Occupational therapist concerned about functional capacity definition (Individual advocacy)

Submission 744

Jenny Gribbin

PO Box 2146

Runcorn QLD 4113

jenny@drivingwell.com.au

31 May 2026

Committee Secretary

National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No. 1) Bill 2024

Department of the Senate

PO Box 6100

Parliament House

CANBERRA ACT 2600

AUSTRALIA

Submission to the Senate Community Affairs Legislation Committee

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

Introduction

I have spent more than 20 years working with people whose disability impacts their ability to drive, access employment, participate in their communities and live independently.

I support the need for a sustainable NDIS.

What I cannot support are reforms that appear to achieve sustainability by reducing opportunities for people with disability to participate in society. Having read this Bill, I am genuinely struggling to understand how some of these proposed changes can be considered reasonable. I am particularly concerned about:

• the proposed definition of functional capacity;
• the repeal of Section 31 and the principles of individualised planning;
• increased reliance on standardised assessments and automation;
• the apparent shift away from capacity building and participation; and
• the assumption that reducing supports will somehow improve sustainability. Every day I work with people who have been told what they cannot do. My job is to identify what they can do, what they may be able to do in the future, and what supports might help them get there. That is what occupational therapy does – help people do the things they need to and love to do. That is what rehabilitation does – build capacity. That is what the NDIS was intended to do – it was intended to help people achieve what they can do with the right support.

Submission 744

The Proposed Definition of Functional Capacity Makes No Sense

The proposed definition of functional capacity is, quite frankly, one of the most concerning aspects of this Bill. The Bill proposes assessing what a person can do:

• without assistance from other people;
• without assistive technology or modifications; and
• excluding environmental and personal circumstances as far as possible. As an occupational therapist, I simply cannot understand how this can be considered a reasonable way to assess disability.

Would you assess a person’s ability to see while ignoring their glasses? Would you assess a person’s ability to hear while ignoring their hearing aids? Would you assess a wheelchair user’s mobility while ignoring their wheelchair? Of course not.

Yet this Bill proposes assessing functional capacity while deliberately excluding many of the supports, technologies and environmental factors that allow people with disability to function. That is not how disability or participation works.

For decades, occupational therapists and rehabilitation professionals have worked within the World Health Organisation’s International Classification of Functioning, Disability and Health (ICF).

The ICF recognises a simple truth: Disability does not exist in isolation. People function within environments that include the physical environment, assistive technology, and formal and informal supports.

The proposed definition appears to ignore all of that. It represents a step backwards towards an outdated medical model of disability that many of us thought Australia had moved beyond.

I encourage Senators to stop and think about what is actually being proposed. The NDIS funds supports because supports improve function. The NDIS funds assistive technology because assistive technology improves function. The NDIS funds rehabilitation because rehabilitation improves function. The NDIS funds environmental modifications because environmental modifications improve function.

When function is improve, people can participate in society: drive a car, take their kids to school, go shopping, go to work. Ultimately, they can spend more money, and potentially become tax payers.

Yet this Bill appears to ask decision-makers to assess people as though those supports do not exist. That makes no sense!

Capacity Is Not Fixed

One of the biggest flaws in this Bill is that it appears to treat functional capacity as something static. My entire professional career has shown me the opposite. Every day I assess people who cannot currently drive, but that does not mean they will never drive. Capacity can be developed, skills can be learned, strategies can be taught, vehicles can be modified, environments can be adapted, independence can increase.

Submission 744

Throughout my career I have worked with thousands of people with physical disabilities, neurological conditions, autism, acquired brain injuries and other disabilities who have successfully returned to driving or learned to drive. Many required vehicle modifications, specialised driving lessons, rehabilitation and other capacity-building supports to achieve this outcome.

Importantly, not everybody is suitable to drive. Occupational therapy driving assessments are specifically designed to determine who has the potential to achieve safe and independent driving and who does not. In some cases, we recommend a capped number of specialised driving lessons to address disability-related barriers. In other cases, we determine that driving is not a realistic or safe goal. This approach ensures that NDIS funding is targeted appropriately and invested where there is a genuine opportunity to improve function, increase independence and reduce long-term reliance on supports.

What I find so difficult to understand about the proposed definition of functional capacity is that it appears to ignore the very things that allow people to function. The purpose of rehabilitation, assistive technology, vehicle modifications and capacity-building supports is to improve a person’s ability to participate in everyday life. Yet the Bill appears to require decision-makers to assess people as though these supports, modifications and environmental adaptations do not exist.

The Bills proposal suggests that a person with a physical disability may be able to walk independently within a physiotherapy clinic or NDIS office and therefore appear functionally independent during an assessment. However, if they return home and are unable to safely negotiate the ten steps required to enter their house, they are clearly not independent in their actual environment. If environmental factors are deliberately excluded from the assessment of functional capacity, would that person no longer qualify for home modifications because they can technically walk in a controlled setting? Does this also apply to driving?

Many of my clients are unable to drive a standard vehicle. However, with hand controls, a lowered floor vehicle, wheelchair access modifications or other adaptive equipment, they can become completely independent drivers. If environmental factors and modifications are excluded from the assessment of functional capacity, does that mean these individuals would no longer qualify for the very supports that would allow them to achieve independence?

This is the contradiction I cannot reconcile. The NDIS funds supports because supports improve function. Assessing people as though those supports do not exist is not a realistic assessment of functional capacity. It is simply an assessment of impairment.

The proposed reforms risk replacing this principle with a narrow assessment of current performance. If that approach had existed throughout my career, many of the people I have worked with would never have achieved independent driving, employment, education or community participation; more importantly they would have required increased supports at increased costs to the federal government.

