Does the NDIS Cover People With ADHD

Does the NDIS Cover People With ADHD?

The National Disability Insurance Scheme (NDIS) helps Australian citizens better meet the challenges respective disabilities throw their way. Of course, it’s only fair for you to wonder if Attention deficit hyperactivity disorder (ADHD) also qualifies for NDIS coverage. Unfortunately, ADHD is not on the list of NDIS-approved disabilities. Although you can benefit from NDIS services as an ADHD patient, much more goes into being “eligible” for the scheme. Here, you can see how NDIS and ADHD are related and how exactly your eligibility is determined.

What is ADHD?

ADHD or Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder that affects an individual’s behaviour. The disorder affects the nervous system, resulting in hypersensitivity and an inability to pay prolonged attention or control impulsive behaviour.

ADHD is generally diagnosed during childhood, but some people recognise ADHD symptoms well into adulthood as well. The disorder comprises three types: inattentive, predominantly hyperactive-impulsive, and combined ADHD.

Generally, ADHD is not a life-threatening disorder. You can lead a normal life with the right medication and therapy. However, ADHD can lead to a lower life expectancy, severe mental illnesses, and many other complications when left untreated.

Symptoms of ADHD

As mentioned above, ADHD is diagnosed right from childhood and with the right treatment, affected individuals can lead normal lives. However, how can you distinguish between ADHD and normal behaviour in patients? Here are some of the most telling ADHD symptoms.

  • Ignoring activities, abandoning tasks, or being slow when completing them.
  • Excessive fidgeting and physical movement
  • Disorganisation, poor planning, and lack of effort in prioritising
  • Challenges in multitasking
  • Restlessness and minimal tolerance for frustration
  • Interrupting conversations and inability to wait their turn
  • Forgetfulness or easily distracted

How NDIS Responds to ADHD

Since you can treat and manage ADHD with medication and psychotherapy, the organisation doesn’t list this disorder as a disability. Currently, the National Disability Insurance Scheme doesn’t consider ADHD a permanent disability or impairment.

However, ADHD is known to co-occur alongside other conditions like autism, anxiety, dyslexia, and developmental delays. If that’s the case and you have comorbid ADHD conditions, you will become eligible for NDIS funding support.

For more information on what NDIS funding covers, see What Can NDIS Funding Be Used For?

In addition, patients must undergo conclusive tests to determine an accurate diagnosis before they apply for NDIS’ ADHD funding. Certain eligibility criteria and disability requirements must be met in order to be considered eligible NDIS related benefits.

NDIS Eligibility Criteria

As mentioned above, to qualify for an NDIS cover with ADHD, you must meet the eligibility criteria, which includes an underlying condition listed by NDIS. Here is an extensive list of NDIS requirements for ADHD patients.

  • The applicant must have a permanent disability that significantly impacts their ability to participate in everyday activities. You must provide proof showing the disability is permanent, or how long it is expected to last.
  • The applicant’s disability affects their capacity to engage in social and economic events for an extended period of time.
  • You must be an Australian citizen, permanent resident, or hold the Special Protected Category visa. Non-citizens are ineligible.
  • All applicants must be below 65 years at the time of the application. However, you will continue to access funding support if you turn 65 years old under the NDIS cover. Furthermore, the organisation allows NDIS package holders to access benefits until they transition to a residential aged care funding organisation.

These are the top eligibility requirements at NDIS, but the determination is generally undertaken on a case-by-case basis. In addition, NDIS works with the National Disability Insurance Agency (NDIA) to determine who qualifies for NDIS funding.

How to Support Your NDIS Eligibility

Since ADHD is a contentious condition at NDIS, you must produce conclusive evidence of the comorbid condition to avoid dismissal. Here is the evidence required by NDIS and NDIA.

  • The primary disability and date of diagnosis. In this case, your primary diagnosis is not ADHD but the comorbid condition that includes anxiety, dyslexia, or cerebral palsy.
  • A complete medical diagnosis from a qualified professional who understands your primary disability. Depending on your primary condition, you can get the report from a general practitioner, orthopaedic surgeon, psychiatrist, neurologist, speech pathologist, or occupational therapist. Remember, your report should be at least 6 to 12 months old.
  • Proof of how long the disability is expected to last and how it will impact your motor skills, communication, social interactions, and self-management.
  • Proof that you have used up all treatment options. Attach previous treatments and outcomes to support your evidence.

Tips to Consider When Applying for NDIS Funding

Is the Comorbid Condition Listed?

On its website, NDIS provides a detailed list of conditions that meet disability requirements. They include autism, cerebral palsy, Angelman syndrome, hemiplegia, Edwards syndrome, and Leigh syndrome. The list is extensive.

Although ADHD isn’t listed, there are many conditions on the list that are more likely to occur in people with ADHD. You can work with a general physician to confirm if you have any underlying conditions and whether they are on the NDIS list.

Check the NDIA Access List

As mentioned above, the NDIA determines patients who qualify for the funding at NDIS. The agency creates regular access lists where the staff will draw guidance while selecting applicants. The lists include conditions for applications with permanent impairment diagnosed less than 7 years and permanent conditions that require further assessment.

You will also find lists of defined programs and conditions that meet specific NDIS disability requirements under section 24 of the NDIS Act. Use these lists to guide your application, so you are easily spotted under the right category.

Request the Access Request Form

The request access form gives you an upper hand. The NDIS staff will have your information and can contact you when funding becomes available in your area. In addition, you will submit your identity or guardian’s identity, evidence of the disability, and answers to the NDIS access requirements questionnaire.

Provide Quality Evidence

As an ADHD patient, you’ll need to provide concrete evidence that your comorbid condition contributes to ADHD. Work with experts in the field to conduct a full medical analysis of your conditions.

Ask them to write letters and reports that can convince the agency of your need for funding. In fact, the NDIS welcomes letters from your family and friends as part of the evidence. You can also work with NDIS providers like the NDSP Plan Managers, who will help you prepare solid applications.

Primarily, ADHD isn’t an untreatable disease but can be costly and impact your life negatively when untreated. Therefore, support from the National Disability Insurance Scheme is a welcome relief. However, if you can’t access NDIS funding, reach out to ADHD-affiliated organisations like the ADHD Foundation and ADHD Australia.

If you have any questions about NDIS plan management, please call us at 1800 63 63 77 or email us at info@ndsp.com.au. Register for Plan Management Sign Uptoday!


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