NDIA Accountability Project

Independent assessments as punishment for disability and threat to mental health

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SUBMISSION TO JOINT STANDING COMMITTEE ON THE NDIS (independent assessments)

Background

I have been an NDIS participant since 2017. My current plan provides funding for psychology, a support worker, co-ordination and plan management. I have Autism Spectrum Disorder Level 1. I also have PTSD and clinical depression from workplace bullying. My psychosocial disability is a result of abusive treatment by my state government employer, WorkSafe Victoria, the Victorian mental health system and the NDIS.

I apologise for my long submission but I have a lot to say about a process that is already negatively impacting on my life. I am confused and overwhelmed by the constant stream of insincere information about independent assessments coming from the NDIS and Stuart Robert. The threat of this compulsory process hanging over me is causing anxiety and distress. My mood, sleep, mental health and well-being is already effected. When I applied to the NDIS I did not apply to be involved with any of the organisations who are contracted to complete my independent assessment. The NDIS should not be permitted to pass their responsibility for my care over to another organisation. I feel trapped by the government body I was fooled into believing would help me. The more I find out about independent assessments, the more I know it is impossible for me to remain in the NDIS. I cannot participate in a process knowing it will cause me harm. There may be inconsistency around access and support but the NDIS’s assertion that independent assessments are the only way to address this issue is fundamentally flawed. This process needs more public input, debate and careful thought before any changes are made to legislation.

Summary

My main reasons for writing this submission are:

  1. My safety: I see independent assessments as punishment for having disability and a threat to my mental health, safety and well-being. If I attend an independent assessment, I will be putting myself at risk. If I don’t comply with a process I know will cause me harm, the NDIS will revoke my status as a participant and take away my support. I feel like I am backed into a corner with no choices. It is terrifying.

  2. No consultation: I am disturbed by the steamroller approach used to introduce independent assessments. The people most impacted by this process have been largely excluded and their opinions and thoughts ignored. The NDIS seems to think they are above societal expectations and can disregard the opinions of community. The lack of genuine consultation clearly demonstrates that the NDIS were always intent on forcing this arbitrary process onto participants regardless. This is not how changes to the NDIS should be made by any Australian government.

  3. Human rights abuse: Australia needs to do much better. For ten years I have fought dysfunctional and broken government systems who have been determined to harm me to save money. Here I am again with no choice but to fight for the same reason. The NDIS has been a stressful factor in my life evidenced by my submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability. What was the point of thousands of people baring their souls to the Royal Commission if nothing has been learnt and government bodies like the Productivity Commission, the DSS and the NDIS are still allowed to initiate and support a process with the full knowledge that it will abuse, exploit and damage vulnerable people with disability?

Stuart Robert and the NDIS are supremely confident the independent assessment process will be introduced mid-year. How can such a damaging piece of legislative change be forced through as a done deal? Australia is a signatory to the UN Convention on the Rights of Persons with Disabilities. It has an obligation to and has pledged to protect the rights and dignity of people with disability. The NDIS independent assessment process completely disregards that obligation, fails to uphold those rights and will damage the very people the

  1. Cost cutting at the expense of human lives: The independent assessment process has been proposed by the Productivity Commission and planned behind the scenes by the NDIS for several years without any thought or regard for the damage it will cause to vulnerable human beings. It’s only aim is to save money by giving the NDIS complete control over access to deny, limit and remove support from people with disability. The government-employed decision makers involved obviously don’t see participants as real people. We’re just things to be managed using the least amount of effort and money possible. During the few months I have taken to write this submission, information on the NDIS website has constantly changed. They are refining detail as they go along, creatively playing around with the lives, rights and dignity of people with disability to goet the best bang for their buck.

  2. Decision making hypocrisy: The decision makers who dreamt up this process would never accept me, a complete stranger who knows nothing about them, coming to their workplace or home for twenty minutes to a few hours to assess their functional capacity. Using the tools of my choice I would assess them on their:

    • position on the narcissistic personality scale
    • ability to put themselves in someone else’s shoes and to feel compassion and empathy
    • knowledge of the UN Convention on the Rights of Persons with Disabilities, ASD, psychosocial dataility, PTSD, clinical depression, the effects of workplace bullying and trauma based therapy
    • tendency to make decisions from a position of ignorance
    • complaint handling and telephone skills
    • capacity to communicate honestly, effectively and respectfully and to write a competent and professional email.

If after a twenty minute examination, I subjectively determined they were not functioning to the level I had in mind for a government employee, I would have the power to terminate their employment, only give them a summary of my findings and not allow them any option to appeal. None of these decision makers would agree to be forced to participate in my process. None of these decision makers would accept me having the power to control and change their lives and take away their employment. So why do these people think its fine to do this to me?

