Submission 158
Submission to the Senate Community Affairs Legislation Committee
National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026
Prepared by: Susan Austin, Valued Directions Occupational Therapy Date: 24 May 2026
Introduction
This submission is made in response to the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.
This submission draws substantially on concerns raised in the Occupational Therapy Society Inc (OTSi) discussion papers regarding invisible disability, functional capacity assessment, and proposed NDIS planning reforms. It also reflects concerns consistently raised by occupational therapists, allied health practitioners, participants, carers, and disability advocates regarding the implementation of standardised assessment systems within the NDIS.
The NDIS is a foundational social reform that has significantly improved participation, independence, safety, and quality of life for Australians with disability. While measures to improve sustainability, reduce fraud, and increase consistency are legitimate policy goals, these objectives must not be achieved through reforms that undermine participant rights, procedural fairness, individualised assessment, or evidence-based practice.
This submission argues that several elements of the Bill risk disproportionately disadvantaging people with invisible disabilities, fluctuating disabilities, psychosocial disability, neurodevelopmental conditions, trauma-related conditions, chronic illness, and complex multi-system impairments.
The Bill should not proceed in its current form without substantial safeguards, co-design, independent oversight, and explicit protections for participants whose disabilities may not be readily observable or easily captured through standardised functional assessments.
Key Recommendations
- Retain individualised, evidence-based planning as the central principle of the NDIS.
- Ensure functional capacity assessments do not override treating clinician evidence.
- Explicitly protect participants with invisible, fluctuating, episodic, psychosocial, and neurodevelopmental disabilities.
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- Prevent the use of rigid standardised assessment tools as the sole determinant of eligibility or funding.
- Establish transparent review and appeal rights for all assessment and planning decisions.
- Require co-design with disabled people, allied health professionals, and representative organisations before implementation.
- Delay implementation of new framework planning until independent evaluation and piloting have occurred.
- Maintain participant choice and control as core legislative principles.
- Ensure occupational therapists and other treating professionals remain central contributors to functional assessment.
- Introduce safeguards to prevent algorithmic or automated decision-making from replacing clinical reasoning.
Concerns Regarding Functional Capacity Frameworks
The Bill introduces a stronger legislative focus on “functional capacity” and foreshadows future assessment frameworks intended to create greater consistency in access and planning decisions.
While consistency is an important objective, there are significant risks associated with oversimplified or standardised models of functional assessment.
Occupational therapists working with invisible disability routinely observe substantial discrepancies between:
- observed presentation during brief assessments;
- actual day-to-day functioning;
- functioning in unfamiliar environments;
- functioning under stress or sensory load;
- sustainability of performance over time; and
- the cumulative impact of fatigue, executive dysfunction, trauma, anxiety, pain, sensory overwhelm, or cognitive impairment.
Many invisible disabilities cannot be accurately understood through snapshot assessments.
People with autism, ADHD, psychosocial disability, ME/CFS, fibromyalgia, acquired brain injury, intellectual disability, PTSD, neurological conditions, and chronic illness may appear superficially capable during short assessments while experiencing profound functional impairment in daily life.
Occupational therapists frequently document “masking” and compensatory behaviours, particularly among autistic women, trauma survivors, and people with high cognitive ability who expend extraordinary effort to maintain minimal functioning.
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Standardised assessment systems risk rewarding superficial presentation rather than identifying genuine support needs.
This creates a substantial risk that participants with invisible disability will:
- be deemed “too functional” for support;
- receive inadequate budgets;
- lose preventative supports;
- deteriorate functionally;
- experience increased mental health crises;
- require more intensive future interventions; or
- disengage from community participation altogether.
The Bill should explicitly state that functional assessments are only one source of evidence and cannot override comprehensive evidence from treating practitioners.
Concerns Regarding Ministerial Powers to Impose Category-Wide Reductions
The Bill appears to expand the Minister’s capacity to set rules or directions that may enable broad, category-wide funding adjustments (for example, across support classes such as community access), without sufficient regard to individual participant circumstances.
This raises serious concerns regarding the potential for sweeping reductions (e.g. percentage-based cuts applied across entire support categories) that are not grounded in individual functional need, clinical evidence, or participant goals.
Such provisions risk fundamentally undermining the core principles of the NDIS, particularly:
- individualised assessment;
- reasonable and necessary decision-making;
- participant choice and control; and
- evidence-based planning.
A blanket reduction approach (for example, applying a fixed percentage reduction to community access supports across participants) would:
- disproportionately impact participants with high social support needs;
- increase isolation and mental health risk;
- reduce preventative supports that maintain stability;
- shift costs to crisis systems (e.g. acute health, housing, justice);
- ignore variability in environmental demands; and
- penalise participants whose disabilities require higher levels of community-based support to maintain functioning.
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From an occupational therapy perspective, community access supports are often not discretionary but essential for:
- maintaining mental health stability;
- preventing functional decline;
- supporting executive functioning;
- enabling participation in education and employment pathways;
- reducing carer burnout; and
- sustaining daily living routines.
The Bill should explicitly prohibit the use of broad, category-wide funding reductions that are not based on individualised assessment.
