Occupational therapist outlines concerns regarding functional capacity definition and support cuts (Provider experience) | External submission

Submission 2770 - Supplementary Submission

Submission to: NDIS Amendment (“Securing the future for NDIS”) Bill

1 June, 2026 Notes from an Occupational Therapist

Introduction:

I am an Occupational Therapist with over 20 years experience. I have been working with NDIS participants since the NDIS rolled out 12 years ago. I’ve worked in a variety of roles: in the public health system, as an employee of a small private business, and as a sole trader.

I have helped participants meet their NDIS goals by assisting them with assessment, documentation and intervention in a variety of areas.The majority of my work hours are spent writing long reports to the NDIS, as is necessary to assist clients to seek funding for the supports they need to be able to live their lives with as much safety, independence, dignity and quality of life as possible. (Making report templates for assistive technology and complex home modifications shorter is one way NDIS could save funding!)

I am also a parent of autistic children, including one who is home schooling (by necessity not choice). As such, I also have the experience of being a carer and a “child nominee” for NDIS participants, and understand the stress that parents go through when trying to navigate the hurdles of both the NDIS system and the Education system, with a reducing amount of support from NDIS, while we also provide a much higher level of day to day care to our children than parents of children without disability do.

Both my home and work roles are stressful, time consuming, and often difficult to juggle - and the more that NDIS changes contribute to that stress in various ways, the less I can work, the less I can help my clients, and the less tax and expenditure I contribute to the economy. As a mother, and as person working in a female-dominated allied health profession, I am one example of what it means when people say “the proposed changes to the NDIS will impact women disproportionately”. However, in this submission I will focus my concerns primarily on what I see in my work role.

I have many, many concerns with the proposed NDIS Amendment Bill. It backtracks on some of the key principles underpinning the NDIS, such as participants having choice and control, and having access to the reasonable and necessary supports they require (based on their individual needs) to help them “live an ordinary life” on par with other people. Reducing supports increases risks to Australians with disabilities, in many different ways. The proposed changes have short term cost-saving, rather support for people with disabilities, as their driving force – while failing to acknowledge that support needs do not disappear (they are just transferred elsewhere, e.g. to hospitals and unpaid carers), or that NDIS funding is actually an investment, with a positive net effect to the economy (each $1 spent on NDIS returns $2.25 to the economy as per the Per Capita report, which Bill Shorten often quoted). Some of my key concerns are:

This Bill will help Labor rip away support from almost a third of NDIS participants entirely and make broad cuts to others. Those cuts and loss of support will cause harm and cost lives.
This Bill will support reductionist assessments and algorithm-based “robo planning” which will likely be set up to underestimate support needs - just like we’re seeing in Aged Care, with devastating effects.

Submission 2770 - Supplementary Submission

This Bill will also cost hundreds of thousands of Australian jobs. I recall that, back when the NDIS was first rolled out, it was described as like “a jumbo jet being built mid-flight”. If the NDIS is a jumbo jet, then these NDIS changes involve dismantling the plane mid flight, and are akin to:
Tossing a third of all passengers out the door in mid-air, one by one (a fiscal decision made by someone who is not on the plane and does not understand the ins and outs of how the plane operates), not so they can give the remaining passengers more leg room, but so they can chop off the back third of the plane and use it as scrap metal for other purposes (Buses? Nuclear submarines?)
Ejecting the passengers before the parachutes (foundational supports) are fully designed, let alone fitted to the passengers.
Giving the parachute factory a sixth of the budget that they would need to manufacture quality, full sized parachutes (foundational supports), risking there being not enough to go around, and the dire outcomes that will cause.

Schedule 1: Access and Planning

1.1 Functional Capacity Definition

Description:

The bill proposes a new definition of functional capacity which assesses what people can do without assistance from other people, assistive technology or modifications, and excluding (as far as possible) environmental and personal circumstances.

Concerns:

Disability and functional capacity do not occur in isolation from environmental and personal circumstances.
This definition of functional capacity is simplistic and contradicts existing models used in occupational therapy, in which occupational performance or function is seen as being impacted by numerous factors relating to the person, their environment, and the activities they engage in. Excluding relevant factors leads to an incorrect understanding of functional capacity of an individual.
The proposal appears inconsistent with the social model of disability underpinning both the NDIS and the Convention on the Rights of Persons with Disabilities (UNCRPD).
Assessing functional capacity is usually the role of allied health professionals, particularly occupational therapists, who have internationally recognised expertise in this area. While I don’t mind work being taken off me (as I have too much already), I have strong concerns that NDIA have an oversimplified understanding of function, which fails to take individual context and complexities into account, and which will lead to inadequate support funding and associated risks for people with disability. 2

Submission 2770 - Supplementary Submission

Under the current system, participants can select their providers, and often do so based on the provider’s profession and areas of expertise, as well as other factors such as availability, reputation, and “fit”.

Examples:

(Current) Mary lives in Melbourne and has motor neurone disease (MND). She sees a team of health professionals at the MND clinic who have an excellent understanding of MND, including the different types of MND, predicted rate of progression, supports that help, etc. She gets a report from an occupational therapist who has had lengthy discussions with her and has completed standardised assessments – but has also observed her function in daily activities, has seen her home environment and the barriers that are in it which need modifying, understands the types of assistive technology (disability related equipment) and home modifications she is likely to need, and has met her husband (“informal support”) and is aware of the level of assistance he can provide. Secondly, she gets a report from the physiotherapist, who has observed her mobility, transfers, and respiratory function, has completed standardised assessments of her muscle strength and balance, provided exercises, trialled mobility aids, and monitored progress. Thirdly, she gets a report from the speech pathologist, regarding changes to her speech and swallowing. Each of these three health professionals provide recommendations relevant to their scope of practise, which the NDIA staff member can read and consider while developing her NDIS plan.

