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: May 24th, 2026

Introduction

This submission is made in response to the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026.

The submission draws substantially on concerns raised regarding invisible disability, functional capacity assessment, proposed reforms within occupational therapy society discussion papers; it also reflects consistent concerns from therapists, allied health practitioners, participant carers, advocates about implementing standardized systems into the NDIS program; The NDIS has significantly improved participation independence safety quality life Australians’ disabled while measures improve sustainability reduce fraud increase consistency legitimate policy goals these objectives must be achieved through reforms that undermine rights procedural fairness individualized assessment or evidence-based practice, Several elements of this bill risk disproportionately disadvantage people’s invisible fluctuations psychosocial conditions trauma-related chronic illness complex multi-system impairments The bill should not proceed current form without substantial safeguards co-design independent oversight explicit protections participants disabilities may readily observable easily captured standardised assessments.

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 158

4. Prevent the use of rigid standardised assessment tools as the sole determinant of eligibility or funding.
5. Establish transparent review and appeal rights for all assessment and planning decisions.
6. Require co-design with disabled people, allied health professionals, and representative organisations before implementation.
7. Delay implementation of new framework planning until independent evaluation and piloting have occurred.
8. Maintain participant choice and control as core legislative principles.
9. Ensure occupational therapists and other treating professionals remain central contributors to functional assessment.
10. 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.

National Disability Insurance Scheme Amendment Bill

Submission: Submission-158 Standardized assessments may reward superficial presentation over genuine support requirements. This creates significant risks for invisible disability participants:

• be deemed “too functional”;
• receive inadequate budgets;
• lose preventive services;
• deteriorate functionally;
• experience increased mental health crises;
• need more intensive future interventions or disengage from community participation altogether. The bill should explicitly state that these are just one source of information not overriding comprehensive treatment practitioner data.

National Disability Insurance Scheme Amendment

Submission: [158]

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 based upon individualized assessment. Any rule-making power granted to Minister must be tightly constrained so as follows, to ensure decisions remain individualized, clinical & functionally evidenced considered participants are subject arbitrary reduction Parliament retains appropriate oversight significant policy changes Concerns Regarding Definition Functional Capacity The evolving emphasis “functional capacity” raises concern if adopted excludes minimizes environment context Occupational Therapy grounded well-established models such Person Environment Occupation (PEO) framework recognizes cannot understood isolation from environments contextual factors Functionality dynamic shaped physical sensory social cultural trauma task demands availability support accommodations A definition focusing solely on what person can do decontextualised clinical setting fundamentally inconsistent contemporary disability practice evidence-based occupational therapy Excluding environmental context risks

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Submission 158

• Overestimating functional ability;
• Under-identifying support needs;
• Disadvantaging participants with invisible disabilities;
• Failing to recognize 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, stuctured assessment setting but be unable to perform the same task in a real world environment characterised as:

sensory overload; -time pressure; -social complexity; fatigue; competing cognitive demands or lack of supports. The distinction is critical conditions such autism ADHD psychosocial disability acquired brain injury chronic illness.The legislation should therefore explicitly define function capacity context-dependentenvironment-sensitiveassessed over time inclusive impacts Supports accommodations.It also requires that assessments consider whether person can safely consistently repeatedly sustainably within their real-world environments.

Concerns Regarding Support Needs Assessments Standardisation The proposed planning reforms appear shift NDIS away individualized determination reasonable necessary supports standardised allocation methodologies This represents significant philosophical departure original intent NDIS.

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Submission 158

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 clinicalassessment.

Risks for People with Invisible and Fluctuating Disability The Bill risks disproportionately disadvantaging people whose impairments fluctuate overtime.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:

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Submission 158

• 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, * can recover from sensory overload or maintain community participation without significant support.The Bill should include explicit recognition that disability-related functional impairment mustbe assessed longitudinally and contextually rather than through isolated performance tasks.

Importance of Treating Clinician EvidenceTreating allied health practitioners possess longitudinal understanding of participantfunctioning that cannot be replicated through one-off assessments.Occupational therapists in particular assess:Functional performance across environmentsexecutive functioningsensory regulationdaily living capacitycognitive fatiguebehavioural regulatiioncommunity accesssocial participatioriskandsafetyassistive technology needsand sustainabilityof functioning.Treating clinicians often observe participants over monthsor years.

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Submission 158

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, derunning trust in the NDIS ;andincreasing appeals and administrative burden.The legislation should explicitly prohibit fully automated decision-making in relation to eligibility,support budgets,support categories,reassessment decisions,andplan reductions.Human clinical reasoning and individualised consideration must remain central.### Procedural Fairness and Review RightsParticipantsmust retain meaningful opportunitiesto challengedecisions.

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Submission 158 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

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Submission 158

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; in volvment of culturally and linguistically diverse communitie s ;and invol vement o f all i ed healt h prfessionals with direct clinical expertise . Consultation cannot be treated as a procedural formality.The Government should delay implementa tionof major planning refor ms until genuine codesign an d independent evalu ation have occurred.

Recommendations fo r A mendment The following amendments are recommended:

Protect Individualised Assessment Insert legislative provisions confirming that : individualis ed assess ment remains central to ND IS decision-making standard is e tool s ar e supplementary on ly clini cal judgmen t must not b e displacedby formulaic methodologies . ### Protect Invisible nd Fluctuating Disabilit y Include explicit recognitionthat : disabili ty may fluctuate maskingan d compensatorybehavioursmay obscure impairment assessmentsmust consider sustainability , consistency, anda ccumulative impact. ### Require Treating Practitioner Evidence Mandate considerationo flongitudinal evidencefrom treating practitioners including occupational therapists andre other allied health professionals

4.Prevent Fully Automated Decision-Making

National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026

Submission 158

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 excluding people whose disabilities complex invisible fluctuating difficult quantify Occupational therapists working across disability mental health neurodevelopmental practice chronic illness community settings consistently observe functional capacity highly contextual dynamic influenced environmental demands Proposed reforms risk oversimplifying disability ways may unintentionally harm participants already experience substantial barriers participation and support access

The NDIS must remain grounded in individualized assessment participant choice control multidisciplinary evidence procedural fairness clinical reasonings genuine co-design with disablement community This submission urges Committee amend bill ensure that reforms intended secure future NDIS do not intentionally undermine right dignity wellbeing Scheme created support

Submission

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, flicking, pyschosocially, or neuropsychologically disabled individuals; to ensure such considerations are reflected in a future planning framework; preserving its individually tailored approach based upon empirical research.