NDIS review in 2026: what changed, what’s challengeable and what evidence you need

If you are advising a participant or their nominee about an NDIS decision the first question is always whether the decision can be reviewed and through which pathway. That question has become more complex since August 2026. The reforms introduced by the Securing the NDIS for Future Generations Act 2026 have changed reassessment eligibility, evidence requirements and which funding changes are actually open to challenge. Functional capacity evidence from an occupational therapist sits at the centre of many of these matters; understanding where it fits helps you instruct the right expert at the right time and avoid building a file around a pathway that is not available.

What has changed since August 2026

The Securing the NDIS for Future Generations Act 2026 commenced in stages from 27 August 2026. For legal representatives working on NDIS review and ART matters three changes are the most immediately relevant to how you advise clients and build their files.

First, from 27 August 2026 requests for unscheduled plan reassessment operate under a higher threshold. Only the participant, their plan nominee or a child representative can make the request. Providers and support coordinators can no longer request a reassessment on a participant’s behalf though they can assist in preparing supporting evidence. To qualify the request must generally demonstrate a significant and ongoing change in the participant’s functional capacity or support needs or a significant and ongoing change in their living arrangements, education, employment or available informal supports. Where your client’s circumstances have changed, functional capacity evidence is now more directly relevant to getting a reassessment request across the threshold than it was under the previous rules.

Second the NDIA now has up to 90 days to decide a reassessment request. If no decision is made within that period the request is treated as a deemed refusal and that deemed refusal is itself a reviewable decision. For matters where the NDIA has been slow to respond, this creates a clear trigger for the next step.

Third, from 1 October 2026 the NDIA began applying reductions to participant budgets in two support categories. Understanding which funding changes are reviewable and which are not is now an essential first step before advising a client on their options.

Reviewable and non-reviewable decisions

Many NDIA decisions remain reviewable. These include decisions on NDIS access, plan funding, reassessment requests and plan variations. A participant who disagrees with any of these decisions can request an internal review and if the outcome is unsatisfactory apply to the ART.

The October 2026 budget reductions are different. From 1 October 2026 the NDIA began applying reductions to participant budgets in Social, Economic and Community Participation (SECP) and Improved Daily Living Skills (IDLS). These reductions are made under the new legislation and are expressly stated to be not a reviewable decision under the NDIS Act. A participant whose budget has been reduced in these categories cannot challenge that reduction through internal review or the ART regardless of how large the reduction is or how significantly it affects their supports.

When a client comes to you about a funding change your first practical question is whether their plan was reduced as a result of an individual planning decision or through the legislative budget reduction process. Only the former is open to internal review and ART proceedings. The decision letter and the plan itself will usually make this clear. Where the reduction is in SECP or IDLS and the participant has a combined budget for Assistance with Daily Life, Home and Living and Assistance with SECP of $215,030 or more and receives 24-hour funded supports, a separate plan variation pathway may be available. That request must be lodged within 90 days of receiving the reduced plan and operates under different rules to internal review.

Key dates: 2026 NDIS reforms and review framework
Date	What applies
27 August 2026	Securing the NDIS for Future Generations Act 2026 commenced. New reassessment threshold, 90-day NDIA decision period and updated reasonable and necessary criteria apply from this date.
1 October 2026	NDIA began applying reductions to participant budgets in Social, Economic and Community Participation and Improved Daily Living Skills categories. These reductions are not reviewable decisions under the NDIS Act.
1 February 2027	Additional s34 reasonable and necessary criterion commences: whether another government scheme is more appropriately responsible for the support.
1 January 2028	New access framework commences. New applicants assessed against the standardised functional capacity assessment under the 2026 definition.

The two-step review pathway

For decisions that are reviewable, NDIS review follows a two-stage process. The first stage is an internal review conducted within the NDIA. The second, if the outcome is unsatisfactory, is an application to the Administrative Review Tribunal. These stages are sequential: a participant cannot apply directly to the ART without first exhausting the internal review process. The order matters practically because the evidence built at internal review stage often shapes what the ART subsequently examines.

Internal review

A participant has three months from the date they receive a planning decision to request an internal review. The request must state clearly that the participant is seeking a section 100 internal review of a reviewable decision so it is not treated as a process complaint. The review is conducted by a different NDIA staff member who was not involved in the original decision. That officer can affirm the original decision, vary it or substitute a new one.