SUBMISSION TO THE JOINT STANDING COMMITTEE ON THE NDIS: Independent Assessments

a. The development, modelling, reasons and justifications for the introduction of independent assessments into the NDIS.

Development and Modelling

I received nothing from the NDIS informing me of their plan to introduce independent assessments. It is incomprehensible that their website is the only way they communicate information to participants. By the time I was alerted by negative media attention, the independent assessments process was well developed and set in motion to proceed. The NDIS eNewsletter is user friendly but as it is only available electronically, many participants are still excluded from accessing important information. I struggle to use the NDIS website because I am overwhelmed by the vast volume of constantly changing information. For example it is impossible to search “Independent Assessments” and find all the information in one place. There are snippets of information under different headings accessed only by browsing for hours all over the website clicking dozens of links. There is no cohesiveness and this confuses and distresses me. The creative spin and misinformation on the NDIS website triggers past trauma for me so I need to limit my exposure to reading such obvious propaganda. If the plan for independent assessments was disclosed from the beginning to coordinators and support workers they could have helped disseminate information about this huge change to participants like me who cannot cope with the website.

The NDIS have introduced independent assessments by stealth. There was no transparent consultative process before developing and introducing this major change. The independent assessment process has been years in the making behind closed doors. The NDIS have revealed the process to the community by releasing detail incrementally, allowing no-one to gain a comprehensive view of the whole process so as to provide informed feedback. This deliberate strategy was particularly noticeable when the NDIS waited until mid-March to release details about the contracted organisations and the assessors. The NDIS released innocuous information first, leaving the most damaging until the last minute so there is no time for anyone to object and contribute feedback. It is wholly deceptive.

The NDIS should have informed all participants by personal email or letter of the proposed changes to access and eligibility and asked for their feedback long before any actual planning was begun. Instead they did the classic box-ticking exercise, asking for feedback even when they knew that the process was “finalised” and would begin mid-2021 anyway. There is no honesty, transparency or legitimacy in the NDIS’s feedback process because they requested feedback with the full knowledge that any information submitted was never going to be genuinely considered and was never going to effect the introduction of the process.

Despite the NDIS stating they are committed to getting change to access and eligibility right, their only real commitment was to legislate these changes as quickly as possible. Their claim of a 91% satisfaction rate for the introduction of independent assessments is fabricated. They used the opinions of 35 out of more than 400,000 participants and creatively spun that into a 91% participant satisfaction rate. Website information on how the NDIS survey participant satisfaction is intentionally vague. There is no information about how participants are selected, how many are selected, if the cohort includes participants with a wide range of disability, if the cohort changes over time, how regularly participants are surveyed etc. There are several links stating “click here for more information” but the information is identical and just keeps looping back. The NDIS state they, “regularly collect information on participants’ views of their interactions” and “we will be contacting participants or their nominees by phone, email or SMS to take part in a survey” and “a link to an online version will be offered” but in over four years I’ve never been contacted or asked to complete a participant satisfaction survey. The NDIS and Australian Healthcare Association (who conduct the surveys) have almost identical website information. I rang the AHA and was told their survey sample is not random. The NDIS advise them which participants to survey and they tend to continue surveying the same people. This is not a legitimate, trustworthy or ethical survey process yet the NDIS and Stuart Robert continue to circulate this misleading, dishonest and distorted data and are using it as the basis for major change for participants.

Reasons and Justification

From the beginning, the NDS has consistently ignored the expectations of hundreds of thousands of participants, carers, advocacy groups, community, service providers, disability support organisations etc. and this process has been no different. The NDIs says the independent assessment process intends to meet participant expectations. Using the opinions of 34 participants and passing that off as an appropriate monitoring gauge as to how the expectations of more than 400,000 participants are being met, is deceptive. It’s obvious the NDI don’t want to know or care if this process meets anyone’s expectations except their own All of the reasons and justifications the NDIS have given are shams, lies and creative spin.

  1. The NDISs claim that independent assessments are “just one piece in a collection of supporting evidence” is false. There is no collection of supporting evidence. My practitioners’ opinions are not able to be accessed by the assessor and I’m not allowed to bring any supporting evidence to the assessment. Obviously the independent assessment will be the only evidence the NDIS will ultimately accept and all decisions about my eligibility and the support I need in life can in fact be totally based on a twenty minute assessment by an outsourced, inadequately trained stranger.

  2. The NDIS claim that an independent assessment process will empower participants is false. This process takes away all my choice and control and does not reflect my individual support needs. I’m a human being - ot some object to be analysed using the tools a stranger carries in their toolbox. Independent assessments allows the NDIs to pigeonhole people with disability into neat and tidy boxes to suit themselves. My right to be treated as an individual is being abused and ignored for the sake of bureaucracy? I have no power in this process.