Any rule-making power granted to the Minister must be tightly constrained to ensure that:
- decisions remain individualised;
- clinical and functional evidence is considered;
- participants are not subject to arbitrary reductions; and
- Parliament retains appropriate oversight of significant policy changes.
Concerns Regarding Definition of Functional Capacity
The Bill’s evolving emphasis on “functional capacity” raises concern if the definition adopted excludes or minimises environmental context.
Occupational therapy is grounded in well-established models such as the Person–Environment–Occupation (PEO) framework, which recognises that function cannot be understood in isolation from environmental and contextual factors.
Functional capacity is not a fixed attribute of the individual. It is dynamically shaped by:
- physical environments (e.g. housing, transport, accessibility);
- sensory environments (e.g. noise, lighting, crowding);
- social environments (e.g. supports, relationships, stigma);
- cultural context;
- trauma history;
- task demands; and
- availability of supports and accommodations.
A definition of functional capacity that focuses solely on what a person can do in a decontextualised or clinical setting is fundamentally inconsistent with contemporary disability practice and evidence-based occupational therapy.
Excluding environmental context risks:
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- overestimating functional ability;
- under-identifying support needs;
- disadvantaging participants with invisible disabilities;
- failing to recognise the impact of inaccessible environments; and
- placing responsibility on individuals rather than systems.
For example, a participant may demonstrate the ability to complete a task in a quiet, structured assessment setting, but be unable to perform the same task in a real-world environment characterised by:
- sensory overload;
- time pressure;
- social complexity;
- fatigue;
- competing cognitive demands; or
- lack of supports.
This distinction is critical in conditions such as autism, ADHD, psychosocial disability, aquired brain injury, and chronic illness.
The legislation should therefore explicitly define functional capacity as:
- context-dependent;
- environment-sensitive;
- assessed over time; and
- inclusive of the impact of supports and accommodations.
It should also require that assessment processes consider whether a person can perform tasks:
- safely;
- consistently;
- repeatedly; and
- sustainably, within their real-world environments.
Concerns Regarding Support Needs
Assessments and Standardisation
The proposed planning reforms appear to shift the NDIS away from individualised determination of reasonable and necessary supports and toward standardised support allocation methodologies.
This represents a significant philosophical departure from the original intent of the NDIS.
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The NDIS was designed to recognise that disability impacts people differently and that supports must be tailored to individual circumstances, goals, environments, trauma histories, co-occurring conditions, cultural context, and personal risk factors.
A heavily standardised framework risks:
- reducing participants to diagnostic categories;
- minimising the complexity of intersecting impairments;
- privileging administrative efficiency over participant outcomes;
- discouraging nuanced clinical reasoning;
- reducing flexibility in support delivery; and
- creating systemic inequities for people whose disabilities are less visible or harder to quantify.
Occupational therapy assessment relies heavily on contextual understanding. Functional capacity cannot be meaningfully separated from:
- environmental supports;
- sensory environments;
- trauma history;
- social isolation;
- executive functioning demands;
- cumulative fatigue;
- housing instability;
- carer supports;
- communication barriers; and
- community accessibility.
No standardised tool can adequately replace comprehensive multidisciplinary clinical assessment.
Risks for People with Invisible and Fluctuating Disability
The Bill risks disproportionately disadvantaging people whose impairments fluctuate over time.
Many participants experience variable functioning across days, weeks, or environments. This includes participants with:
- psychosocial disability;
- autoimmune disease;
- neurological conditions;
- chronic pain;
- epilepsy;
- migraine disorders;
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- trauma-related disorders;
- long COVID;
- ME/CFS; and
- neurodevelopmental disability.
Participants may temporarily perform tasks during assessments that they cannot safely, consistently, repeatedly, or sustainably perform in everyday life.
This distinction is well recognised within occupational therapy practice.
A participant who can complete an activity once in a clinical setting may still be unable to:
- sustain employment;
- manage parenting responsibilities;
- attend appointments consistently;
- regulate emotions safely;
- maintain nutrition and hygiene;
- manage medications;
- navigate public environments;
- recover from sensory overload; or
- maintain community participation without significant support.
The Bill should include explicit recognition that disability-related functional impairment must be assessed longitudinally and contextually rather than through isolated performance tasks.
Importance of Treating Clinician Evidence
Treating allied health practitioners possess longitudinal understanding of participant functioning that cannot be replicated through one-off assessments.
Occupational therapists in particular assess:
- functional performance across environments;
- executive functioning;
- sensory regulation;
- daily living capacity;
- cognitive fatigue;
- behavioural regulation;
- community access;
- social participation;
- risk and safety;
- assistive technology needs; and
- sustainability of functioning.
Treating clinicians often observe participants over months or years.
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Any framework that reduces the weighting of treating clinician evidence risks increasing inaccurate decisions and worsening participant outcomes.
The legislation should therefore:
- require consideration of treating practitioner evidence;
- prohibit sole reliance on standardised assessment outcomes;
- ensure multidisciplinary evidence remains central to planning decisions; and
- preserve participant rights to submit additional evidence.