VERSES:

(Future) Mary has MND. She sees a team of health professionals at the MND clinic. She does not ask these professionals for reports because she has no funding to spare for reports, and NDIA no longer take allied health functional reports into account anyway. She is seen for a functional capacity by Jane at the NDIA via telephone. Jane isn’t very familiar with MND and has never heard of the type that Mary has. She takes Mary through a series of questions about her daily function that are in the ICAN assessment, the assessment form that NDIA have selected to use with all participants. Jane doesn’t see Mary face to face. She can’t see what her mobility looks like, or whether she can safely move around her home, or whether she can use one arm more than the other – it’s all just based on what Mary says. Mary has difficulty articulating her needs because her MND has affected how clear her speech is. Jane does the best she can and then puts the results into the computer for the algorithm to develop her NDIS plan. When Mary receives the NDIS plan, she realises that it is underfunded, with many supports she needs missing from the plan. Mary can appeal, but the plan cannot be changed even at tribunal level (they can only request the same assessment be repeated). Mary passes away 2 years later (from MND), before the tribunal case goes to hearing.

1.2 Activities “as a whole” and whole-of-person assessment

Description:

Submission 2770 - Supplementary Submission

The Bill risks reversing the “whole person” approach, which may disadvantage people with multiple, intersecting impairments.

Concerns:

If funding can only be allocated to a small number of set impairment categories or functional domains, the integrity of comprehensive assessment will be compromised – because in reality, people, and disabilities, are much more complex than that. It is common for people to have multiple impairments, which each have overlapping symptoms and each contributing to functional impact in a way that can be difficult to tease apart.

Example/s:

(Current) Sam is a 30 year old who lives in rural Queensland and is on the NDIS for severe rheumatoid arthritis (RA), which he’s had since he was a child (originally “juvenile arthritis). His symptoms include stiff, painful and swollen joints at many joints around his body, as well as fatigue, fever, and poor appetite. Sam also has myalgic encephalomyelitis (ME) causing chronic fatigue and other symptoms, but NDIS deemed these not severe enough to meet NDIS access criteria. Sam lives alone in a country town and is unable to manage tasks like grocery shopping and driving to appointments due to increasing difficulty with both fatigue and joint movement. He currently receives 2 hours/week for social and community participation which he uses to access his frequent appointments and pharmacy visits. He is seeking an additional 2 hours funding per week (at a cost of $70/hour) for a support worker to also take him grocery shopping in his next plan. NDIA see that this is related to his RA symptoms of fatigue and stiff joints, and approve the request. They are aware that ME could also be contributing to his fatigue, which is acceptable.
(Future) NDIS deny his request, claiming that his fatigue is caused at least in part by his ME/CFS, and is not wholly related to his RA. The Minister also cut social and community participation funding by 50% for everyone on the scheme, so the 2 hours he did have for this was reduced to 1 hour. There is no mainstream support that can help him in his location. He ends up going to hospital for four months with acopia, depression and malnutrition (at a cost to the government of $2000/day). His hospital team are concerned this will recur after discharge if his needs are still not met adequately.

1.3 Functional Capacity, Disability Evidence, and Safeguarding

Description:

The proposed amendments significantly expand the role of functional capacity assessment within NDIS access, planning, reassessment, and funding decisions.

Concerns:

See 1.1
This embeds an increasingly reductionist approach to functional capacity that risks oversimplifying disability, excluding critical context, and weakening safeguards.

Submission 2770 - Supplementary Submission

There has been a lack of transparency around assessment methodologies and impairment categorisation to date.
Non-clinical workforces should not be used to make complex determinations regarding disability-related functional capacity and support needs.
Functional assessment is usually the role of occupational therapists and (to an extent) other allied health professionals. Occupational therapists observe people functioning in various environments (e.g. home, clinic, workplace) as well as interviewing clients and carers and using appropriate standardised assessments – that is, selecting from a range of assessment tools that are valid and reliable for the person, which varies depending on their age group, diagnosis, and presenting issues – NOT use of a one-size-fits-all assessment which doesn’t actually capture all issues as well as it should – especially if modified by the agency.
In contrast, the vast majority of NDIA personnel do not have health professional qualifications.
It has been proposed that NDIS will put participants in different categories of “classes” of participant status, based on their diagnoses, and send each participant an “impairment notice” to tell them of their class. The proposed categories are: physical, sensory, intellectual, cognitive, psychosocial and neurological. This again oversimplifies disability. Some diagnoses may be easy to “pigeonhole”, but many will not be, because they cross the boundaries of many of these categories.
There is a lack of detail in the Bill regarding the intent and means of trying to divide participants into “classes”. It may be to assist “robo-planning”, the use of a computer algorithm to be used for planning purposes – but if the information going in is faulty, the planning coming out will be too. It may also be a method of dividing participants into groups that the Minister then intends to use powers on to cut various supports from different groups, e.g. by saying “core supports (which includes support worker funding) for people with autism are to be cut by 70%”, which would obviously be unfair and irresponsible as it does not take individual factors, including severity, into account. (Some people with autism require round-the-clock care.)

Example/s:

See 1.1
Autism is an example of a diagnosis that is not easy to categorise into the above mentioned “classes”, because of the diverse ways it can impact people (“if you’ve met one person with autism, you’ve met one person with autism”). In fact, it could fit in ANY OR ALL of the above categories. Some autistic people appear fine physically, while many others have related co occuring conditions such as joint hypermobility or dyspraxia (motor planning problems). Most have sensory differences, such as being oversensitive to sound, the feel of clothing, the taste of food, etc. Others may seek out more sensory input (e.g. want to shower six times a day), or be always on the move. Some autistic people have co-occurring intellectual disability, some have an average IQ, and some are bona fide geniuses who would be appalled to receive an impairment notice calling them “intellectually impaired”. Executive dysfunction and burnout can impact cognitive processes. Psychosocial problems such as anxiety and depression are common co-occurances, particularly when people are late diagnosed and have not been well supported to date. Autism is defined as a neurodevelopmental condition.

Submission 2770 - Supplementary Submission

The above is only one example of a diagnosis that can fit in many categories. It gets even more complicated when a person has multiple diagnoses with overlapping symptoms.

