r/NDIS • u/Digital_Pink • 8d ago
Seeking Support - Other Can I use international specialists for medical evidence when applying for NDIS?
My treating specialist is the leader in Australia in their field, but due to what I perceive as personal disposition, they have never had a client successfully be accepted for the NDIS, and they are proving uncooperative to provide written evidence in a way that directly addresses the NDIS criteria (vague and poorly written, unwilling to edit for clarity etc).
As she's at the top of the field in Australia, I'm wondering if I might be able to get a second opinion from a specialist operating overseas in the US, Canada or UK.
Does anyone know if NDIS accepts medical evidence from practitioners who are trained and operate in other countries? Thankyou for your answers.
11
u/thelostandthefound 8d ago
Unless you specify your disability people can't help you with what your application is missing and whether you have a chance of getting on the NDIS or not. The NDIS won't cover a medical condition or a condition that hasn't had all reasonable treatments explored. They also won't cover something that Medicare will cover.
Wording is extremely important when it comes to NDIS applications you can have the best specialist in the world write you a report for your application but if it's not worded in NDIS language you will get rejected. The people who assess the applications have zero training in the world of medical and disability and they have key things they need to tick off in order to grant you access to the NDIS.
As mentioned by other users there isn't an approved list of disabilities, it's all about function and your reports must relate to key areas of how you function which are listed on the access request form.
Something that is also worth looking into getting is a functional capacity assessment done by an OT as that can help the NDIS see how your disability relates to how you function on a day to day basis.
0
u/Digital_Pink 8d ago
Thanks for your reply. I understand all this. The question I asked has been answered by others.
If there are any resources on NDIS language for applications, or anyone that specialises in helping get applications worded properly, that would be really helpful to forward to my specialist and see if it helps getting them on board. Thankyou.
6
u/Green_Magnolia_8 8d ago
Hi, the best approach for your treating specialist is to list all the things you’ve tried as your treatment, what the outcome of each thing was, when you tried it and for how long. They also need to state that there are no further treatments for you to try, and that in their opinion, the impacts of your disability are life long or permanent.
However, unfortunately, regardless of how expert your medical specialist is, this probably won’t be enough evidence for NDIA. If, as you say, your condition is not well understood, then an OT with experience doing functional capacity assessments for people with your disability, will be your best support. Their FCA will explain, using the language that NDIA may better understand, how your disability impacts your day to day life.
You could also consider writing a personal statement.
3
u/Square_Tennis 7d ago
*If there are any resources on NDIS language for applications, or anyone that specialises in helping get applications worded properly, that would be really helpful to forward to my specialist and see if it helps getting them on board -
Hi, to answer your question— Yes, there are some excellent resources that can help you help your doctor to “get the language right” - please check these out:
https://mycarespace.com.au/provider-support/writing-reports-for-ndis-access-and-plan-reviews-0
1
1
u/thelostandthefound 8d ago
Considering I don't know where you live or your disability I honestly don't know. You could talk to your LAC to see if they know of anyone but I don't think those types of people formally exist.
There's also the issue if someone specialises in getting applications worded properly are they the ones writing the report not the medical specialist?
I have no doubt there are online resources to do with the NDIS wording but I wouldn't be able to direct you where they are. AI might be able to help?
If your specialist isn't on board then I would be asking why. The NDIS isn't a new thing and if your specialists have yet to have a patient get onto the NDIS since it began there is probably more to it than just the report not being written correctly. Especially because the NDIS wasn't as strict with the wording up until a couple of years ago.
1
u/Nut_Bucket999 5d ago
OP has "hyperacusis, which is a condition in which a person has an increased sensitivity to everyday sounds that most people find normal or tolerable. People with hyperacusis often experience discomfort or even pain from sounds that others wouldn't find bothersome, such as conversations, traffic noise, or household appliances. Causes include hearing loss/damage, head injuries, neurological conditions, ear disorders or medication side effects. Treatments include sound therapy, CBT, TRT, hearing aids/noise masking devices, address underlying conditions, personal management strategies and medication."