The Repeal of Section 31 Undermines the Original Intent of the NDIS I am also deeply concerned about the repeal of Section 31 of the NDIS Act. Section 31 currently requires plans to be:

• individualised;
• participant directed;
• focused on choice and control;
• supportive of participation and inclusion;
• responsive to individual goals and aspirations; and

Submission 744

• tailored and flexible to individual needs. These principles are the foundation of the NDIS.

The repeal of Section 31 appears to remove the clearest legislative commitment to individualised planning. As someone who works in driving rehabilitation, I can tell you that disability support does not work through standardisation: two people with the same diagnosis may require completely different supports to achieve the same outcome.

When I look at the repeal of Section 31 alongside the proposed functional capacity definition, standardised assessment models, automation provisions and broad funding reduction powers, I see a clear shift away from individualised support and towards categorisation and administrative efficiency. That is not the NDIS that was promised to Australians.

Sustainability Should Mean Independence, Not Cost Shifting

I support the goal of sustainability. What I do not support is the assumption that reducing supports automatically improves sustainability.

I am concerned that this Bill appears to assume that reducing supports will automatically make the NDIS more sustainable. In my experience, the opposite is often true. When people lose access to supports that build capacity and independence, they do not suddenly become less disabled. Instead, they often become more reliant on support workers, family members, health services and crisis systems. The costs do not disappear; they are simply transferred elsewhere. A sustainable NDIS is not one that spends less at all costs. It is one that invests wisely in supports that help people become more independent, participate in their communities and reduce their reliance on long-term assistance.

A Real Example: Dave

I would like to provide a real example from my practice. Dave has a significant physical disability and requires advanced vehicle modifications including joystick steering, voice control technology and wheelchair access systems in order to drive independently. The cost of these modifications is approximately $143,537. At first glance, that sounds expensive – but Dave doesn’t want a $143,000 vehicle modification. He wants to: go to work; buy his own groceries; go swimming; attend medical appointments independently; support his parents; visit family over the state border. He wants to participate in life like every other Australian.

The vehicle modifications are simply the mechanism that makes that possible. This support is also the most cost-effective option. Spread across the ten-year life of the vehicle, the modifications cost approximately $276 per week. Equivalent support worker assistance would cost at least $360 per week and likely much more. Accessible taxi services would cost more than $464 per week for a minimum level of participation.

Unlike these alternatives, the vehicle modifications provide genuine independence.

Research examining the social return on investment of vehicle modifications found that high-cost modifications generated approximately $3.40 in social value for every dollar invested and achieved payback within approximately 2 years and 8 months. The study concluded that vehicle modifications generate significant social value for consumers, families and the wider community.

Submission 744

Who Benefits? I genuinely struggle to understand who many of these changes are intended to benefit.

They do not appear to benefit people with disability, families, carers, or communities. They do not appear to benefit the clinicians and providers working to build independence and participation.

The primary benefit appears to be a reduction in projected expenditure. But reducing expenditure and creating sustainability are not the same thing.

When a participant loses access to a support worker, assistive technology, home modifications, driving supports, transport assistance or other capacity-building supports, their disability does not disappear. Their need does not disappear. Their dependence does not disappear.

In my experience, people who lose access to essential supports are more likely to become socially isolated, experience declining mental health, disengage from employment and education, and place greater pressure on family members and informal carers. For some people, the consequences are even more serious. Reduced support can lead to falls, pressure injuries, preventable infections, poor nutrition, medication mismanagement, carer burnout and escalating mental health crises.

When people can no longer cope safely in the community, they do not simply vanish from the system. They present to emergency departments. They require hospital admissions. They access crisis services. Their families reach breaking point. Costs are transferred from the NDIS to already overstretched health, hospital and community systems.

This is why I struggle with the narrative that reducing supports automatically creates sustainability. Sustainability should be measured across the whole system, not within a single budget line. If the result of these reforms is increased pressure on emergency departments, hospitals, carers and state-funded services, then the costs have not been reduced. They have simply been shifted elsewhere.

At a time when governments are simultaneously acknowledging the growing pressure on public hospitals and committing additional funding to the health system, it seems reasonable to ask whether these reforms risk increasing demand on those same services by reducing the supports that help people remain safe, independent and well in their own homes and communities.

Recommendations

I urge the Committee to:

1. Reject the proposed definition of functional capacity and replace it with a definition consistent with the ICF and contemporary disability practice.

2. Retain the principles contained within Section 31, including individualised, participant-directed and goal- focused planning.

3. Ensure functional capacity assessments consider environmental factors, assistive technology, rehabilitation, support systems and participation outcomes.

4. Prohibit fully automated eligibility and funding decisions.

5. Protect access to capacity-building supports that build independence and reduce future support dependence.

6. Ensure sustainability measures consider long-term social and economic returns, not simply short-term expenditure reductions.

Submission 744

Conclusion

I encourage Senators to ask themselves one simple question. If this legislation was being applied to your child, your spouse, your parent or your friend, would you think it was fair? Would you want their future determined by an assessment that ignored the supports that help them succeed? Would you want their capacity assessed as though their rehabilitation, assistive technology, environmental modifications and support networks did not exist? Most Australians would answer no.

The sustainability of the NDIS will not be secured by reducing opportunities for people with disability to participate in society. It will be secured by helping people become more independent, more connected and less reliant on long-term support. That is what the NDIS was created to do.

I urge the Committee not to lose sight of that.

Thank you for your attention to this matter.

Kind regards,

Jenny