1.4 Self-Management and Executive Function

Description:

The functional domain of self-management includes a person’s ability to plan and sequence activities, organise routines, manage appointments, initiate tasks, regulate behaviour, navigate systems, etc.

This can be impaired in people with autism, cognitive changes, brain injury, intellectual disability, psychosocial disability, and many neurological conditions.

Concerns

A snapshot style assessment will likely underestimate these needs, especially when people’s needs fluctuate and present inconsistently.
It is common for people with autism to (consciously or automatically) mask their symptoms during formal assessments (having masked their traits and difficulties in an attempt to fit in at school, work, and other social situations across many years, especially if late diagnosed).
People with cognitive problems, intellectual disabilities, speech problems, and/or language barriers may not be able to describe their function in these areas well, causing their needs to be poorly understood by the assessor, especially if they are unable to have a family member or well known support coordinator present on the day of assessment.
Skilled and experienced allied health professionals who have an in-depth understanding of these challenges as well as access to a choice of multiple assessment methods and tools, are likely to be able to capture these difficulties much better than an NDIA staff member who does not have a health professional background, and who is using one type of assessment for every participant (Support Needs Assessment).
Under-estimation of these difficulties would disadvantage certain participant groups, especially those with invisible (or less visible / less physical) conditions.

Example/s:

John is a 27-year-old with level 2 autism, ADHD, moderate intellectual disability, depression/anxiety, OCD and PTSD. His diagnoses impact his function in multiple ways. Although he can physically take a shower, he has a lot of difficulty initiating and completing the task, leading to him showering only around once a fortnight. John also has difficulty managing forms, navigating systems (especially complex ones like NDIS), understanding a bus timetable, referring to providers, and making phone calls. He hasn’t made it to the dentist in 6 years. He processes sensory information differently from other people and becomes easily overwhelmed by noises, lights, and other sensations so tends to stay home on his own in a dimly lit apartment most of the time. When he does out to the shops, he becomes extremely fatigued and overwhelmed afterwards and is in bed for most of the next 5 days, except for toileting and eating simple food like toast. It’s also hard to him to interpret social cues, especially over the 6

Submission 2770 - Supplementary Submission

phone, so he usually avoids phone calls unless it’s someone he knows well. He knows how to vacuum, but is unable to because his executive function problems, compulsive buying, and depression have led to a build up of personal items in his house that he has not been able to sort and organise.

(Current) He has a support coordinator who can help arrange referrals for him, assist with NDIS forms, and sit with him in his planning meeting to help describe his challenges or prompt him to. He also has an OT report which describes his level of function in each functional domain including self-management. He may get assistance with managing hoarding.
(Future) His support co-ordinator is no longer funded. NDIA no longer consider OT reports on functional capacity. The NDIA staff member asks John if he can shower, grocery shop, and vacuum on his own. He says yes to each. He’s unable to describe how his executive function problems impact on his day to day function, and that all goes undetected. John gets removed from the NDIS. There are no foundational supports available to help him yet, and he falls between the gaps (/chasms) in the system, leaving him with little support.
Or, NDIA tries to call him a couple of times but he misses the calls, and doesn’t see his email because he’s forgotten the password and can’t figure out how to access it, so he get’s removed from the NDIS. Without support, he falls into a heap.

1.5 Tightening of Permanence and “appropriate treatment”

Description:

The Bill introduces a significantly stricter permanence test requiring participants to undertake “all appropriate treatments” before impairments may be considered permanent.

Concerns:

The proposed definition states that treatment may still be considered “appropriate” regardless of financial barriers, geographical location, or a person’s ability to access the treatment.
This disadvantages people who can’t access treatments because of factors such as poverty, workforce shortages, trauma, lack of specialists in the region, lack of culturally appropriate services, communication barriers, transport barriers etc.
It also raises concerns about bodily autonomy and consent (the right to refuse a treatment that is invasive, painful, or medically risky).
The requirements for documentation don’t take into account situations where people have lost access to their medical records for various reasons, e.g. their old GP practise closed down, or the papers were in a cabinet that got flooded, or their laptop died, or they had to leave the house with only the clothes on their backs to escape family violence.
It is unclear where the boundaries of “appropriate treatment” are. Example/s:
Adeline has level 2 autism, myalgic encephalomyelitis (ME), and Ehler’s Danlos Syndrome (EDS). She lives in a rural area in West Australia.

Current: 7

Submission 2770 - Supplementary Submission

Adeline was accepted on to NDIS previously with level 2 autism as it is in the List A of diagnoses likely to be permanent, ensuring her access to the scheme.
NDIA don’t recognise her Ehler’s Danlos because, although her GP has described how she meets all diagnostic criteria, and her OT has provided photos of her extremely hypermobile joints and described impact on function, she hasn’t yet gone through the entire diagnostic process including waiting 3 years to see a rheumatologist, getting genetic testing, etc.
Adeline’s Ehler’s Danlos symptoms are so severe that she needs a powered wheelchair in the community, but NDIA won’t fund one, because she is on the scheme for autism not EDS.
NDIA don’t recognise her myalgic encephalomyelitis as likely to be permanent even though it is in 80% of cases. No matter how many medical reports she submits, NDIA say it’s insufficient.

Future:

NDIA adds that Adeline hasn’t tried all appropriate treatments for ME, because she hasn’t tried graded exercise or cognitive behavioural therapy. Adeline requests an internal review and provides research papers and clinical guidelines saying these treatments are no longer recommended for ME and in fact have been shown to make it worse. NDIA accept that but then say Adeline hasn’t tried exercise physiology and occupational therapy. Adeline points out that there are no exercise physiologists within a 2 hour drive of where she lives, and she doesn’t have enough funding for any more OT at present unless her NDIS plan is increased. NDIA say too bad, so sad, you don’t meet criteria.
Her autism is dismissed by the NDIS as “only moderate autism” (following 3 years of the government unfairly dismissing autism as “mild to moderate” and common in the media), despite level 2 autism actually being defined by internationally recognised diagnostic manuals as “requires substantial support”, which is very close to the NDIS eligibility criteria of “significant functional impact.”
Adeline feels like she’s going around in circles looking for answers to problems that have been impacting her greatly for years/decades, and not getting anywhere. She is at risk of suicide but can’t find anyone who can help her.

