What is Considered Evidence of Permanency?

The NDIS defines a disability as permanent if it is lifelong or there is no known, available, and effective treatment that would result in significant improvement. The evidence must demonstrate the following:

• The disability is unlikely to be cured or substantially improved by existing treatments or interventions.

• Any available treatments or therapies may assist in managing the symptoms or maintaining capacity but will not eliminate the disability.

Types of Evidence Required to Demonstrate Permanency

1. Diagnosis and Medical Reports from Qualified Professionals
   The NDIS expects a diagnosis from a qualified health professional such as a General Practitioner (GP), Specialist, or Allied Health professional. The medical report should include:

• Confirmation of the diagnosis: Clear identification of the diagnosed condition and a description of its nature and symptoms.

• Details of when and how the diagnosis was made: This includes when the person was first diagnosed and who made the diagnosis.

• A statement regarding the permanency: The report should specifically mention that the condition is “permanent” or “likely to be permanent,” based on the professional’s medical judgment.

• Prognosis: An assessment of the expected course of the disability over time, including whether significant functional improvement is expected or not.

For example: A specialist report for a person with Multiple Sclerosis might state, “The individual has been diagnosed with relapsing-remitting Multiple Sclerosis. The condition is permanent, and while there may be fluctuations in severity, the overall prognosis indicates a decline in mobility over time.”

1. Clinical History and Evidence of Treatments
   A comprehensive treatment history should show:

• What treatments or interventions have been tried: This includes medications, surgeries, therapies, rehabilitation programs, and alternative approaches.

• The effectiveness of these treatments: Whether treatments provided temporary relief, partial improvements, or no improvement in the person’s condition.

• Current ongoing management: Highlight any current treatments or management strategies being applied and their purpose. For example, medication might be used to manage symptoms but not eliminate the underlying condition.

For example: A report could note, “The patient has been on anti-seizure medication for epilepsy for the past five years. Despite this, they continue to experience frequent seizures which significantly impact daily life. The epilepsy is permanent and medication is only able to partially control the symptoms.”

1. Details on Unsuccessful or Unavailable Interventions
   This evidence should address whether any further treatment options are available, and if not, why they aren’t. The report should discuss:

• Past attempts at treatment and why these didn’t lead to a substantial improvement.

• Whether there are no further medical or therapeutic interventions available that could alter the course of the condition.

For example: For a person with cerebral palsy, an Occupational Therapist might report: “The client has undergone extensive physiotherapy and mobility training since childhood. Despite all interventions, their functional limitations in mobility and fine motor skills are permanent.”

1. Statements on the Nature of the Condition
   For some conditions, the health professional may directly describe the natural progression of the disability and its permanency. The statement should:

• Indicate that the disability is lifelong or that any improvements would only be marginal and not eliminate the condition.

• Emphasize that while symptoms or impacts may fluctuate, the overall condition is not expected to resolve.

For example: A psychologist’s report might include, “The individual has been diagnosed with autism spectrum disorder (ASD). ASD is a lifelong condition, and while therapy can help improve coping strategies and communication skills, the core symptoms will remain throughout their life.”

Be clear, be confident and don’t overthink it. The beauty of your story is that it’s going to continue to evolve and your site can evolve with it. Your goal should be to make it feel right for right now. Later will take care of itself. It always does.