When an NDIS participant disagrees with an NDIA decision, they have the right to seek a review. If the internal review process does not resolve the matter, the participant can apply to the Administrative Review Tribunal — the ART — for an independent review of the decision. Getting the right functional evidence in place before and during that process can make a significant difference to the outcome.

Why functional evidence matters in NDIA reviews

The NDIS does not fund diagnoses. It funds the functional impact of disability — the effect that a person’s condition has on their ability to participate in daily life, manage their own affairs, and live safely and with as much independence as possible.

A participant may have extensive medical evidence confirming their diagnosis, but if that evidence does not clearly translate into functional terms — explaining how the condition affects daily activities, what supports are required, and why — it may not carry sufficient weight in the review process. An independent Occupational Therapy Functional Capacity Assessment is designed specifically to provide that evidence.

What makes an FCA report independent?

An independent Functional Capacity Assessment is completed by an Occupational Therapist who has no prior treating relationship with the participant and no stake in the outcome of the assessment. This independence gives the report credibility in ART proceedings — it is not an advocacy document, and the opinion is formed on the basis of direct observation, structured assessment, and review of documentation.

What does an independent FCA report contain?

An independent FCA prepared for ART matters covers the full range of NDIS-relevant functional domains: self-care, mobility, communication, social interaction, learning and applying knowledge, and self-management. Each domain is assessed through direct observation in the participant’s home and community environment, structured interview, review of existing documentation, and standardised assessment tools where clinically appropriate.

The report provides a clear clinical opinion — not just a description of difficulties, but a functional conclusion about what supports the participant requires and why. Reports are prepared in a format suitable for submission as evidence in ART proceedings.

When is an independent FCA most useful in ART proceedings?

An independent FCA is particularly valuable where:

• The NDIA decision was based on insufficient functional evidence
• The participant has psychosocial disability, cognitive impairment, or a fluctuating condition not well captured in standard clinical documentation
• The participant’s condition has changed since the original assessment
• The matter involves complex or overlapping diagnoses
• The participant is justice-involved and in-custody observation was limited

Who can instruct Sina OT for an ART matter?

Sina OT accepts instructions for independent Functional Capacity Assessments for ART matters and NDIA appeals from solicitors and legal representatives, participants and families who are self-represented, and support coordinators and advocates preparing documentation for a review.

Assessments are available in person across Adelaide and South Australia, Melbourne, and Sydney. National availability is considered on a case-by-case basis.

Refer to Sina OT

Sina OT is an independent Occupational Therapy practice providing Functional Capacity Assessments across Adelaide, Melbourne and Sydney. All assessments are completed by experienced, registered Occupational Therapists. Services are available in English and Farsi (Persian). 400+ FCAs completed.