1.6 Plan Reassessments and Suspension Powers

Description:

The Bill significantly restricts reassessment processes by:

Extending the time that NDIA has to make a decision on a reassessment from 21 to 90 days.
Limiting who can request reassessment
Imposing stricter requirements of evidence
Narrowing what counts as exceptional circumstances. The Bill also allows NDIS plans to be suspended when the Agency “cannot contact” a participant.

Concerns:

About reassessment:

Submission 2770 - Supplementary Submission

People with disabilities can be subject to sudden changes – e.g. housing instability such as being asked to leave a rental property and having nowhere else accessible to go, sudden deterioration in a progressive neurological condition such as multiple sclerosis, and loss of informal supports (unpaid carers, e.g. if a parent dies or a spouse moves out).
The requirement that change be “unanticipated” could create barriers when a need for increased support was foreseeable but still very impactful. It also makes ZERO sense unless the anticipated change was fully accounted for at the time the plan was created, which seems unlikely, as NDIA also say they can only provide funding based on current needs, not future needs.
The requirement that the change be permanent would fail to assist with temporary situations such as a person needing much more help while their partner/main carer is away or in hospital.

About suspension powers:

The proposal to suspend plans if the agency cannot contact a participant presents serious safeguarding risks. People should not have the supports they need to live ripped away from them just because they missed a phone call or two.
Some participants have barriers to communication. They may be blind, deaf, have speech difficulties, have cognitive problems, or have English as a second language.
Other participants may have none of the above barriers but can still miss a phone call. Although NDIA usually text 5-60 minutes before calling a participant, it is still likely that a person who is not on their mobile phone 24/7 can miss both the text and the phone call. (I’ve missed calls from NDIS at times including when I’ve been outside gardening, when I was visiting a client at work and had my phone on silent, and when I’ve been driving.)
NDIA call from an unidentified number. They don’t leave a direct number or their full name, so you can’t call them back. Emails sent to NDIA frequently go unanswered for months.

Example regarding reassessments:

Matthew has secondary progressive multiple sclerosis, impacting him in many ways (reduced mobility, “brain fog”, muscle spasms, fatigue, heat sensitivity, etc). He experiences a decline in his overall condition, resulting in him needing to use a wheelchair full time, being no longer able to transfer to/from a car seat, and no longer able to step over the hob into his shower recess. He urgently needs more support, including increased support worker hours, and increased therapy hours for occupational therapy assessments of his need for vehicle modifications, a custom powered wheelchair, and major bathroom modifications (all of which are lengthy processes taking many hours of therapy time). Mathew submits a Change of Circumstances form and a report from his occupational therapist to request the funding needed to commence these processed.
Current: Despite the participant service guarantee, Matthew doesn’t hear back from NDIS for 4 months, even when he and his support coordinator try following up via phone and email. In the meantime, he is largely housebound, unable to leave the house except in an uncomfortable manual wheelchair (that doesn’t meet his postural needs and causes pain) in a wheelchair taxi for essential medical care. He can’t use his own shower, and only has enough support hours

Submission 2770 - Supplementary Submission

for a support worker to sponge-bathe him on his bed twice a week. But he does eventually hear back from NDIA and has most of his requests approved.

Future: NDIA could potentially (but hopefully wouldn’t!!) say that his decline was anticipated, because multiple sclerosis is a progressive neurological condition, and decline his request for additional support work and therapy hours. He may end up having a fall or developing a nasty pressure injury, and needing to go to hospital where he would likely stay for many months, or even a year (at a cost to the government of approx. $2000/day) as he can’t be discharged until his home environment is safe. And/or, his assistive technology funding for a powered wheelchair or other essential equipment may be denied or delayed by NDIA - to the extent that he ends up paying so much in equipment rental costs (through his NDIS plan) to hire suitable equipment while waiting for NDIS to approve purchase of one, that the hire fees add up to double what it would have cost if NDIA had just funded his equipment in the first place.

Example regarding plan suspension:

Michelle has a thoracic spinal cord injury and works for Defence. She misses a call from NDIA while she is at work, in a role where she is unable to answer personal phone calls. She misses a second call from them while she is in the dentist’s chair. She can’t call them back because they didn’t leave a number or surname. She emails the enquiries line but gets no response. The next day, she finds her plan is suspended. This means that she has no funding available to pay her support workers who visit daily to help her shower, help with transport to work, and help with domestic chores that she is unable to manage from her wheelchair. She has to take personal leave while sorting this out (on top of leave also taken for medical complications and appointments), and is at risk of losing her job.

1.7 Funding Cuts and Ministerial Powers

Description:

The Bill grants the Minister extraordinarily broad powers to reduce funding for specified groups through support determination, meaning that the Minister will have the power to decide on a whim that they can make substantial cuts to the funding for all people in a particular cohort (e.g. cutting plans to all children, or all people with Downs Syndrome, or all people with transport in their plans) by a set percentage, regardless of their individual needs and the risks that not meeting those needs presents.

Concerns:

This presents a huge risk of increased discrimination against certain client groups, such as all people with psychosocial disability, or all people with autism – groups that are already treated worse, under the scheme, than people with more obvious physical disabilities.
It has already been flagged that the Minister will use these powers to cut social and community funding by 50% and therapy funding by 10% to everyone on the scheme - regardless of how severe their disability is and how much they depend on that support. I would like to point out that social and community funding isn’t just “taking people out for coffees and haircuts” (and also, coffees and haircuts aren’t funded) – it’s often the ONLY way people can leave their 10

Submission 2770 - Supplementary Submission

house. It’s their access to therapy clinics, to medical appointments, to visit disability equipment showrooms to trial essential equipment, to the bank, to the pharmacy, etc as well as social participation, which is also an important aspect of life.

Broad cuts like this are dangerous because they strip supports – whether by 10% or 99% - en masse across the board without taking individual circumstances into account.
This presents a significant departure from the foundational principles on the NDIS, which are intended to be based on individualised assessment of needs, not arbitrary fiscal measures.

