Health Conditions vs Disabilities under the NDIS Section 24

Health Conditions vs Disabilities

Understanding the difference between a health condition and a disability is important to determine the eligibility under the national disability insurance scheme (NDIS). Section 24 of the National disability insurance scheme act 2013 specifically outlines the important differences, stating who qualify for the necessary support under the act.

https://www.legislation.gov.au/C2013A00020/latest/text

What are Health conditions?

A Health condition generally refers to temporary or curable illness that doesn’t permanently limit a person’s daily activities or the ability to participate in the society. These conditions involve the medical issues that are treatable. Examples of such health conditions include acute diseases like flu, asthma infections, temporary injuries like a fracture, and manageable chronic conditions that significantly improve with proper medical care and medication. Individuals experiencing health conditions often recover fully through short term medical treatment and don’t usually require long term support.

Disability under the NDIS Act

The term Disability under the NDIS act is a permanent impairment significantly affecting an individual’s ability to perform day to day tasks, social and economic participation. A disability as defined under the act, must be permanent or likely to be permanent, causing limitations on the person’s functional capabilities.

For an individual to qualify for NDIS assistance, specific criteria are outlined under the section 24 of the act that must be satisfied:

·       The disability must be permanent or likely to be permanent

·       The disability should substantially reduce the functional capacity of the individual

·       The individual must require ongoing support to manage day to day tasks, social and economic activities

Further Explanation

To further explain and differentiate between a health condition and a disability. A health condition such as asthma, managed effectively by medications and lifestyle adjustments wouldn’t constitute as a disability under the NDIS unless it severely affecting everyday life of a person and demands substantial ongoing support. On the other hand, intellectual disabilities, severe autism and/or permanent physical impairments clearly qualify under section 24 of the act due to the impact these disabilities create in an individual’s day to day life.

Key differences between a health condition and a disability

·       Duration: Health conditions are typically short term and are also curable or manageable whereas disabilities are long term or permanent.

·       Impact on life: Disabilities permanently restricts an individual’s day to day activities and social interactions whereas a health condition has short term and less sever impacts on an individual’s life.

·       Requirement of support: Individual with a disability requires continuous, structured and personalised support, whereas health condition primarily requires medical treatment.

Transitional Rules

Transitional rules are temporary guidelines established by the Minister for the NDIS, outlining what supports the NDIS will fund and what it won't, until final rules are agreed upon with states and territories to ensure scheme sustainability. Some key aspects include:

·       The list of support “in” list and “out” list. The “out”/ prohibited list includes services like sex work, illicit drugs and alternative therapies without scientific backing such as crystal therapy.

·       Participants can request to replace an approved support with another option if it provides better outcomes and value. However, this requires prior approval from the National Disability Insurance Agency (NDIA).

·       New NDIS plans now display total budget allocations, specific funding components, and timeframes to enhance transparency and ensure proper utilisation of funds.

These transitional measures aim to refine the NDIS framework, ensuring support is provided only for necessary services.

Challenges in Determining Eligibility

Determining eligibility under Section 24 can sometimes pose challenges, particularly in borderline cases where health conditions may develop into long-term disabilities. Accurate and timely medical assessments are essential to ensure individuals receive the support they need at the right time. Health practitioners, disability advocates, and legal professionals play an important role in accurately interpreting and applying Section 24 criteria to ensure fair and consistent decision-making.

Conclusion

Understanding the difference between health conditions and disabilities is important for individuals seeking support under the NDIS. Section 24 of the NDIS Act provides clear guidelines to ensure that only individuals with permanent impairments receive ongoing assistance. With the introduction of transitional rules, participants must stay informed about eligibility criteria and policy changes to ensure they receive the appropriate support.

Need to know more: Bespoke Legal Group is well versed when it comes to Disability Law.

Our team is here to help, contact us on 07 56200558 to discuss.

This article is provided for general information purposes only. Its content is current at the date of publication. It is not legal advice and is not tailored to meet your individual needs. You should obtain specialist advice based on your specific circumstances before taking any action concerning the matters discussed in this article.