As OTs, we're often called on to support NDIS reviews and appeals. Whether it's a matter of plan funding, equipment approvals or eligibility, our clinical input can make or break a case. But when we're brought into the Administrative Review Tribunal (ART) process, it's essential we protect our time, ensure our role is clear and keep sight of the independent position we hold.

This isn't just about being helpful – it's about being strategic and ensuring our involvement is both purposeful and sustainable.

But what is the ART?

The Administrative Review Tribunal (ART) is the new federal body responsible for reviewing decisions made by Australian Government agencies, including the National Disability Insurance Agency (NDIA). It commenced on 14 October 2024, replacing the former Administrative Appeals Tribunal (AAT). The ART aims to be fair, accessible and transparent, resolving applications in a timely manner and being responsive to the needs and circumstances of applicants.

You might be interested to know that in the second quarter of 2024–25, participants lodged 1,895 new cases with the ART, each concerning decisions made by the NDIA.

That sounds like a lot of cases to me…

How do I know if I need to get involved in an appeal?

Before any matter is escalated to the Administrative Review Tribunal (ART), several steps must occur within the NDIS. As an OT, your involvement typically begins with the submission of a request for a particular support – for example, funding for assistive technology, therapy hours or home modifications. But not all requests result in an appeal. Here’s a simplified breakdown of what usually happens before your input is requested as part of a review or appeal:

1. Support request submitted – The OT submits a report, recommendation or formal request for a specific support to be considered by the NDIA. This may occur as part of an access request, plan reassessment or change of circumstances.

2. NDIA decision made – The NDIA reviews the submitted information and makes a decision. This may include approving the support in full, partially approving it or declining the request.

3. Decision communicated to the participant – The participant receives a formal outcome in writing. If the request is not fully approved, the NDIA must provide reasons for the decision. This may come in the form of a decision letter or a new plan.

4. Internal review requested (optional but recommended) – If the participant disagrees with the decision, they can request an internal review within 3 months. This involves a different NDIA officer reassessing the original decision based on the available evidence.

5. Outcome of internal review provided – The NDIA provides a new decision in writing. If the participant still disagrees with the outcome, they can apply for an external review.

6. Application made to the ART – The participant lodges an application with the Administrative Review Tribunal to have the decision independently reviewed. This is when your involvement as an OT may be requested again – particularly if additional evidence is required or your report becomes central to the appeal.

7. Legal or advocate involvement (if applicable) – At this point, the participant may engage a lawyer or advocate to assist with their appeal. They may contact you for clarification, additional documentation or expert evidence in support of the case.

You’ll usually know that an appeal is progressing when you’re contacted by the participant, their legal team or a representative from the NDIA.

If you're being asked to provide further clarification, attend a case conference or participate in tribunal proceedings, that's your cue to confirm your role, expectations and funding arrangements.

Understanding the OT role in a review or appeal

It is important to remember that your role in the ART process is to provide a professional, independent and unbiased opinion. It doesn't matter whether you're engaged by the NDIA or by a participant – your responsibility is to present the clinical facts and evidence in a way that supports decision-making.

This means being prepared. Before you participate in any appeal process, make sure you've reviewed your notes and documentation thoroughly.

Be familiar with the key points of your report, anticipate possible questions and check that the evidence you've provided aligns with the participant's goals and NDIS criteria.

If you're attending the tribunal, either in writing or in person, clarity and clinical reasoning matter more than ever.

Don't forget to ask: Who's paying?

Once you're clear on your role, the next step is just as important – confirming who's covering your time.

If the instruction comes from the NDIA (such as a request for an independent functional assessment or expert evidence), the NDIA will always pay for your time. They should provide clear confirmation of this and ideally engage you through a formal process.

However, in most other cases – especially when the participant or their legal representative engages you to support their appeal – it's your responsibility to clarify payment. Before you agree to attend a tribunal, review documentation or prepare additional reports, ask, "Who's funding this?" It might feel uncomfortable at first, but you deserve to be compensated for your time. These cases often require hours of review, preparation and communication, which go beyond your standard therapy role.

Some participants may have access to legal aid funding to cover your time if their appeal involves lawyers. Others might have flexible funds remaining in their core or capacity-building budgets that can be used to support the process. If they don't, you'll need to decide whether you're willing to proceed – and how you'll invoice for your time.

Setting these expectations upfront protects you, the participant and your practice.

Practical tips for ART preparation

Being called to give evidence (whether at a case conference, conciliation or hearing) can be daunting. Here are a few tips to help you stay confident and prepared:

• Remain objective – your opinion should be grounded in functional evidence and aligned with NDIS legislation and guidelines.

• Review your documentation – go back over your initial reports and assessment notes to ensure consistency.

• Know what's changed – if the participant's function has improved or declined since the last report, you may need to clarify this and explain the change.

• Stay calm – tribunal proceedings can feel formal, but you're there as a clinical expert, not to be cross-examined. Stick to what you know.

• Keep communication professional – if you're liaising with legal reps, make sure all your input is evidence-based and recorded.

Staying informed and supported

Navigating reviews and appeals is complex – and emotionally draining, too.

It's not something we're always trained for as OTs, but it's increasingly part of our reality under the NDIS.

Keep yourself updated on best practice by attending PD sessions, engaging in supervision or mentoring and learning from peers who've had similar experiences. And don't hesitate to reach out for clarification when approached to be involved in an ART process – it's okay to ask questions and protect your boundaries.

At the end of the day, your time, expertise and objectivity matter. The NDIS needs your input – but you get to decide how and when you give it.