Example/s:

Lucy is 14 year old with level 3 autism, an intellectual disability, and PTSD from school related trama. She lives in Canberra. Lucy is minimally verbal, only able to speak a small number of words and phrases. She has significant developmental delays. She is unable to read or write, and is working on learning to use an AAC device for communication, but is not managing this consistently yet. She uses continence aids. Lucy no longer attends school due to bullying she experienced at one school, and then a worsening in her behaviours of concern that was observed from her copying the actions of other children with significant disabilities at another school. Lucy is now home with her mother full time, and is enrolled in home education. Lucy requires support 24/7, which is primarily provided by her parents, and supplemented by support work. They are slowly re-building her daily and weekly routine. Lucy volunteers at Lids 4 Kids (with help from a support worker) where she helps sort bottle tops into colours one afternoon a week, a role she takes pride in. She also goes to an equine-assisted occupational therapy sessions fortnightly, which she very much enjoys, and goes to speech pathology weekly, where she is making slow but steady progress with use of an AAC device for communication. Lucy also receives 2 hours support work a day for assistance with her morning routine including showering. Lucy’s mother has fought hard for these supports, including at the administrative review tribunal, where after a stressful 2 year long process, the member determined that these supports are reasonable and necessary for Lucy, and overturned the NDIA’s decision to cut her funding. Lucy’s mother is no longer able to work full time because of her caring role, and her income has taken a big cut, but she does manage some work from home when a support worker takes Lucy is out with her support worker, which is important as they would be unable to afford the mortgage (given Canberra’s house prices) and bills on her husband’s income alone. It’s a difficult juggle and she is at high risk of burnout.
(Future): The Minister decides that all children/teens with level 2 autism must leave the scheme and go to the underfunded Thriving Kids scheme instead, but as a teen with level 3 autism, Lucy remains on the scheme. The Minister then decides that no-one under age 18 on the NDIS will receive support work in future, declaring that it is “parental responsibility”, without taking into account that children like Lucy require a much higher level of support than children without disability. They also cut social and community supports for everyone by 50%. Lucy loses both her personal care assistance and her help with her volunteer work role. Her mother takes more on and can no longer work (or pay tax) at all. She is in burnout from caring for Lucy almost 24/7. Lucy’s parents experience substantial financial, emotional, and relationship strain, and are at risk of losing their house and marriage.

Submission 2770 - Supplementary Submission

Schedule 2: Fraud and Integrity

Description:

We are aware that after Labor paid $250,000 tax payer for the RedBridge report FOI 23.24 0567 Documents Disclosure Log.pdf in 2023, and took from it the message that the “social licence”, or reputation, of the NDIS was (at that point) strong. People believed that the NDIS was good and necessary for meeting the needs of people with disability.

(The NDIS, if we put aside it’s frustrating bureaucratic barriers and delays – still IS a good and necessary scheme, when people do manage to get the support they need, despite the NDIA seemingly doing their best to not allow that to happen, including by spending tens of millions on lawyers to fight against participants getting the supports they are requesting).

Participants and the general public valued the NDIS as they do Medicare, and did not want to see cuts to the scheme that would harm participants. But the government’s prediction of the number of Australian’s who would be eligible for NDIS, and the total cost, was vastly under-estimated. They gleaned from the RedBridge report that the way to make cuts to the NDIS more acceptable to voters (and MP’s) was to focus on and exaggerate fraud in the scheme. In other words, to intentionally destroy the reputation of the NDIS and NDIS providers, using the media as their mouthpiece.

And didn’t they do a good job of it! Between May 2025 and March 2026 (an 11 month period)alone, the Australian Financial Review published 68 stories about the NDIS. 73% framed the scheme as wasteful, fraudulent, or economically unsustainable. Only one of those articles centred the voice of someone who is actually an NDIS participant. January to March 2026 saw a 500% increase in NDIS headlines.

Fraud is bad and needs to be addressed. But in reality, the level of fraud in NDIS is not very different to in other government schemes, and is lower than that in Medicare.

When you hear larger figures, please pay attention to whether statistics that are quoted are “leakage” or actual fraud. The “leakage” statistics include accidental incorrect claims by participants or plan managers, which were corrected, so should not count as a loss at all.

The vast majority of NDIS providers are honest and caring people, who just want our clients to be well supported, in line with the original aims of the scheme (and legislation), but instead have found themselves subject to unfair blame from the Labor government via the media – especially AFR. One wonders what AFR are getting out of that arrangement.

Concerns:

NDIA don’t appear to have considered that their own agency is not run efficiently, causing long delays, loss of supports, high stress, and adverse outcomes to participants.
High legal costs of NDIA fighting appeals against unfair decisions they have made - especially when the legal cost of NDIA trying to deny the participant the support are higher than the cost of the support that is in dispute.

Submission 2770 - Supplementary Submission

Labor preying on participants insecurities and trying to turn them against the providers that care for them, to damage “social licence” as a smokescreen for major cuts to the scheme worth thousands more dollars than what is wasted on fraud.

Example/s of therapy pricing differences that are NOT price gouging:

