability.
But general lifestyle choices that are not disability-related may not be funded.
The Importance of Daily Life Impact
The NDIS looks closely at how your disability affects your everyday life.
This includes:
• Personal care
• Mobility
• Communication
• Social participation
• Managing daily tasks
The greater the impact, the more likely supports are to be considered reasonable and necessary.
This is why clear examples of your daily challenges are so important.
Supports Must Be Effective and Helpful
The NDIS does not just fund supports because they are requested.
They look at whether the support is likely to make a real difference.
This means:
• The support should improve your daily life
• It should help build skills or independence
• It should be appropriate for your needs
For example:
Therapy may be funded if it helps you build skills, but not if it does not lead to meaningful outcomes.
Value for Money Matters
Another important factor is value for money.
This does not mean choosing the cheapest option.
It means the support should:
• Be cost-effective
• Provide meaningful benefit
• Be a reasonable use of funding
For example:
If two supports achieve the same outcome, the NDIS may fund the one that provides better value.
What the NDIS Will Not Fund
Understanding what is not considered reasonable and necessary is just as important.
The NDIS generally does not fund:
• Everyday living costs like rent or groceries
• Supports unrelated to your disability
• Items that are considered personal choice
• Services more appropriately funded by other systems
A helpful way to think about it is:
If everyone needs it, it is probably not funded by the NDIS.
How to Show a Support Is Reasonable and Necessary
If you are requesting a support, it helps to clearly explain:
• What the support is
• How it relates to your disability
• How it helps you achieve your goals
• What difference it will make in your daily life
Clear explanations make it easier for the NDIS to understand your request.
The Role of Evidence in Decision Making
Evidence is essential when determining whether a support is reasonable and necessary.
This may include:
• Medical reports
• Therapy assessments
• Functional assessments
• Provider recommendations
Evidence helps show:
• Why the support is needed
• What impact it will have
• How it relates to your goals
The stronger your evidence, the clearer your case.
When Supports Are Not Approved
It can be frustrating when a support is not approved.
In many cases, this happens because:
• The link to your disability is unclear
• The benefit is not well explained
• There is not enough supporting evidence
This does not mean the support is not needed.
It often means more clarity is required.
What You Can Do If a Support Is Not Funded
If something is not approved, you have options.
You can:
• Ask for clarification
• Provide additional evidence
• Request a review
Understanding the reasoning behind the decision helps guide your next step.
Working With the Right Support Team
Having the right team around you can make a big difference.
Support coordinators, providers, and health professionals can help:
• Explain what is reasonable and necessary
• Strengthen your requests
• Provide supporting evidence
You do not have to navigate this alone.
Keeping It Practical and Real
It is easy to get caught up in the wording.
But at its core, “reasonable and necessary” is about something simple.
Does this support help you live your life more independently and safely?
If the answer is yes, and it is clearly explained, you are on the right track.
Conclusion
Understanding what “reasonable and necessary” means in the NDIS can feel complex at first.
But when you break it down, it becomes much clearer.
Supports need to:
• Relate to your disability
• Help you achieve your goals
• Improve your daily life
• Be supported by evidence
When these pieces come together, your plan becomes more aligned with your needs.
Take your time, ask questions, and focus on what matters most to you.
You deserve supports that genuinely make a difference in your life.
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