  3. The NDI and Stuart Robert claim independent assessments will be fairer. This process has nothing to do with fairness but everything to do with streamlining the eligibility process for the convenience of the NDSI and saving money by making it more difficult for people with disability to access and remain on the NDIS. How is it fair that I can only choose from a limited list of organisations or that my assessor might be barely qualified in something that is entirely unrelated to my disability? How is it fair that I will be forced into an assessment with a stranger? A stranger who can never treat me impartially or fairly because their primary aim is to minimise my functional capacity and assess me as ineligible so that they get paid, stay employed and help retain their employer’s NDIS contract. The NDIS telling me the assessment will be conducted by a “qualified healthcare professional” using a “disability neutral” tool that may have no reference to my disabilities is not at all reassuring, acceptable or fair. Telling me my assessor will be a plumber using a whipper snipper would be just as believable.

  4. The NDIs say independent assessments will improve the inconsistencies in assessing the functional capacity and funding of psychosocial participants. This is illogical and untrue. All inconsistency lies solely with the NDIIS using LACs and planners with little training or experience of mental illness to assess participants, formulate plans and arrange budgeting. The NDS inference that inconsistency is caused by unreliable practitioners is defamatory. The NDIS should trust the opinions of practitioners instead of undermining their professional integrity by casting dispersions on their reliability and consistency. Employing independent assessors to disprove or minimise the opinions held by a participant’s practitioners will not logically make assessing participants with psychosocial disability any more consistent. In fact it will make the accurate assessment of functional capacity more difficult because of the nature of psychosocial disability and the fact that the assessment is conducted by a stranger.

  5. There may be inconsistency around access and support but the NDIS assertion that independent assessments are the only way to address this issue is false. I do not need to see an independent assessor to assess my functional capacity. My practitioners are intelligent, highly educated, skilled, experienced and truthful professionals who have already provided high quality and consistent information on my functional capacity, clearly identifying that my disability is permanent, lifelong, chronic and regularly acute. They are familiar with and have already used the NDIs assessment tools. For the NDIIS to pretend that only independent assessors are capable of using assessment tools is nonsense.

  6. Quoting David Tune’s recommendations as a reason to introduce independent assessments is a clumsy attempt to add legitimacy to a deeply flawed process to mislead the community. David Tune recommended changes occur only after close and careful consultation with participants. Surveying 35 participants out of

400,000 and having a feedback link where submissions go straight into a shredding machine is not close and careful consultation.

  1. The NDIS argument that independent assessments will reduce the financial burden on participants is a smoke screen. The fact that some people said assessments were too expensive has been exploited by the NDS to mislead the community into believing that free assessment means independent assessment and that they have to exist concurrently. There is no connection between free assessments and independent assessments. Independent assessment has absolutely nothing to do with reducing costs for participants. The NDIS has used this argument to conceal the true aim of independent assessments which is to give the NDIS complete control over the access process by taking participants’ practitioners out of the equation. The word “free” is irresistible to some people who may not be cognizant that in this case, free comes at the expense of having no choice in regard to assessment.

If the NDIS genuinely wanted to reduce the financial burden on participants they could provide a free assessment with an independent assessor for participants who choose that option but allow participants who are happy to “chase” assessments and pay, to choose to be assessed by their own practitioners. Another alternative would be to reimburse participants for assessments with their own practitioners or pay participants’ practitioners for assessments they conduct and the time taken to write reports.

  1. The NDIS is known for dismissing and ignoring complaints from participants as evidenced by the huge number of matters referred to the AAT and the Commonwealth Ombudsman. Why would anyone believe that participant complaints about lengthy wait times and the complexity and prohibitive cost of assessment would matter to the NDS? Using these complaints to exaggerate and twist that into a valid reason to introduce independent assessments is implausible. How many people complained to the NDIS about assessment costs? A few of the same 34 participants? How do the NDIS know how much participants pay for assessments? It is not information the NDIS requests as part of the application process. They certainly don’t know what I paid because they’ve never asked me. Lengthy waiting times and complex or cost prohibitive assessments is not my experience. I think the NDIS is exaggerating the prevalence and extent of these issues and using the information creatively to support their case.

