Navigating Reasonable and Necessary in the NDIS

Understanding what’s considered “reasonable and necessary” under the NDIS can be one of the most confusing parts of managing your plan. If you’ve ever asked yourself, “Why was this funded for someone else but not for me?” or “What can I do to improve my chances of getting something approved?” you’re not alone. 

At Chooze, we know how tricky it can be. That’s why we recently hosted a live webinar with our CEO Kerry and our Partnerships Manager Billy. Together, we unpacked the rules, cleared up some common myths, and shared practical tips to help you make stronger, more confident funding requests. You can watch the full replay of the webinar HERE.

In this blog, we’ll summarise everything we covered so it’s easy to follow and apply to your own situation. 

What Is the NDIS and How Does It Work? 

The National Disability Insurance Scheme (NDIS) provides funding to help people with disability achieve their goals, become more independent, and take part in everyday life. Each person’s plan is tailored to their specific needs, so no two plans are the same. 

NDIS funding is not unlimited. To be included in your plan, a support must be considered reasonable and necessary based on your disability, your goals, and your circumstances. 

What Does “Reasonable and Necessary” Actually Mean?

This is one of the most important things to understand. According to Section 34 of the NDIS Act, a support must meet all of the following seven criteria to be considered reasonable and necessary. 

1. It Must Relate to Your Disability or Impairment

This is the first — and one of the most important — tests for any NDIS support request.

To get something funded, it needs to be clearly connected to your disability, not just a general health issue or something that might help anyone. The NDIS is there to support people with a permanent and significant disability, so the item or service you’re asking for must be necessary because of that disability.

What kind of evidence does the NDIS look for?

• To meet Disability Requirements, you need to show that:
• Your disability is caused by a permanent impairment (like a physical, intellectual, or psychosocial condition)
• That impairment substantially reduces your ability to do everyday things like communicate, move around, or manage tasks independently
• It affects your ability to work, study, or be socially involved
• You’ll need ongoing support under the NDIS for the rest of your life
• To meet Early Intervention requirements (which apply when supports are aimed at reducing the long-term impact of a disability), you need to show that:
• The impairment is likely to be permanent
• Getting support early is likely to help you now and in the future
• The early supports you’re asking for are things that the NDIS actually funds

Note: Early intervention isn’t just for kids! Adults can qualify too, and supports might only be needed for a short time if they help prevent bigger issues later.

Example:

YES – A powered wheelchair for someone with a permanent mobility impairment

NO – A gym membership for general fitness

2. It must help you work towards your goals 

The NDIS is goal-driven. Supports need to help you make progress toward something listed in your plan. 

Tip: Include a mix of goals related to communication, mobility, independence, daily living, and social participation if you need support in these areas. 

3. It must promote social or economic participation 

Support should help you engage in your community, education, or work. 

Example: A support worker might be funded to help you attend a music event if age is appropriate and the need is due to the impact of your disability/ impairment, but the cost of the ticket itself would not be covered. 

4. It must represent value for money 

The cost of the support needs to make sense for the benefit it provides. If two supports offer a similar outcome, the NDIS will usually fund the lower cost option. 

Example: A durable, well-suited wheelchair instead of a luxury model with customised paint.

5. It must be effective and beneficial 

There should be evidence showing the support will help. This can include evidence-based research, allied health reports, or real-life results. The support must be backed by evidence and professional recommendations.

YES – A pressure-relief mattress prescribed by an occupational therapist to prevent pressure sores for a participant with limited mobility due to their NDIS-recognised disability.

NO – A standard memory foam mattress for comfort purchased without clinical justification.

6. It must consider Informal Supports, Mainstream & Community Services

This includes informal support from family, friends, community or mainstream services. The NDIS generally won’t fund supports already provided by informal or free community supports—unless they are age-appropriate or necessary to help informal supports (like carers or family) continue in their caring role.

YES – Personal care for an adult who needs assistance with daily living.

NO – A support worker for a child’s school drop-off and pick-up (parental responsibility).

7. It must not be the responsibility of another system 

If something should be covered by the health or education system, such as medication or school costs, the NDIS is unlikely to fund it.  

Why Two People with the Same Diagnosis Might Get Different Funding 

This is a common question. Just because someone else with a similar disability got something funded does not mean you automatically will too. 

It all comes down to how the support links to your personal needs and goals, as well as the quality of evidence you provide. 

Real example: 
Two twins with autism applied for the same intensive therapy. One child received funding because their reports showed a significant functional impact with completing daily activities, and there was clear evidence that the therapy was working. The other child was not approved for the same therapy because their daily functioning was stronger. Instead, they were funded for general capacity building therapy. 

Let’s Talk About the Grey Areas 

Some items fall into a space where it depends on how they’re used. Here are some common examples. 

iPads 

✅ May be funded if used only as a communication tool 
❌ Not funded for entertainment, games, or general use 

Smart home devices 

✅ Might be approved if they support independence, such as opening blinds or doors 
❌ Not approved for convenience or general household use 

Weighted blankets 

❌ Often not funded due to limited long-term evidence and safety concerns 
✅ Can still be a helpful option you can choose to buy yourself 

Noise-cancelling headphones 

❌ Usually not funded, as they are often seen as a comfort item 
✅ May be worth trying to justify if they help regulate sensory overload in a way that reduces other supports 

What’s In and What’s Out? 

Here’s a simple list of what the NDIS is more likely and less likely to fund. 

Commonly Approved 

• Assistive technology such as walkers, wheelchairs, and communication devices 
• Therapy services like physiotherapy, occupational therapy, and speech therapy
• Personal care and support workers 
• Home modifications that are linked to independence and safety

Not Usually Approved 

• General household items like TVs and couches 
• Subscriptions, streaming services, and holiday costs 
• Gym memberships and general fitness equipment 
• Anything covered by Medicare or school funding 
   

How to Strengthen Your NDIS Claim 

There’s no magic phrase to get support approved. The strongest applications include a mix of personal, practical, and professional evidence. 

Here’s what to include. 

1. Functional assessments 

These explain how your disability affects your day-to-day life, and what would help. 

2. Reports from therapists, doctors, teachers and educators

Support letters from occupational therapists, psychologists, and other professionals should clearly link the item or service to your goals. 

3. Personal statements 

Use your own words to describe what your daily routine looks like and where the support would help. 

4. Results from trials or weekly timelines 

If you’ve tested something and it helped, show it.  

Make It Easier with Chooze 

At www.chooze.com.au, we’ve designed our platform to support your NDIS journey from the very beginning of the purchasing process. 

You can: 

• Add your reasonable and necessary justification right at checkout 
• Upload reports, letters, and extra documents to support your claim 
• Receive one combined invoice, even if you buy from several different sellers 
• Automatically send invoices to your plan manager or to the NDIA if needed 

You’ll also find clear product descriptions, support item reference numbers, and easy-to-understand information on each product page. This means less admin for you and better chances of approval. 

Final Thoughts 

The NDIS can be frustrating, especially when it feels inconsistent or unclear. But understanding how “reasonable and necessary” works can help you feel more confident and in control. 

To recap: 

• Know the 7 criteria and make sure your request meets all of them 
   
• Use a mix of evidence types, not just one report 
   
• Link everything back to your goals 
   
• Be honest, detailed, and clear in your language 
   

You can download a copy of the resource document by clicking HERE!

If you’re using NDIS funding to buy from The Chooze Shop, please remember that your purchase needs to match your plan goals and support needs. Approval for funding may vary based on your disability type and NDIS plan, and final decisions are made by the NDIS. You can learn more about what the NDIS may fund here. Everyone is welcome to buy directly from our store with personal funds, too!