Reasonable and Necessary: the six tests the NDIA uses to decide what gets funded

Quick read: Every dollar the NDIA approves passes through six tests in section 34 of the NDIS Act. They're not vague feelings — they're a specific list the NDIA has to apply. The supports you ask for must (1) relate to your disability, (2) help you participate socially or economically, (3) represent value for money, (4) be likely to work, (5) take account of your informal supports, and (6) be something the NDIS should fund rather than another system. Understanding these tests is the single most useful thing you can do before any planning conversation or appeal.

Why this matters more than people realise

When the NDIA approves or refuses a support, the legal scaffolding underneath their decision is section 34. It doesn't matter if your support coordinator agrees the support is needed, or your OT recommends it, or your family thinks it's essential. The NDIA has to apply section 34, and a support that doesn't pass all six tests can't be funded — even if everyone else thinks it should be.

The good news: once you understand the six tests, you can frame your request so it clearly passes each one. Most refusals come from evidence that addresses one or two tests well but leaves the others to interpretation. Strong applications go test by test.

Test 1 — Does it relate to your disability?

The support has to be a direct response to the functional impact of your disability. Not a general life support, not a wish-list item, not something everyone would benefit from.

Passes the test: A wheelchair for someone with a permanent mobility impairment. Speech therapy for someone whose disability causes a communication impairment. A modified vehicle for someone who can't safely use standard transport because of their disability.

Fails the test: A treadmill because exercise is generally good for everyone. A holiday because it would be nice. A laptop because the participant uses one for personal admin.

The NDIA looks for a clear causal line: because of your disability, you need this specific support. The closer that line is, the easier the support is to fund.

Test 2 — Will it help you participate in social or economic life?

Section 34 requires the support to help you take part in social or economic activities. Both are legitimate. The NDIS isn't only about getting people into paid work — being part of your community, maintaining relationships, accessing services, and pursuing things that matter to you all count.

What this test asks: what does this support unlock for you? If the answer is "more independence at home" — that's social participation (running your own household is part of community life). If the answer is "I can keep my part-time job" — that's economic participation. If the answer is "nothing in particular, but the OT thought it might be nice" — the test is going to be hard to pass.

When you're framing a request, name the outcome. Don't just describe the support — describe what it enables.

Test 3 — Is it value for money?

This isn't about being the cheapest option. The Act asks whether the cost of the support is reasonable given:

• Likely benefits to you
• Cost compared to alternatives that would achieve the same outcome
• Whether the support has been priced sensibly (in the case of capped supports, against the Pricing Arrangements)

A support coordinator visiting a participant once a fortnight at $100/hour for a year is generally good value. A daily two-hour visit for the same person doing the same work probably isn't — unless there's a specific reason daily attendance is needed.

For higher-cost items (like complex assistive technology, home modifications or specialist housing), the NDIA will compare your request against alternatives. If a manual wheelchair would meet your needs, a $40,000 power wheelchair will be questioned even if you'd prefer the power chair.

Test 4 — Is it likely to be effective and beneficial for you?

Translation: is there evidence the support is going to work for someone in your situation? The NDIA leans heavily on:

• Clinical evidence (peer-reviewed research where it exists)
• Professional recommendations from treating clinicians
• Industry best-practice guidelines for disability supports
• Your own history with similar supports (if you've tried something similar before)

This is the test that often catches participants out when they request supports that are novel, experimental or not specific to disability. Treatments that work for some conditions but lack evidence for your specific disability can be refused under this test. So can supports where the evidence supports a different approach.

If you're requesting something unusual, make the evidence case explicit: who recommends it, what evidence backs it, why it suits your specific situation. Don't leave the NDIA to fill in the blanks.

Test 5 — Are your informal supports factored in?

The Act expects the NDIS to be a top-up to your natural supports — not a replacement for them. Your family, friends, neighbours, community connections and the mainstream services you already use are all counted before the NDIS fills the rest.

What "informal supports" actually means: anyone who voluntarily helps you because of who they are to you, not because they're paid. A parent who takes their adult child to medical appointments. A spouse who manages medication. A neighbour who drops off groceries. These are informal supports.