  2. The argument that participants’ plan budgets are determined by their postcodes doesn’t make sense and is a red herring. ALL the inconsistency in plan funding lies with NDIS planners and LACs because they are the people who devise the budgets following planning meetings. I am embarrassed for Stuart Robert constantly banging on in the media using overly simplistic arguments based on contrived statistics to imply that participants from certain postcodes receive higher levels of funding compared to others as a justification for the introduction of independent assessments. The average cost per plan is related to the particular needs of the person with disability, the support they have during the planning process to highlight their support needs, the knowledge and experience of their planner and nothing to do with where they live. Has Mr Robert considered there might just happen to be more people with higher needs disabilities living more frequently in one area as opposed to another. It’s a ridiculous argument.

The NDS could invest the money wasted on paying contracted organisations to ensure participants do get appropriate budgets for their support needs by employing people with expertise to complete budgets instead of using planners like they do now. The NDIS could use an auditing process to oversee plan budgets that red flags plan budgets that seem too high or too low and then investigate the reasons why. I’m sure planners don’t pluck budgets out of nowhere so LACS and planners must already use budget tools that give accurate information on services and cost available in their particular area. Naturally prices for practitioner services would be inconsistent across Australia and the customised nature of equipment for participants would obviously cause inconsistencies in plan budgets depending on transport costs to particular areas. Introducing independent assessments will not effect this inconsistency at all.

  1. The NDIS says the independent assessment process will give all people the “same access to internationally recognised evidence based assessments” and that everyone will go through “the same assessment process”. I cannot believe the NDIS think the community is so naive to believe nonsense like this. This is to distract the community with scientific bla bla in order to disguise the NDIS’s real reason for independent assessments, which is to remove participants’ practitioners from the process. I can access the “internationally recognised evidence based assessments” from the internet. My practitioners already access them, have the necessary qualifications and don’t need any training. Participants do not need an independent assessor to have the same access to the assessment tools.

It is impossible to give everyone “the same assessment process.” Using the same tools does not guarantee the

same process.

Tests will be administered and interpreted by a human being. Humans make errors and their decisions and interpretations are subjective. Every assessor is an individual who will interact and make different choices with every participant they assess depending on a million external factors present on the day at the time of the assessment like how tired they are, how well they’re listening, if they need a coffee, how they’re coping in relation to their own life stressors etc. It is impossible for the NDIS to ensure every participant will experience the exact same assessment process so this claim is absolute nonsense and a lie.

b. The impact of similar policies in other jurisdictions and in the provision of other government services.

It is obvious to me that the NDS independent assessment process is modelled on the workers’ compensation system’s use of independent medical examiners. Just like WorkSafe Victoria who contract the care of injured workers to insurance companies, the NDIS have contracted organisations to employ assessors to conduct independent assessments. Like WorkSafe Victoria, this allows the NDIS to distance itself, absolving them from all care and responsibility for what happens to participants during the assessment process and from involvement in any subsequent appeals process.

I was traumatised and acquired psychosocial disability from seven years of abuse from Worksafe Victoria agents including their use of IMEs. The psychological damage done to injured workers by IMEs employed by Worksafe Victoria and Comcare is well known. Debra Glass, the Victorian Ombudsman has initiated several of her own investigations into Worksafe and documented her findings to parliament where her extensive recommendations have sat gathering dust. Four Corners has produced several programs exposing the harm carried out to workers by Worksafe and Comcare. It is particularly disturbing to me that any government body would contemplate introducing a process based on one that has been proven to abuse, damage and even case the death of injured workers. That government decision makers seem intent of inflicting a similarly destructive process on an equally vulnerable group of people - those with disability – is unconscionable conduct by everyone involved in this appalling decision.

  • See: ABC’s Rachel Clayton’s article 5 February 2021 and substitute Comcare for WorkSafe Victoria. hhttp://www.abc.net.au/news/2021-02-05/insurer-comcare-doctors-bullying-federal-workcover- claimants/13112086?utm source=abc news web&utm medium=content shared&utm content=mail&utm campaign=abc news web

  • See: Debra Glass’s (the Victorian Ombudsman) December 3rd 2019 report “WorkSafe 2: Follow-up investigation into the management of complex workers compensation claims” Part One: Unreasonable decision making by agents  Selective use of IMEs 48  Leading questions to IMEs and treating doctors 57  Failure to provide documents to IMEs 63  Reliance on IME from incorrect specialty 65

Based on my experiences with Worksafe Victoria, the NDIS’s independent assessment process will:  allow people’s lives to be altered and damaged by a mini twenty minute snapshot that will be inaccurate and unfair  allow the NDIS to expect and pressurise the contracted organisations and assessors to exclude people from eligibility and support by providing test results showing limited impact on functional capacity  give participants no choice about who will assess them as choosing from a set list of three assessors is still no choice at all  be conducted by a stranger who may have no qualification, knowledge or experience related to their disability  never be fair and impartial because the organisations are paid by the NDIS and want to keep their contract  create a power imbalance for participants because they are unable to use information or supporting material from their practitioners  allow participants to be excluded from discussions between the assessor and other people

  • deny participants access to a reasonable appeal process to challenge assessment findings or complain about the assessor because decisions are based on an over simplistic tool that gives enormous power to a single assessor

c. The human and financial resources needed to effectively implement independent assessments.

