A Participant Information Access (PIA) request is a formal request to the National Disability Insurance Agency (NDIA) asking them to share information from your NDIS record with your Occupational Therapist.

The NDIA will only release this information:

• With your written consent, and

• To a nominated provider (such as Benefact).

A PIA request does not give us control over your NDIS account. It only allows us to view specific documents the NDIA already holds about you.

We use PIA requests to make sure our assessments and reports are:

• Based on the same information the NDIA is using

• Aligned with your recorded NDIS goals and plan history

• Clinically accurate and properly contextualised

• More likely to meet NDIA evidence and decision-making requirements

This is particularly important for:

• Access requests

• Functional Capacity Assessments (FCAs)

• Change of Circumstances requests

• Plan reviews and reassessments

• Appeals or internal reviews

A PIA request may be used when you are:

• Applying for NDIS access (after previous unsuccessful attempts)

• Undergoing an OT Functional Capacity Assessment

• Requesting or undergoing a review or reassessment of your plan (s48 or s100)

• Seeking ongoing or increased funding for:

  • Disability-related supports

  • New support categories

  • Assistive technology

  • Housing or higher-level assistance

Not every client requires a PIA request. We only request access when it is clinically or administratively useful for your situation.

If approved, the NDIA may provide access to:

• Current and previous NDIS plans

• NDIA decision letters

• Your recorded NDIS goals

• Planning and review notes

• Planning meeting summaries

• Other NDIA records relevant to your supports

Access is limited to what the NDIA authorises external access to. The NDIA may also limit the type and format of information provided at its own discretion.

A PIA request does not allow access to:

• MyGov or MyGovID accounts

• Centrelink or Medicare records

• Other government systems not held by the NDIA

5.1 What these notes are

Planning and review notes are:

• Internal NDIA records written by planners or delegates

• Usually not visible to participants unless specifically requested

• Variable in quality and detail

They often document:

• What supports were requested

• What was approved or declined

• The NDIA’s reasoning

• Notes about expected future changes (for example, an intention to reduce or “scale down” a support over time)

These notes are not clinical reports, but they strongly influence how plans are built and reviewed.

5.2 Typical Support Packages (TSP) and NDIA outcome measures

Planning and review notes commonly include:

• Typical Support Package (TSP) calculations

• Brief NDIA outcome measures, such as:

  • Abbreviated WHODAS scoring

  • Functional impact ratings

  • Internal benchmarking tools

These tools are used to estimate what level of funding a person “should” receive based on broad participant groupings.

5.3 Why this matters for invisible and psychosocial disability

In practice, we sometimes find that internal tools are sometimes completed:

• Without detailed clinical assessment

• Without full understanding of:

  • Fatigue and fluctuating capacity

  • Cognitive and executive functioning difficulties

  • Emotional regulation and trauma impacts

  • Sensory and environmental factors

As a result, NDIA internal scoring may under-estimate the real impact of disability on daily life.

This is particularly common for people with:

• Psychosocial disability

• Neurodivergence

• Chronic illness or chronic pain

• Conditions that are episodic or not outwardly visible

6.1 Understanding what the NDIA already holds

Access to NDIA records allows us to see:

• How your functioning has been recorded

• What assumptions have been made about your capacity

• What supports have previously been approved or declined

6.2 Strengthening clinical evidence

We use this information to:

• Identify gaps or inaccuracies

• Provide fuller functional context

• Reinforce appropriate scoring using clinical evidence

• Align your OT report with NDIA language and frameworks

This helps ensure your lived experience is:

• Accurately described

• Clinically justified

• Clearly linked to your support needs

Knowing what the NDIA already has on file allows us to:

• Anticipate questions or objections

• Address issues before they become barriers

• Strengthen funding justification

• Reduce the likelihood of:

  • Requests for further evidence

  • Misalignment between reports and NDIA expectations

  • Delays in decision-making

This is especially important when recommending:

• A substantial increase in funded supports

• New or more intensive support categories

We will never submit a PIA request without your knowledge and permission.

8.1 What consent means

A PIA request:

• Requires your written consent (via our secure online consent form)

• Consent can be:

  • Time-limited

  • Withdrawn at any time

• Is used only for your clinical care and reporting

You can always:

• Ask what information is being requested

• Ask how it will be used

• Decline consent

8.2. If you choose not to consent

If you do not consent to a PIA request:

• We will rely on information you provide directly

• You may need to supply NDIA documents yourself

• Your report may:

  • Take longer to prepare

  • Be less specific about NDIA decision-making

  • Require further clarification during review

We will discuss any implications with you before proceeding.

If you have questions about:

• What a PIA request involves

• What information is being requested

• How your information will be used

You are encouraged to discuss this with your OT or our management team via hello@benefact.com.au.

We always aim to be transparent, collaborative, and respectful of your autonomy in all information-sharing decisions.

You can also find out more about PIA requests via the NDIS website: https://www.ndis.gov.au/about-us/access-information/participant-information-access