If an Australian aged care assessment outcome does not reflect the older person’s needs, the formal step is an internal review of the decision recorded in the Notice of Decision. It is not the same as complaining about an assessor’s manner, disputing a provider’s conduct or trying to appeal a home’s refusal to offer a room. The Department reviews whether the assessment decision was right using the situation, available information and law, and the person can provide new information.
The current My Aged Care guidance says the request must be made within 28 days of receiving the Notice of Decision. Start with the notice itself and the guide to My Aged Care and the assessment, then identify each decision being challenged. Do not spend the deadline arguing informally with a provider.
Read the Notice of Decision line by line
Record the date received, decision-maker, approval or refusal, service types, classifications or conditions, and the review instructions. Save the envelope, email or online-account record showing receipt. The 28-day period runs from receiving the notice, so the family needs evidence of that date rather than an estimate based on when the assessment occurred.
Mark the exact outcome that causes the problem. “We disagree with the assessment” is less useful than identifying a denied service, an approval that does not match documented needs or a factual premise that is wrong. If several decisions appear in one notice, list them separately and check whether each is reviewable through the stated route.
Separate review, complaint and urgent support
An internal review tests the decision. A complaint addresses service quality, communication or process concerns. A provider complaint concerns care or conduct after a service is involved. These paths can overlap, but using one does not automatically start another. Ask My Aged Care which channel records each issue and keep reference numbers distinct.
Meanwhile, urgent needs must be managed now. A review request does not create interim care or suspend risk at home. Tell the assessor, health service or emergency service about material deterioration through the appropriate route. The Australian hospital discharge to aged care guide can help coordinate immediate options while the formal decision is reconsidered.
Write grounds that connect evidence to the decision
Use a short structure for each ground: what the notice says, why it is inaccurate or incomplete, the evidence supporting that statement, and the outcome requested. Focus on function and risk. Describe transfers, bathing, continence, eating, medicine management, cognition, behaviour, night needs, supervision and what happens when support is absent.
Explain variability and caregiver limits with dates and examples. If the assessor observed one good hour, show the pattern across a week. If family care was treated as permanently available, provide the caregiver’s own health, work, distance or safety limitations. Avoid exaggeration; a consistent record is more persuasive than dramatic language that conflicts with clinical notes.
Choose evidence that closes the information gap
Attach only relevant, current material and label it. Useful evidence may include a clinician’s functional summary, allied-health assessment, discharge plan, falls record, medication-support need, cognitive assessment, behaviour chart or caregiver statement. Ask writers to address the disputed function instead of merely repeating diagnoses.
Create an index showing document, date, author and proposition supported. If an important report is pending, lodge the review request within time and ask how supplementary evidence can be provided. Do not assume a request for medical records extends the statutory or administrative deadline in the notice.
Submit through the stated channel and prove delivery
The published routes include the Request for an Internal Review of a Decision form or a written request to the System Governor using the instructions in the notice. Use the current form and address. Include identity details, the decision, date received, grounds, requested result, attachments and authority for anyone acting as a registered supporter.
Keep the complete submitted pack and delivery evidence. If sending electronically, retain the sent message and attachments; if posting, allow time and use a trackable method. Ask for an acknowledgement and reference. A telephone discussion is useful, but do not treat it as a lodged review unless the Department confirms that it has been recorded as one.
Plan for the review outcome
Ask how updates will be communicated and who can answer procedural questions. Continue documenting material change but avoid sending repetitive evidence without explanation. When the outcome arrives, compare reasons and approvals with what was requested. If the decision changes, confirm how new referral information appears in the online account and what action is needed next.
If the internal review remains unfavourable, current guidance identifies external review by the Administrative Review Tribunal after the internal review, and a charge may apply. Obtain the current deadline and procedure from the decision letter. When comparing possible services through the directory of Australian aged care homes, remember that a favourable assessment does not compel a provider to offer a place.
If the 28-day period may already have passed, do not abandon the issue or invent a receipt date. Contact the review section promptly, explain when and how the notice was received, and ask what options the current law and notice allow. Submit the strongest available material through the instructed channel while seeking procedural guidance. A late request may be treated differently, so record the answer and avoid promising that an extension or review will be accepted.
Is an internal review the same as making a complaint?
No. The review asks whether the assessment decision was correct. A complaint addresses the service or process. State both concerns through the appropriate channels if needed, but do not assume a complaint protects the 28-day review deadline.
Can new evidence be included with the review?
Yes, current guidance allows new information to support the request. Link each document to a disputed finding and keep it current. The reviewer still decides the outcome; submitting more pages does not guarantee a change.
Does winning a review guarantee an aged care bed?
No. A review can change the assessment decision or approval, but provider suitability, vacancies, agreements and admission remain separate. Use the revised outcome promptly and confirm the next referral or placement step.
This guide is procedural information, not legal advice. The Notice of Decision, Department of Health, Disability and Ageing, My Aged Care and any review body must confirm deadlines, standing, evidence and available remedies.