Billy has Medicare funding which pays for $70 of his $210/hour therapy session. Billy pays the other $140 out of pocket. (Not fraud.)
Maria has NDIS funding which pays her therapist $193.99/hour. (Not fraud.)
Steve pays $100 privately for a 30 minute therapy session (= $200/hour). (Not fraud.)
John has DVA funding which pays his therapist very little, but the therapist still helps John, out of respect for his war service. (Not fraud.)
Abdul has funding from a Return to Work scheme in South Australia, which pays his therapist a generous $234.90 per hour - see Fee schedules (Not fraud.)
Susan has no funding and cannot afford to pay much for therapy. Her therapist decides to be kind and only charge her $50/hour while she is paying out of pocket, and also spends hours writing a report for free to help Susan get on to the NDIS, as it is clear she very much needs it, and can’t afford full private fee of $210/hour. Once Susan is on the NDIS, her therapist starts charging her the $193.99 which better covers her time. Susan takes to the internet and tells everyone “my therapist charged four times as much after I got NDIS! They must be a crook!”. (Inaccurate accusation of price gouging.)
Sophia from West Australia chimed in, saying “my therapist charged me $600 for a 1 hour session!” … before mentioning later in the comments that this session involved a therapist driving across Perth to the airport in the morning, paying for airport parking, flying to remote WA, seeing the client, flying back to Perth, and driving home at the end of a long day. (True story). (Inaccurate accusation of price gouging.)
Bill Shorten plays into participant insecurities and sends a letter to every single NDIS participant in Australia, telling them that therapists aren’t allowed to charge different pricing, especially higher pricing, for NDIS participants compared to other people, and that if they do this should be reported to the Commission. This triggered a lot of inaccurate claims of rorting, and time wasted by the Commission trying to “sort the wheat from the chaff”. (This was a few years ago, I think 2022 - before Shorten went swanning off to his new $1 million/year job at UC). (Inaccurate accusation of price gouging.)

Examples of fraud, blocked incorrect claims, and a smokescreen:

The Australian government has spent $550 million looking for fraud in the NDIS since 2022, including the Fraud Fusion Taskforce – which is a much higher amount than the worth of the $86 million in “dodgy claims” they claim to have blocked ( $86 million in dodgy NDIS claims

blocked | NDIS.) It is unclear whether this figure includes ONLY fraud, or also includes claims

by participants or plan managers which the NDIS did not agree were for reasonable supports, and were therefore not paid (so those funds were not lost). They have reviewed 20,000 claims a month. They have successfully prosecuted only 20 fraudulent providers – but this has not stopped them from making it seem, through media coverage, that fraud is rife in the NDIS, intentionally ruining the reputation of the NDIS system and NDIS providers – the vast majority

Submission 2770 - Supplementary Submission

of whom have done nothing wrong – for the purpose of garnering support for cuts to the scheme.

Schedule 3: Governance

3.1 Pricing Powers

Description:

The Bill gives the Minister power to set maximum NDIS prices through legislative instruments.

Concerns:

This is concerning because I feel certain that the Ministers will use these powers to FURTHER decrease rates that providers can be paid, which seems particularly likely for businesses that are (for valid reasons) not NDIS registered.
From an optimistic viewpoint, The Ministers may hope to use this as an incentive for more business to register with the NDIS (perhaps so that they would have more control over therapists who speak out in writing like I am doing right now…) - however this is unlikely to occur unless the cost and time it takes to register is reduced considerably. Reducing therapy rates further would make it even harder for small businesses to afford registration. It would also likely have the effect of steering more participants towards any small, unregistered businesses that do manage to stay afloat, as they would be drawn towards therapy that is lower cost, to help their therapy budget stretch further.
Alternatively - from a more sceptical viewpoint - the Ministers may also be using pricing changes intentionally to push small private practises over the brink so that it is longer feasible for sole traders and small business (who are less likely to be able to pay thousands in registration fees) to provide NDIS services at all. This would support more work going towards their buddies in big businesses – exactly like what is happening with the proposed, underfunded “Thriving Kids” programs, where contracts for private work have only offered to a select few large companies – particularly those who are “in cahoots” with the government. (Please don’t get me started on Autism Awareness Australia and their links with ABA – a type of therapy that it controversial because many autistics adults have spoken out on the harm and trauma this type of therapy have caused them.)
Regardless of which of the above scenarios are true (or whether both are), we are likely to see therapy providers exit from working in the NDIS en masse, which will be devastating for participants who often already face long waiting lists for therapies.
The Minister already reduced the caps on therapy rates last year, including:
Reducing the Physiotherapy rates by $10 in some states and $40/hour in others.
Reducing rates for podiatrists and dietitians by $5/hour.
Reducing rates for Music Therapists and Art Therapists by $37.83/hour to bring these professions in line with counselling, even though people can become counsellors with only

one year of training, as per Diploma of Counselling | Online Course | AIPC , whereas training

for Music and Art Therapy typically involves a two year Master’s course, among other

Submission 2770 - Supplementary Submission

requirements. (Counselling should not be confused with Psychology, which involves many more years of university study.)

Reducing rates for therapist provider travel time (for home visits to see clients) by 50%.
The Minister has sought independent advice regarding fair pricing in the past, including through the IHACPA report in 2025, and through the Duckett report. It would appear that copies of these reports have still not yet been provided to the public, despite multiple FOI requests. Could this be because the therapy prices that were lowered in the 2025 Pricing Arrangements document were not actually based on the reports recommendations, or only on very “cherry picked” recommendations? This appears likely.
A document that was provided instead was a copy of an internal email with “pack lines” and a longer Q&A commentary provided to help Ministers answer questions on why they reduced therapy rates: FOI 25-0506 LD MO – NDIS Independent Pricing and Comms. This document relied heavily on comparing NDIS therapy rates to government schemes that pay providers even less than the NDIS, rather than the multiple funding bodies (e.g. some insurance schemes) that pay them more. They compared it to the Department of Veterans Affairs (DVA). However, DVA has long had a reputation of paying therapists very dismally, to the extent that not many private therapy providers have been able to afford to offer services to veterans, and those who do are effectively volunteering most of their time out of respect for war veterans. They also compared it to Medicare. However, in the Medicare world, co-payments from clients are the norm, because they are both permitted and necessary. In effect, this means that the client is paying for more of the therapists time than the government is (e.g. if Medicare funds $70/session, the client may be paying the other $140 to cover 1 hour of therapist time). As such, it is not a fair comparison. It’s not “apples for apples”. Physiotherapists has also expressed suspicion that when their websites were searched to measure pricing, the IHACPA report may have included faulty data by using prices for sessions that went for less than an hour (e.g. a 30 minute exercise group) and assumed those lower prices were for an hour.
$193.99/hour may sound like a good rate – however, therapy rates should not be mistaken for therapist pay rates. This mistake is made frequently by those who have never run a small business, and only ever worked for a wage or salary. In reality, a small business owner must pay a lot of business expenses from that income prior to making a profit.
The government seem to falsely believe that NDIS registered providers = better quality (based on what they tell the media, and how skewed their participant survey on the topic was. This is simply not true. In the case of allied health professionals – there ARE already checks and balances in place, with most if not all professions having mandatory registration with AHPRA or an equivalent regulatory body. Also in the case of health professionals, you will find that the NDIS is currently largely running off the backs of work done by small, non-NDIS registered businesses, and that these businesses tend to have more experienced therapists and better reputations than the large therapy companies who often hire, poorly support, and churn through new graduate therapists. Among the small number of major fraud cases that have occurred in the NDIS system, most were by large, NDIS-registered companies, who have access to the NDIS portal and to large amounts of funding.