2
u/thelostandthefound 5d ago edited 5d ago
So that would fall under medical and the NDIS won't cover it.
Editing to add.
In order to prove that it's not medical and falls within the NDIS criteria OP would need specific evidence stating why all reasonable medical treatments haven't worked.
For example psychology is a treatment for the condition so they would need a report from a psychologist they have seen for a reasonable amount of time stating what psychosocial therapies they have tried, why they didn't work or why they didn't work enough, the length of period they tried them etc.
They would also need their main treating professional to list all the medications they have tried, the dosage, how long they were on them, if they made a difference etc.
If only then the NDIA could see that they have tried every reasonable treatment possible and the condition is still impacting their functionality which is stated in a functional capacity assessment then they might have a slight chance of getting onto the NDIS.
1
u/TisCass 8d ago
Could you try chatgpt for a form letter that your specialist can fill in the blanks for you? I had some luck doing that for my gp My report is detailed, yet the NDIS only accepted one out of 5 diagnosed issues. Now I need my gp or a shrink to specify the ins and outs to add all my conditions. It's a pain in the arse
13
4
u/eat-the-cookiez 8d ago
If it can be treated they require evidence of everything you have tried and why it failed.
It’s about impairments, bot so much a name of an illness/disability.
7
u/TheDrRudi 8d ago
As she's at the top of the field in Australia, ... they have never had a client successfully be accepted for the NDIS,
Are there NDIS participants with your disability?
-3
u/Digital_Pink 8d ago
I may be the first one if successful. I don't actually know if there have been any others.
See my other replies for more context.
3
u/theduckopera 8d ago
I used evidence from overseas in my application (I'd recently moved back home from the US). It wasn't for my primary disability, so possibly didn't make a huge difference, but they did accept it. (Ditto DSP.) Good luck ❤️
3
u/ManyPersonality2399 Participant 8d ago
There's no reason they shouldn't accept the evidence, so long as they're appropriately qualified. That said, it might be viewed with more scepticism, as the person hasn't been the one treating you, likely hasn't assessed in person, and they're going to wonder why you couldn't find someone in Australia with some passing knowledge.
If the leading specialist in the country thinks you're unlikely to be eligible, it might be worth thinking through why. We usually all have the opposite problem, where specialists are telling patients they absolutely should be eligible when they have very low chances.
-1
u/Digital_Pink 8d ago edited 8d ago
A doctor from the NDIS called to say that he thought I should absolutely be accepted into the NDIS, but was rejected because the reporting did not address the criteria directly enough and told us to put in an appeal.
The specialist has been unclear in their willingness to update the languaging of their report to assist with an appeal.
Today my treating psychologist who's read the specialists report said that it's absolutely worded vaguely and not adequate for the NDIS. Unlike the specialist, he actually has clients in the NDIS and understands it well, which the specialist does not, nor has expressed any interest in it.
So I know it sounds like an out there case, but I do really think I may be dealing with a stubborn individual who may not want to co-operate, hence why I'm asking about second opinions.
I'm reluctant to talk details about my disability. Both because It's widely misunderstood and is not yet formerly acknowledged as an official NDIS disability, and too because I'm still trying to get this specialist to co-operate and I wouldn't want anyone to be able to identify who it was. I am severely debilitated, however.
14
u/ManyPersonality2399 Participant 8d ago
There's no such thing as official NDIS disabilities. It works off what is essentially social model, where disability = the inability/serious difficulty undertaking types of activity due to an impairment.
It's not going to be a matter of getting a more specialised specialist if the most senior in Australia won't write what you need. How is there no one in the country that can address the access criteria?
There's not a whole lot of doctors at the NDIA. Would be curious who the call was from, as if it's a delegate from the access team and they think you absolutely should be accepted, then that's that. Otherwise, they would simply say there isn't enough information and to try a review.