I have never seen the need for the NDIS to introduce independent assessments that could be done by participants’ practitioners. Participants’ practitioners already exist, don’t need any recruiting or training and can use the assessment tools the NDIS require. I thought it would be physically and financially impossible for the NDIS to recruit and train a bank of independent assessors and establish the administration to service the whole of Australia by mid-2021. Now I know that long before the access and eligibility changes were ever announced to the community, the NDIS had already contracted out this process to organisations who have recruited and trained assessors. No wonder the NDIS has been so supremely confident. They set this whole assessment process up, withheld information, trickle fed the community minor changes over a period of time before announcing the major changes at the very end to achieve their fait accompli. Contracting organisations to implement independent assessments means this was always designed to sideline practitioners so the NDIS can completely control access. This is deceitful conduct.

The NDIS claim that independent assessments are necessary to reduce the costs for participants is a sham. Only one of my practitioners charged for a report. The other two charged me nothing. I didn’t pay any consultation fees. There is no doubt the contract fees for the organisations will be costly as they are all private companies whose only goal is to make money. The NDIS have weighed that up and decided that contractor costs will be balanced by the assessors ensuring there are fewer people on the NDIS. That’s how the NDIS have decided to save money. The NDIS will be forking out money to private businesses that could be spent increasing funding for participants, improving the administration and training of current NDIS processes and employees or reimbursing participants for obtaining reports from the practitioners of their choice. The NDIS are not interested in any of these options. They simply want less people on the NDIS and contracted assessors will ensure that.

d. The independence, qualifications, training, expertise and quality assurance of assessors.

The skills I’d like to see in an assessor are the ones I’ve already identified in the practitioners I have chosen to work with. They have the qualifications, expertise and experience specific to my disabilities and should be assessing me. The NDIS has washed their hands of all responsibility for my care and contracted out my health and wellbeing to the cheapest tenders. They have transferred my life to organisations who are only interested in making money. I will never again be assured of a quality assessment because the organisations and random stranger assessors have a financial motive to find me ineligible for NDIS support. These organisations have not been attracted to the NDIS’s tender process because they want to work with people with disability. They have only been attracted because the NDIS is a huge employer providing a secure and financially lucrative contract in a growth industry. We have seen the devastating impact when similar reasoning is applied to the management, ownership and employees in the aged care sector. Is nothing ever learnt from Royal Commission findings?

All independence is compromised by the financial co-dependency relationships between the assessor, their employer organisation and the NDIS. WorkSafe Victoria IMEs are sold as independent too but that’s been proven to be untrue countless times. Immediately prior to my workers compensation impairment assessment, my WorkSafe agent sent me to a particular IME in an attempt to limit my compensation payout. He was selected because they were confident he would diagnose me with a less serious condition to that of nine other practitioners. They paid this IME to diagnose me with a condition it was impossible for me to have but because he is a doctor, his diagnosis can never be refuted or changed. Only due to the strength of my practitioners, the IME’s opinion failed to influence my impairment assessment and compensation. I have no doubt this same sort of corruptive arrangement will operate between the NDIS, their contractors and the assessors.

I can tell you from personal experience that no-one will be able to control what happens in an assessment. Assessors will do exactly what they like to participants in an examination. The NDIS and the organisations may say their assessors have the necessary training but behind closed doors, no-one will know how they speak to and treat participants. Having a Code of Conduct, engagement principles, service standards or anything else

will not matter because the NDS will claim this is not their process and I will not be protected by them. It’s unlikely I will have any recourse to complain about an assessment or an assessor and even if I did, it will boil down to my word against theirs and they will always win. If I have a bad experience there’s no point in complaining because it’s too late by then. The damage has been done.

Like WorkSafe Victoria’s IME system, there is an inherent danger that the organisations will attract people who want to be assessors because they:

  • like having power over vulnerable people because it makes them feel superior
  • are not confident or competent enough to work in the real world
  • are fresh out of university and need a job to quickly pay back their university fees
  • want some extra income over and above their usual job.

I could be assessed by a twenty year old who has one year of social work training, has only worked for a minimum of twelve months and not in a field that aligns with my disability. A twenty year old is unlikely to have any expertise in trauma informed care so I will be re-traumatised by the experience. Who would ever consent to that?

e. The appropriateness of the assessment tools selected for use in independent assessments to determine plan funding.

