KB Type: Research Theme
Domain Area: Legislative
Confidence: Researched (Andrew via NbLM, RS-03)
Depth Hint: Standard
Version: 1.0 — 2026-04-23
Status: Active

To secure NDIS funding, requested supports must be backed by evidence that aligns with all six Section 34(1) criteria. Allied Health evidence is critical for proving supports are effective and beneficial under s34(1)(d). Value for Money under s34(1)(c) requires demonstrating that costs are reasonable relative to benefits and that cheaper alternatives have been trialed or are unavailable. NDIA delegates assess justifications by cross-referencing requests against Section 34(1) criteria and NDIA Operational Guidelines, and are audited by the Australian National Audit Office (ANAO) on value for money compliance. Common rejection triggers include missing value for money narratives, absent allied health evidence summaries, failure to document goal progress under prior plans, and inadequate documentation of informal support limits.

The Reasonable and Necessary criteria in Section 34(1) establish six tests that every funded support must pass. Practitioners must provide explicit evidence for each:

Section 34(1)(a) — Assist the Participant's Goals

The support must directly assist the participant to pursue a goal explicitly stated in their Participant Statement. Every requested support must be mapped to a specific short-term or long-term goal. Vague or aspirational links are insufficient — the connection must be direct and actionable.

Section 34(1)(b) — Facilitate Social and Economic Participation

The support must enable the participant to participate in social and economic activities. This criterion connects to NDIS Outcome Domains, particularly Domain 1 (Daily Personal Activities), Domain 2 (Mobility), Domain 3 (Life Skills), Domain 4 (Social Participation), and Domain 5 (Economic Participation).

Section 34(1)(c) — Value for Money

Costs must be reasonable relative to both the benefits achieved and the cost of alternative supports. The Value for Money justification must address:

Section 34(1)(d) — Effective and Beneficial (Current Good Practice)

The support must be effective and beneficial, having regard to current good practice. This is where allied health evidence becomes critical:

Section 34(1)(e) — What Informal Networks Should Reasonably Provide

The NDIA must consider what is reasonable to expect informal supports (family, friends, community) to provide. Practitioners must document:

Section 34(1)(f) — What Mainstream Systems Should Reasonably Provide

The NDIA must consider what is reasonable to expect mainstream systems (health, education, aged care) to provide. Practitioners must document:

NDIA delegates assess Participant Statements by cross-referencing requested supports against all six Section 34(1) criteria. The Australian National Audit Office (ANAO) actively audits the NDIA on value for money compliance, meaning delegates are under pressure to reject supports without explicit s34(1)(c) justifications. A missing value for money narrative is a common rejection trigger.

Based on NbLM analysis, the following are common reasons for support rejection:

The Progress Report is a critical source of evidence for Section 34 justifications. It provides:

Administrative Appeals Tribunal (AAT) precedents dictate that to determine if a support is effective and beneficial, planners must look at the participant's progress under previous plans. The Progress Report provides this exact historical data.