1.3.3 National Disability Insurance Agency (NDIA) Compensation Recoveries
The National Disability Insurance Agency (NDIA) is an independent statutory agency that provides funding for supports and services for Australians who have permanent and significant disabilities via the National Disability Insurance Scheme (NDIS).
Worker receiving concurrent services through NDIS and workers compensation
Any person who meets the eligibility criteria of the NDIS can be eligible for an NDIS plan under their scheme.
WorkSafe entitlements can operate concurrently with an NDIS plan either by funding for the same injury, or related to separate injuries or disabilities. Compensation for NDIS is a lump sum or periodic payment for a personal injury that is at least in part for the cost of supports the NDIS may fund. The NDIA accounts for compensation to avoid duplicating funding of the types of supports provided in compensation payments. It does not extend to weekly payments.
The services and supports being provided by the NDIS plan should not influence any decision by an Agent to cease any support or services where the worker still has a compensable entitlement to services or supports under the workers compensation scheme.
When a worker has a claim with WorkSafe and also has an NDIS plan, the NDIA may reduce their funding by the value of the compensation and care that is expected to be received under their WorkSafe claim.
There may be certain circumstances where a co-funding arrangement between the Agent and the NDIA may be appropriate, such as when a worker is seeking treatment to address two separate injuries at the same time.
All co-funding requests received from the NDIA should be escalated to the managing WorkSafe Agent to assess the request. Agents should review requests received in accordance with the relevant medical and like policy.
Upon approval of a co-funded service with NDIA, Agents are required to make an entitlements and benefits case note on NOVUS supporting the decision. A copy of the Agent’s decision must be provided to the NDIA Compensation Recoveries Branch by contacting Compensation.recoveries@ndis.gov.au.
NDIA recoveries
NDIA will only seek recoveries from common law or lump sum payments relating to medical expenses. As our common law settlements do not include a medical expenses component NDIA recoveries would not apply.
If the NDIA has an interest in a worker’s claim, they may issue a Preliminary notice A preliminary notice is issued by Centrelink indicating that they have an interest in the worker referred to in the notice and may wish to recover an amount equal to all or part of the amount payable. This notice places an obligation on WorkSafe/Agent to notify Centrelink prior to releasing any weekly payments to the worker. WorkSafe/Agent is to advise Centrelink within seven calendar days of accepting liability for weekly compensation or receiving the notice if liability has been already been accepted, whichever is the later. for the claim in a similar manner to Centrelink.
Further information
Further information on the NDIS and eligibility criteria can be found at https://www.ndis.gov.au