The NDIA considers what's sustainable — a 75-year-old parent providing 80 hours of care per week is unlikely to be a sustainable informal support, regardless of their goodwill. The NDIA's expectation is that informal supports are reasonable in scale, not crushing the people providing them.

If you're applying for a support that overlaps with what someone is currently doing informally, be clear about why that's unsustainable. "My partner has been doing my personal care but they've returned to full-time work and can no longer be home in the morning" is a much stronger case than "I'd like a paid worker."

Test 6 — Is it appropriately funded by the NDIS, not another system?

The NDIS doesn't pay for things other systems are responsible for. Section 34 explicitly requires the support to be the NDIS's job, not health's, education's, housing's, or another government program's.

The boundary lines:

• Health system pays for medical and clinical care — GP visits, hospital admissions, mental health treatment, medication. The NDIS picks up disability-related supports that go beyond clinical treatment.
• Education system pays for school staff and teaching. The NDIS picks up disability supports that go beyond what mainstream education provides — communication devices used in school, support workers who attend with the student.
• Housing system pays for general housing. The NDIS picks up specialist accommodation (SDA) for participants with extreme functional impairment.
• Justice system, child protection, aged care, employment services — each has its own funded responsibilities. The NDIS sits alongside them.

This is the test that catches a lot of requests at the borderline. A request for ongoing physiotherapy after a stroke might be partly health-system territory (acute rehabilitation) and partly NDIS-system territory (ongoing disability supports for the lasting functional impact). The NDIA looks for clear NDIS-side framing.

What changed in October 2024

From 3 October 2024, an additional layer was added: the support must also fall within the official NDIS Support Lists (in or out). These lists clarify which supports are inside the scheme and which sit outside. They're available on ndis.gov.au.

This was part of a broader tightening of "what the NDIS funds" rather than a change to the six tests. The tests still apply. The Support Lists just give an authoritative answer to "is this kind of support inside the scheme at all?" before you even get to the six tests.

If a support is on the "not an NDIS support" list, all the s 34 reasoning in the world won't get it funded. If it's on the "is an NDIS support" list, the six tests then apply to decide whether it's funded for you specifically.

How to use the six tests in practice

When you're preparing for a plan reassessment or appealing a refused support:

1. Read the tests in order. Don't skip ahead. Each one is a separate hurdle.
2. Write a one-paragraph case for each test. Even just to yourself. If you can't argue one of the tests, that's the test you need stronger evidence on.
3. Bring the evidence that addresses the weakest test first. Don't pile up evidence on the test you already pass.
4. Use the NDIA's own language. If your evidence uses the phrases "functional impact," "reasonable and necessary," "section 34 criteria," reviewers find their reasoning easier.
5. Quote the Act directly when you appeal. Section 34(1)(a) through (f) are not optional considerations — they're the legal framework. Naming them shows you've engaged with the actual decision-making framework.

When supports get refused

Most refusals trace back to one of the tests not being clearly met. Refusal letters usually tell you which one. Decoding the refusal:

• "The support has not been shown to relate to the participant's disability" → Test 1 failed
• "Insufficient evidence that the support will achieve outcomes" → Test 4 failed
• "Should be funded by [other system]" → Test 6 failed
• "Cost is disproportionate to benefit" → Test 3 failed

That's your roadmap for what to fix in an internal review.

Sources

This guide is grounded in section 34 of the NDIS Act 2013 and the NDIA's Operational Guideline on including reasonable and necessary supports in a plan. Both are linked at the top.

For anyone preparing to challenge a decision, the Operational Guideline is worth reading carefully — the NDIA writes against itself when it sets out how decision-makers should apply each test. If the decision on your support doesn't match what the Operational Guideline says about that test, that mismatch is worth surfacing in your review.

Sources & last verified

Last verified 24 May 2026 against:

• NDIS Act 2013 — Section 34 (Reasonable and necessary supports)
• NDIA — Including reasonable and necessary supports in your plan

Next review scheduled 24 August 2026.