Example/s: 15

Submission 2770 - Supplementary Submission

Melissa is an occupational therapist (OT) with 25 years of experience, who lives in the ACT and provides therapy services to children. Up until 2014, Melissa worked for Therapy ACT, a publicly funded, multidisciplinary therapy service. However, when NDIS rolled out in Canberra in 2014, Therapy ACT was closed down and Melissa’s job became redundant. Melissa is passionate about working with children and wanted to keep doing so (rather than work in a public health role that only provides services to adults). So, she started building her own small private clinic, which now employs 5 other OT’s. Melissa’s business primarily sees children who are NDIS participants, including many who are autistic, and some with other diagnoses. Melissa’s business has a great reputation for providing quality service in helping children to participate in their activities of daily living, maximise independence (reducing future supports needs and costs), helping them to manage emotions and reduce behaviours of concern, supporting development, reducing sensory overwhelm, etc. They have a 6-12 month waiting list. Melissa and her employees earn the NDIS rate of $193.99, a rate which has not increased in seven years, despite the inflation and cost of daily living rises we have seen since then. Melissa and her employees do NOT take home $193.99, unlike what participants seem to think. They also do not earn that for every hour spent: their billable time is only 60-70% of their work day. Melissa has to pay her employees the award salaries, which are increasing. She has to pay rent and rising utility costs for the clinic space they work from. She pays a receptionist. She pays for computers and software, cleaners, loads of therapy supplies (including an indoor playground) and assessment kits. They have to pay tax, and superannuation, and business insurances, and AHPRA registration, and OTA membership fees. By the time all these business expenses are covered, there is little profit left for Melissa. Certainly not enough to pay an external auditor thousands of dollars to read their policies, as is required for NDIS registration. Melissa daydreams about throwing in the towel and working as a gardener instead, where she would likely make more profit, for less stress.
Tim is a sole trader occupational therapist who lives in Sydney and assists adult NDIS participants with assistive technology (essential disability related equipment such as wheelchairs, adjustable beds, commodes etc) and home modifications (ramps, bathroom modifications etc that enables people with disabilities to move safely around their own home). Tim pays many of the same costs as Melissa, with the exception of clinic rent and employee wages. He thanks his lucky stars that he is able to do his office work at home, avoiding the need for clinic rent. Travelling to client’s homes is a vital part of Tim’s work – he cannot assess client’s unique equipment and home modification needs without seeing them in their own homes (to do so would risk mistakes, such as a wheelchair not fitting through doorways). Unfortunately, the 2025 pricing changes means he is only allowed to claim half of what he used to for his time travelling between clients. If he has to drive 1.5 hours across the city, he can only claim 30 minutes of that time, and can only charge that at half the therapy rate. So, Tim’s income has not only been frozen for 7 years, but has also gone backwards in the past year, while his expenses only seem to go up. The hours he can bill, as a proportion of his overall work time, are lower than Melissa’s. He doesn’t have a receptionist, so does all his own admin and business management tasks (unpaid time). Tim slaves over long, unwieldy and repetitive forms

Submission 2770 - Supplementary Submission

designed by the NDIA, including the painful Assistive Technology form (to request high cost equipment items like powered wheelchairs), which is 18 pages when blank, and the multiple long documents needed to submit Complex Home Modifications funding requests to NDIS for his clients. He frequently ends up spending more hours on these documents than he can be paid for – especially now that NDIS “plan periods” have been brought in, limiting how much a participant can pay for in a month or quarter, which might be ok for professionals who operate with regular hour long time slots in a clinic, but doesn’t work for the type of work he is doing, which involves spending many hours at a time writing a report for a client. Tim wonders if that’s exactly why they brought plan periods in – to reduce requests for costly, albeit very necessary, funding requests for participants. It seems to Tim that as each year goes by, the NDIS make it harder and harder for these assistive technology and home modifications to be approved, so he keeps putting more effort into making the justification as clear and detailed as possible for his client’s sake, which takes even more time. Sometimes he has to support clients going through internal appeals or tribunal cases to help get their disability related needs met – meaning even more lengthy reports. He’s been to a tribunal case as a witness for a client who was seeking a $6000 equipment item, and is aware that the legal costs of that to the system would have cost the scheme 6 times as much as just paying for the item in the first place. He knows that the outcome was that NDIA still had to pay for the equipment anyway – showing that NDIA had made the wrong decision. Tim wishes that instead of the government trying to save costs by declining supports that his clients desperately need, they would save costs by looking inward at NDIA – such as making their forms shorter, and hiring more experienced and qualified staff who had the relevant background to understand health professional reports and make fair decisions rather than inept ones. He misses the pre-NDIS days, when he could put in a 4 page request for wheelchair funding to a state-based equipment funding program and have it approved within 4 weeks. He reflects on how much time and cost would be saved in NDIS operated like that, and how much lower the risks were to clients under that model (e.g. if they were waiting 1 month not 9 months to have their wheelchair funding approved, they were less likely to fall and injure themselves and go to hospital in that time). He’s feeling burnt out and is strongly considering leaving the profession – except that would be leaving clients in the lurch, particularly as not many OT’s specialise in NDIS complex home modifications. He battles on for now, but is determined to not ever vote for Labor again, or work for the public system which he sees repeatedly throwing NDIS providers and participants “under the bus” for political gain.