I have no problem with any of the assessment tools per se but relying on them to determine functional capacity is over simplistic and unfair. My issue lies with the companies selecting the employees who will use the tools to assess me. The NDIS website says assessors will be “qualified healthcare professionals”. This means absolutely nothing. A healthcare professional could be a podiatrist, chiropractor, dentist, nurse, optometrist, pharmacist, occupational therapist or physiotherapist, none of whom I consider qualified to assess me. Historically, all of the tools were designed to be administered and interpreted by someone with a high level of specific training, experience and knowledge like a psychologist. I don’t believe these organisations are going to ensure my assessor has it takes.

In Australia we all have the reasonable expectation and protective legislation that people providing services to us have the professional qualifications and training appropriate to their position. That expectation extends to all facets of life - education, construction, dentistry, medical treatment, hairdressers, personal training, accountants, car mechanics, lawyers etc. Why should independent assessments be exempt from this expectation?

f. The implications of independent assessments for access to and eligibility for the NDS.

There is no doubt that many more people with disability will be denied eligibility, have their eligibility challenged or revoked as a result of this process because it is fundamentally flawed. It will be a debacle. The stress imposed on applicants and participants and the harm caused by this process will be profound. People with disability who fail the test will be left with no support as the introduction of NDs put an end to all alternatives. I already use a combination of funding to access the psychology I need to keep me functional and at home, out of hospital and alive. There is nothing for autistic adults where I live except for those who also have intellectual disability which clearly I don’t have. I am a tad too old for Headspace and my mental illness is not seen as serious enough because I’ve never been psychotic so I have no access to any ongoing mental health support in Victoria. As I’m not a war veteran I am denied access to all programs offering support for PTSD. If my NDIS eligibility is removed, I will only have my psychologist and psychiatrist. As good as they are, it will not be enough. h. The circumstances in which a person may not be required to complete an independent assessment.

I totally object to compulsory independent assessments. There should be limited circumstances for a person to be required to complete an independent assessment and many more reasons why a person is exempt. Exemptions should apply to people:

  • who request to be exempt
  • would be adversely psychologically affected by having to be assessed by a stranger
  • where there is a significant risk to safety during and following assessment
  • who already have diagnosed disability and functional incapacity in the listed domains covered by the tools
  • who have already had the seriousness and permanence of their disability and loss of functional capacity confirmed from a legal process like a WorkSafe Victoria impairment assessment
  • who choose to pay for their own practitioners to complete the assessment and report.

I have clearly been autistic for 61 years so I shouldn’t have to prove that on a yearly basis. I have been through an extensive and thorough WorkSafe Victoria compensation process proving I have a permanent and serious work injury and psychosocial disability resulting in 35% impairment. That should be fully recognised by the NDIS without any expectation that I am required to jump through assessment hoops on a regular basis for what has already been clearly proven. As for my functional capacity, it deteriorates exponentially as I age and struggle to manage my disability. I would have thought this was bleedingly obvious.

i. Opportunities to review or challenge the outcomes of independent assessments.

The NDIS obviously aren’t so stupid as to assume that most assessments are going to be accepted by participants. The website currently has unclear, limited and contradictory information about the opportunities participants have to review or challenge assessments and this raises a warning flag. If I request an exemption and that is denied, I can’t seek a review. I only get a summary of the assessment report and have to request a full copy. My practitioners do not have the right to challenge a capacity assessment that contradicts their opinions. If I disagree with the assessor’s report, I might be able to request an internal review or complain but I can’t get another assessment and am denied a second opinion. If I’m not happy with the internal process I might be able to go to the AAT but maybe not. All of this information is probably now obsolete because as the NDIS has transferred the responsibility for this process over to organisations, I would say that gives the NDIS an out from any review process.

From its inception, the NDIS has avoided quality and accountability processes so they will have thought this aspect of independent assessments through and set everything up in such a way as to make it as difficult as possible for participants to assert any right of appeal. There will be limited opportunities to challenge independent assessments because the organisations won’t have competent complaints systems to cope with the demand. The NDIS will simply say, “It’s not our process.” This is exactly what happens with WorkSafe and its agents. Complaints to agents go nowhere. Complaints to WorkSafe result in, “this is not what we expect from our agents,” but they do nothing. Undoubtedly many people will be harmed by this process and unhappy with their assessments but there will be nowhere they can go and nothing they can do. This is flagrant abuse, a violation of human rights and fundamentally unjust.