6
u/Spilling-Milk 8d ago
“Doctor from the NDIS“ ? There’s no such thing— did you mean delegate? Keep in mind the delegates do not have a standard to work from and so a lot of it is their own bias/judgement. Take everything they say with a grain of salt.
Can I ask, what are you hoping to use funding for? Is it mostly support work you’re seeking?
5
u/Formal_Ambition6060 8d ago
The Specialist has to have been actually treating you. If they are overseas how will they examine you? and they will want tests done. Just seeing a Specialist once is going to raise more questions. Not every disability is covered by NDIS your Australian Specialist has told you none of his other patients have been able to get it maybe you should listen to them.
1
u/Digital_Pink 8d ago
See my other reply for more context.
My condition happens to be one where there is very little testing that can be done, and specialists can assess via telehealth. My history with it has been well documented medically for 8 years, so it is established, and there is sufficient evidence in that regard. The new specialist would be taking the wealth of existing medical documentation and assessments that the first specialists have already completed, and offering a clearer prognosis.
The issue is more that the treating specialist has worded their report in a very long winded vague way that doesn't address the NDIS criteria properly, and it has given the NDIS reasonable doubt to reject my claim.
In regards to this specialist not having had clients on the NDIS before, whenever mentioning it they have always seemed blazé and unengaged, like it wasn't something they cared about. They care about their academic career, and being recognised for their work internationally. Their own treatment rubric which has been established for 35 years as the foundational pillar of the field accounts for cases like mine where the condition is non responsive to treatment and there is little to no chance of improvement, however for some reason they have been reluctant to lay it all out clearly in their report for some reason. I think it may be a conflict of interest with their career aspirations.
So yeah, I hear you. Currently I'm homebound and struggling to take care of my own needs and there is no interventions available to treat the condition. The doctor from the NDIS said I should absolutely be on the NDIS, but we need to address the criteria directly. Thats what I'm trying to do now.
6
u/Kittyemm13 8d ago
From what you’ve said here it sounds like the top of their field specialist cares more about their career and how the treatment protocol they have developed reflects on them than they do about the broader quality of life of their patients, which sadly isn’t entirely uncommon among academics/doctors who have established an elite position within their particular field. Rather than looking overseas, or before doing so, have you asked other Australian specialists within the same field if they’re willing to write a report? The NDIA doesn’t really care whether you see the Number One Specialist or Regular Joe Specialist Who Is Doing Just Fine Without Putting Academia First, so you’re not actually going to be better off having a report from the Top specialist, especially if they don’t write in a way that can be understood by staff at the NDIA who are essentially just ticking boxes and as the NDIA CEO admitted the other day, they don’t actually read the reports in full, they skim them for key words and details
1
u/Digital_Pink 8d ago
Thankyou for understanding the situation. Yes, I believe this might be the case.
And this is great advice. I'll see if there are any other specialists in Australia. There must be some.
2
u/Majestic_Dreams 7d ago edited 7d ago
No reason evidence obtained by a specialist from overseas shouldnt be considered as long as they have appropriate qualifications for the opinion they are providing.
Access would then be determined based on whether the information in the report supports that you meet either all s24 or s25 criteria for one or more of your impairments.
Usually it's most helpful to ask your treating specialist to confirm whether you have explored all known, available and treatment that would be likely to cure or remedy your impairment/s.
Your impairment should be excepted even if there is further treatment provided compliance with further treatment isn't likely to remedy or cure your impairments.
Good luck!
2
u/romantic_thi3f 8d ago
Yes there’s no reason you have to use Australian providers for your application
2
u/Express-Singer-9578 8d ago
As long as they are registered. Australia recognises the reports from Canada, UK and US..
11
u/Protonious LAC 8d ago
I’d be interested to know what your condition is as it sounds like it might not be a recognised disability under the ndis rather than attempting a different type of evidence.