3.2 Automation and Decision-Making

Description:

Automated decision making – which will allow the use of computer algorithms rather than people to make planning decisions, and will not be able to be overridden by a human – is one of the most concerning of all the many concerns in this Bill. In short, it is a terrible and dangerous idea which will cause very real harm to a lot of people with disabilities.

If that it still not concerning to the reader - and in particular to any MP’s who will vote on this Bill please consider that it could be you, or people who love, using the system one day. You might have a

Submission 2770 - Supplementary Submission

stroke tomorrow and have to go through the NDIS after a long hospital admission. You, or your neighbour or child or partner or parent, could be hit by a bus tomorrow and have to receive supports through the NDIS.

Would you want your level of function and support needs to be assessed by?

a) An allied health professional who you’ve selected, who has seen how you function in your home environment, considered your holistic needs, selected assessments appropriate for your diagnosis and age, and written a comprehensive report with support recommendations,

b) An unknown person from the NDIA who has no health professional qualifications, has never met you face to face, and is using one particular assessment for everyone regardless of how well it does or doesn’t capture the needs of people in your age bracket and diagnosis?

Then how would you like that information to be turned into a plan, with budgets for support in different areas of need?

a) By a human at NDIA or

b) By a computer algorithm? And if you disagree with the planning (funding) decisions, what would you like to see happen next?

a) An appeal process as currently occurs – first an internal appeal and then if needed, an administrative review tribunal.

b) Internal review then tribunal, but there’s little point because the tribunal won’t have the power to change the funding in the plan as it does now, and can only order that the support needs assessment be repeated, putting you back to step 1.

Concerns:

Every person is different. Disability, and assessment of functional capacity, are complex. Too complex and too important, to be reduced down to just a few “impairment categories” or “classes of participants”. And too complex for every participant to have their function assessed through just one or two formal assessment tools.
If the NDIA use the ICAN assessment but modify it from it’s original version to suit their needs (as has been proposed), the validity and reliability of that assessment will be very questionable.
An algorithm may well achieve “more consistency in planning decisions” than the current system, as marketed. In the current system, a lot does depend on which desk in the NDIA your paperwork lands on. However, it seems very clear to me that the government’s main goal for the use of algorithms is to have consistently LESS funding in every NDIS plan, rather than consistently better outcomes for people with disabilities. 18

Submission 2770 - Supplementary Submission

The rollout of the Integrated Assessment Tool within the new Aged Care System (Support at Home) provides a cautionary example. News articles show that algorithm use in the Aged Care System has resulted in people being consistently UNDER funded for their needs – with even people who are extremely severely disabled or terminally ill being incorrectly ranked as needing only low levels of support. Those outcomes are unable to be revised by a human assessor. This has resulted in a steep rise in complaints and appeals. New aged care algorithm under fire as 800 apply for review - ABC News and has been referred for investigation by the Ombudsman. Labor’s controversial algorithm tool for aged care under investigation by

ombudsman | Aged care | The Guardian
Roboplanning does not belong in either Aged Care or the NDIS, and will undoubtedly result in more harm, and more deaths, than Robodebt.

Example/s:

Anil has his NDIS plan reviewed. He sits through a long structured interview with an NDIA planner (who used to be a taxi driver) over the phone. The NDIA planner plugs the resulting numbers into a computer for the algorithm to work it’s magic. The algorithm, which was designed to underestimate needs and underfund plans, and said that Anil doesn’t need much support at all in his daily life. But he does. Anil commits suicide.

Schedule 4: New Framework Planning

Description:

It appears that the new framework planning provisions seek to further entrench the “directly arising from” test for supports.

Concerns:

This ignores the fact that disability supports are often complex and interconnected. It aims to deny claims for funding that are related to overlapping symptoms of two or more diagnoses or conditions (one that met NDIS access criteria and others that don’t). It is often difficult or impossible to untangle which support is connected to which diagnosis, where there are overlapping symptoms.
The new framework planning model, like many other items in this Bill, appears to be designed primarily around expenditure control, rather than participant outcomes.

Example/s:

Daniel needs a custom wheelchair because of the symptoms of his muscular sclerosis (MS). These cost tens of thousands of dollars. Daniel’s MS also causes issues with fatigue and mobility that make it hard for him to exercise, and he has gained weight. As such, he needs a more expensive wheelchair that is appropriate for his weight and other body measurements. Would this Bill mean Daniel gets his wheelchair declined or only partially funded, with NDIA saying “the need isn’t directly from his MS, it’s also because of obesity”?

Submission 2770 - Supplementary Submission

Martin is 63 years old and is on the NDIS for peripheral neuropathy, i.e. damage to the nerves in his upper and lower limbs, which cause weakness, numbness and pain in his hands and lower legs. Martin also has osteoarthritis causing him knee pain. Martin needs home modifications to ensure he can keep moving around his home safely and reduce his risk of falls and injuries. Will this new Bill mean that NDIA would decline Martin’s home modification funding request by claiming his need is impacted by his osteoarthritis and not directly caused by his peripheral neuropathy alone?
Alice sees a Psychologist to help her build functional capacity, in relation to her NDIS-accepted (for now) diagnosis of autism. NDIA say that Alice, and thousands of other children and adults with autism, should be using Medicare (partial) funding instead of NDIS for her Psychology needs, even though autism is NOT listed on the list of “mental disorders” that Medicare is meant to cover for Psychology sessions.

Schedule 5: Transitional Rules

Description:

The Bill grants broad transitional rule-making powers to the Minister/s, including the ability to temporarily modify how provisions operate.

Concerns:

These powers are highly discretionary, may significantly affect participants rights, and operate with limited parliamentary scrutiny.

Example/s:

This Submission is already full of concerns and examples of the serious negative outcomes that occur when the government has too much power, and prioritises spending cuts above the safety and wellbeing of Australians with disabilities – some of the most vulnerable members of our society.

Conclusion

Instead of making changes to the NDIS that will negatively impact hundreds of thousands of Australians with disabilities and likely kill some – how about we tax gas instead?