Even if review processes are available, they are of little help to someone who has disability. All review processes are designed to make the complainant want to give up. They are always difficult to navigate, stressful, hard to follow and time consuming and as there are few options for advocacy, people with disability are left with the overwhelming task of fighting alone on top of everything else they have to do. The effort involved to get an improved outcome is outweighed by the fight it takes to get it. I’ve spent ten years fighting a negligent state government employer, WorkSafe Victoria, the Victorian mental health system and the NDIS and I am exhausted in every way possible. I’ve been through a yearlong review and complaints process with the NDIS without advocacy, before the AAT was established and it was like swimming through wet cement forever. The time taken from my life can never be replaced. The toll on my physical and mental health was extreme and I’ve never recovered from the trauma of the process.

It is inevitable that any external appeal bodies will be swamped with complaints following a forced independent assessment process. By not providing participants with a robust appeals process, the NDIS is clearly and arrogantly saying they are accountable to no-one. Independent assessments will create a monster that will eat up time and money reviewing decisions from what the NDIS must already know is a fundamentally flawed process. The NDIS also knows that review processes cause substantial stress for participants yet their contempt for the health and wellbeing of complainants means they’re prepared to ignore that to gain total control over access. There would never be a need for me to challenge the outcome of an assessment with my own practitioners. Why are the NDIS creating this monster that will consume and destroy people with disability?

k. The appropriateness of independent assessments for people with particular disability types, including psychosocial disability.

I don’t agree with independent assessments at all but this process will be particularly damaging for psychologically vulnerable participants like me whose psychosocial disability was caused by interpersonal trauma (being harmed by people). By forcing me to have an independent assessment the NDIS are setting me up for more abuse, harm and trauma and gambling with my mental health and welfare. Five years ago I had an experience with a WorkSafe IME that lasted one hour but haunts me still. After the examination I was so distraught that I was taken by ambulance to hospital and admitted for three weeks. I complained to WorkSafe, received the IME’s response and that was the end of their complaint process. Even though there have been other complaints against this particular IME over many years, WorkSafe continues to enable him to continue damaging vulnerable workers. The same will happen with independent assessors. Complaints from participants won’t weed out the bad assessors. There would need to be an independent quality assurance body to identify systemic issues with the organisations and individual assessors with the power to remove them from the system.

I will also be disadvantaged because I am autistic. My eligibility will be questioned because I will test as very functional. I drive a car, look after my house, garden and pets, do volunteer work, manage my business affairs, look after my personal care, write submissions etc. but all that flies in the face of how I feel, the difficulties I have relating to others and dealing with the stress of life.

My main concerns about attending an independent assessment are:

  1. It will pose a serious risk to my well-being and safety: I will be on trial, judged and punished by a stranger I won’t trust for even a second. I will feel extremely distressed, anxious and threatened because my brain will be telling me, “We’ve been here before. It’s an unsafe situation and this person is dangerous.” My response will be automatic – either fight, flight or freeze. There is no possible way for any examiner to put me at my ease. Having a support person with me won’t help. I don’t have family or friends to attend with me and if I ask my psychologist to attend, who is going to pay for her time? Me? If the assessment takes three hours that could cost me up to $600. I thought the NDIS were all about limiting costs to participants. Even if my psychologist didn’t charge me a cent, her time is of value. How can she afford the time and cost of attending assessments with her NDIS clients? That the assessor has the power to speak to my psychologist during the assessment without my presence is intolerable to both of us. We both value my right to privacy and full transparency which includes being present when anyone is having a discussion about me. After I leave, I will be alone dealing with the consequences of having my trauma activated. I will not be safe.

  2. It will be unjust: My functional capacity varies through a vast spectrum changing on a weekly, daily, hourly or even minute by minute basis according to my ability to manage my autism and my mental illnesses. My functional capacity is dependent on things like the stress I am experiencing in my life, the amount of support I have, the depth of my depression or if my trauma is triggered. I struggle to consistently manage my responsibilities, organise myself and maintain sufficient motivation to do anything. I experience episodes of major psychological ill-health on a regular basis with limited periods of reasonable health in between. Judgements about my functional capacity should come from people who have witnessed and know this about me. I know how these standardised tests work. It’s like being in court. You’re asked closed questions that only require a yes or no response and are never allowed to expand or explain your answers. I know that whatever I say, it will be misinterpreted and used against me. If I don’t cooperate my NDIS status will be revoked.

  3. Limited test time means unreliable assessment: There is no possible way for a stranger to “capture the full impact” of my disabilities on my functional capacity in one appointment lasting less than three hours. It has taken years for my practitioners to gain a thorough understanding of my disabilities, one of which was only diagnosed two years ago despite being present all my life. It has taken four years for me to trust and develop relationships with my practitioners. We are all still learning how my different disabilities interact and how they affect my ability to function in life. The thought of having less than three hours to give honest but appropriate answers to trick questions to convey the depth and breadth the impact my disabilities have on my daily life through a limited, over simplistic and standardised tool is already completely overwhelming and makes me feel sick.