Concerns About Automated or Algorithmic Decision-Making
There is growing concern within the disability community regarding the potential use of algorithmic systems, formula-based budget allocation, or automated planning methodologies.
While consistency and transparency are important, disability support decisions involve nuanced clinical, social, and environmental considerations that cannot be adequately captured through automated processes.
Overreliance on algorithmic systems risks:
- reproducing systemic bias;
- disadvantaging people with complex or atypical presentations;
- oversimplifying disability;
- reducing transparency;
- limiting procedural fairness;
- undermining trust in the NDIS; and
- increasing appeals and administrative burden.
The legislation should explicitly prohibit fully automated decision-making in relation to:
- eligibility;
- support budgets;
- support categories;
- reassessment decisions; and
- plan reductions.
Human clinical reasoning and individualised consideration must remain central.
Procedural Fairness and Review Rights
Participants must retain meaningful opportunities to challenge decisions.
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Changes to assessment and planning frameworks should not weaken access to review mechanisms or reduce transparency regarding how decisions are made.
Participants should:
- receive clear written reasons for decisions;
- have access to assessment methodologies used;
- understand how evidence was weighted;
- be able to submit additional evidence;
- have access to independent advocacy; and
- retain accessible internal and external review rights.
People with disability should not be expected to navigate increasingly complex systems without adequate support.
Fraud Prevention Must Not Harm Legitimate Participants
Measures aimed at reducing fraud and non-compliance are necessary and supported.
However, anti-fraud responses must be proportionate and carefully targeted.
Broad restrictions, excessive evidence burdens, or overly rigid planning systems may unintentionally penalise legitimate participants while failing to address sophisticated fraudulent activity.
Participants with cognitive disability, psychosocial disability, intellectual disability, or communication barriers may be particularly vulnerable to adverse consequences arising from increased administrative complexity.
Fraud prevention strategies should focus primarily on:
- provider regulation;
- quality assurance;
- transparency of billing;
- enforcement against exploitative providers;
- participant safeguards; and
- improved oversight of high-risk service models.
Participants themselves should not bear the primary burden of systemic fraud control.
The Need for Genuine Co-Design
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The disability community has repeatedly expressed concern regarding the pace and scope of proposed reforms.
Meaningful co-design requires:
- accessible consultation periods;
- publication of proposed rules and assessment tools before implementation;
- independent pilot testing;
- transparent evaluation processes;
- involvement of disabled people;
- involvement of First Nations communities;
- involvement of culturally and linguistically diverse communities; and
- involvement of allied health professionals with direct clinical expertise.
Consultation cannot be treated as a procedural formality.
The Government should delay implementation of major planning reforms until genuine co- design and independent evaluation have occurred.
Recommendations for Amendment
The following amendments are recommended:
1. Protect Individualised Assessment
Insert legislative provisions confirming that:
- individualised assessment remains central to NDIS decision-making;
- standardised tools are supplementary only;
- clinical judgment must not be displaced by formulaic methodologies.
2. Protect Invisible and Fluctuating Disability
Include explicit recognition that:
- disability may fluctuate;
- masking and compensatory behaviours may obscure impairment;
- assessments must consider sustainability, consistency, and cumulative impact.
3. Require Treating Practitioner Evidence
Mandate consideration of longitudinal evidence from treating practitioners, including occupational therapists and other allied health professionals.
4. Prevent Fully Automated Decision-Making
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Insert safeguards preventing eligibility or funding decisions from being determined solely by algorithms, automated systems, or standardised scoring tools.
Strengthen Procedural Fairness
Ensure participants retain:
- full review rights;
- transparent reasoning;
- access to advocacy;
- access to assessment methodologies;
- opportunities to submit additional evidence.
Delay Implementation Pending Evaluation
Delay rollout of new framework planning until:
- pilot programs are independently evaluated;
- outcomes data is publicly released;
- disability representative organisations support implementation.
Conclusion
The long-term sustainability of the NDIS is critically important. However, sustainability cannot be achieved by reducing fairness, undermining evidence-based practice, or excluding people whose disabilities are complex, invisible, fluctuating, or difficult to quantify.
Occupational therapists working across disability, mental health, neurodevelopmental practice, chronic illness, and community settings consistently observe that functional capacity is highly contextual, dynamic, and influenced by environmental demands.
The proposed reforms risk oversimplifying disability in ways that may unintentionally harm participants who already experience substantial barriers to participation and support access.
The NDIS must remain grounded in:
- individualised assessment;
- participant choice and control;
- multidisciplinary evidence;
- procedural fairness;
- clinical reasoning; and
- genuine co-design with the disability community.
This submission urges the Committee to amend the Bill to ensure that reforms intended to secure the future of the NDIS do not unintentionally undermine the rights, dignity, and wellbeing of the people the Scheme was created to support.
Submission 158
Thank you for the opportunity to provide this submission. I urge the Committee to carefully consider the disproportionate impact these reforms may have on people with invisible, fluctuating, psychosocial, and neurodevelopmental disabilities, and to ensure that any future planning framework preserves the individualised, evidence-based foundations of the NDIS.
Yours Sincerely,
Susan Austin
Director
Valued Directions Occupational Therapy
Hobart, Tasmania