Any other related matters

The “Have Your Say On Changes to the NDIS” link on the homepage says they welcome and appreciate feedback. It appears to allow participants, carers, parents, professional bodies or support organisations to have their say about changes being made to the NDIS. I spent time and effort writing a submission about independent assessments and submitted it on January 23. I want to highlight two issues not related to the committee’s terms of reference by focussing on this link.

1) The lack of timeliness and professionalism of the NDIS’s communication with participants.

The communication from the NDIS after I sent in my submission demonstrates continuing serious and systemic deficiencies in timeliness, communication and professional standards. The project team in charge couldn’t even show me the professional courtesy of acknowledging they received my submission until they were pushed to do so by an MP and a formal complaint. This demonstrates an unprofessional attitude bordering on arrogance and contempt, no understanding or appreciation of how much time and effort people put into writing submissions and a lack of awareness or more likely a casual indifference that they are a government body communicating with a person who has disability.

Confirmation from the NDIS finally came three days after an MP’s office had confirmed that my submission had been received.

IACOMMS

Tue, Feb 9, 1:28 PM

Thanks ,

Apologies for not replying to your email on 29/01

I can confirm we have received your submission.

Cheers, doesn’t know me, I am not her friend so signing off “cheers” is inappropriately informal and unacceptable by any professional standard. I assume from its brevity that resented the fact that she had to waste her time communicating with me at all. ’s communication should demonstrate a higher degree of professional respect reflective of my status as a participant, her professional role within the NDIS and the fact that she is communicating on behalf of her employer.

In contrast, the complaints officer handling my complaint about the lack of communication from the project team was very professional. Interestingly, she had the same difficulty I had. The communications team failed to respond to her until the very last day of the accepted complaint handling time frame demonstrating an attitude of arrogance and contempt within their own system. The complaints officer thanked me for being patient and for writing the submission and acknowledged the time I’d taken to provide feedback. The project team, as you can see by the above email, did none of this. It’s pathetic.

2) I do not believe this feedback link is legitimate.

The process followed by the NDIS after receiving my submission was so ineffectual and below the standard expected of any government body that I don’t believe it is legitimate.

a) It is implausible that a federal government body as vast as the NDIS accepts feedback from interested people but cannot use even the most basic of technological support to provide an automatic response to acknowledge that feedback. The NDIS provide automatic responses following enquiries or complaints submitted through their website so why wasn’t that set up for feedback sent via this link? The complaints

  • officer told me that there was an acknowledgement once feedback was submitted but the team “understand it was not very clear and they are working on making an improvement to this in the future.” I sent my submission three times through the link and there was no acknowledgment clear or otherwise. Seriously? They knew it was unclear and still didn’t fix it? Don’t they have technical support that check everything is clear before they open a link to the public? Over the months that this link operated was I the only person who noticed the acknowledge-ment was so insignificant as to be invisible? This is not believable.

b) The only contact information provided on the link was the project team’s email
and this was obviously not monitored as they ignored three emails from me. Even emailing my submis-sion directly to the project team failed to gain a response.

c) The only phone number provided was the general call centre number 1800 800 110 and they had, “no knowledge of the submission link,” and had been given “no clear directions and can’t resolve any enquiri-es related to the link so please don’t ring again.” 1/2/21

d) All of the available options for assistance (1800 number, web chat, enquiries, feedback and pro-ject team emails) could not provide any advice on how I could confirm my submission had been received. This systemic issue has been continually present in the NDIS since the beginning and the subject of thousands of complaints. It’s a faceless organisation that is impenetrable to participants seeking help. It’s worse than Services Australia. At least they try and have improved.

e) Taking twelve working days to acknowledge a submission after numerous requests is rude, improfessional and unacceptable. Without intervention from an MP’s office and a complaint to the NDIS, I imagine and her team would have continued to have a laugh and ignore the pesky, demanding participant who wanted her submission acknowledged.

Based on this experience, I believe this link to provide feedback was a box ticking exercise and a scam. I do not believe that the project team ever had any intention of considering feedback submitted through this link seriously or with respect. People and organisations sent in feedback in good faith with the inten-tion of having their say about independent assessments. The reality is that it didn’t matter what we said or how many of us said it, the NDIS made their decision long ago and independent assess-ments will begin in a few months. This attitude demonstrates an obvious disregard for legitimate and genuine consultation and a lack of transparency about their feedback process. Will the NDIS ever reveal accurate and transparent data about the number of submissions they received? No. The fact that the NDIS is ploughing ahead to introduce inde-pendent assessments indicates they were never going to genuinely consider feedback re-ceived via this link anyway.