Internal review does not require independent expert evidence. Many participants submit supporting letters from treating practitioners or allied health providers. Where the dispute centres on the nature or extent of a functional impairment, a treating practitioner’s letter may carry limited weight. Treating clinicians have a therapeutic relationship with the participant and may not have conducted a structured functional assessment. Their evidence is often qualitative and shaped by the treatment context rather than by the question the reviewer needs to answer.

An independent functional capacity assessment at internal review stage provides a structured and impartial account of what the participant can and cannot do across the domains relevant to the supports in dispute. It connects impairment to daily function and grounds the submission in observable findings rather than clinical impression alone.

Moving to the ART

Following an unsatisfactory internal review, a participant has 28 days from the date of that decision to apply to the Administrative Review Tribunal. The Tribunal may allow a longer period depending on circumstances but 28 days is the default timeframe and legal representatives should treat it accordingly.

The ART conducts its own review of the decision on the merits. It is not limited to the material before the NDIA and can receive fresh evidence. This means the quality and rigour of expert evidence becomes far more significant at ART stage than it typically is at internal review. Once a matter is lodged the NDIA must file and provide relevant documents within 28 days of becoming aware of the application.

NDIS matters are currently one of the primary drivers of ART caseload and the Tribunal is managing significant volume. The ART uses an Early Assessment and Resolution process to resolve disputes through alternative dispute resolution before a full hearing. Most matters proceed through case conference, then conciliation, then a directions hearing if the matter remains unresolved. Most NDIS matters at the ART settle by agreement before reaching a final hearing. Where a matter does proceed to a full hearing, resolution from lodgement to outcome typically takes more than a year. Legal representatives should factor realistic timelines into their advice, particularly where a participant has support gaps while the review is pending.

Where an OT report fits

Functional capacity evidence from an occupational therapist is relevant at both stages but serves different purposes at each.

At internal review, an OT report can frame the participant’s difficulties in a way that maps directly onto the support criteria the NDIA applies. A strong OT report shows how the participant’s impairments affect their capacity to perform daily tasks and why the supports sought are reasonable and necessary.

At ART stage that report or a more detailed version prepared specifically for the proceedings operates as expert evidence and is assessed under the Tribunal’s rules for expert witnesses. The ART Expert Evidence Practice Direction 2026 applies to all expert reports in ART proceedings. Under the Practice Direction the expert’s overriding duty is to assist the Tribunal impartially. The report must cover: qualifications and experience; instructions given to the expert; documents and materials considered; facts and assumptions relied on; and reasons for each opinion expressed. The expert must sign a declaration confirming impartiality and accuracy.

An occupational therapy expert report for the Administrative Review Tribunal that meets this standard gives the Tribunal a clear account of the participant’s functional profile grounded in assessment findings rather than opinion alone. A report that falls short of those requirements, such as one that offers conclusions without explaining the basis for them or presents the participant’s self-report as the primary evidence, may be given reduced weight.

Our clinical reflection

What we invest in at Sina OT is understanding the decision-making framework before the assessment begins. That means knowing what question the decision-maker needs to answer; what the relevant criteria require; and how clinical findings about function connect to those criteria. The report a lawyer or a delegate receives from us is structured around those questions rather than around a generic clinical picture.

This is where the value of instructing a specialist lies. A report that a non-clinician can read, follow and apply to the question in front of them takes considerable clinical investment to produce. That investment begins well before the participant walks through the door.

What this means for your practice

For lawyers working on NDIS review and ART matters the 2026 reforms have made the preliminary assessment of a new client matter more important than it was before. Before advising on whether to pursue internal review you now need to assess reviewability, identify the appropriate pathway and consider whether the client’s functional capacity evidence is sufficient to meet the threshold or support the grounds of dispute.

Where the matter involves a reviewable individual planning decision the next question is whether the existing functional evidence addresses the specific supports in dispute clearly enough for a reviewing officer to act on it. Treating letters and clinical notes written for therapeutic purposes often do not answer the questions the review process requires. Where they do not, instructing an independent OT before lodging the internal review request gives you a more complete evidential foundation for both stages of the process.

At ART stage the evidentiary standard rises considerably. An OT report prepared with the Practice Direction requirements in mind: one that explains the expert’s qualifications, instructions, materials considered, factual basis for each opinion and their reasoning, is in a materially different position to a general clinical document. Instructing the right expert early and providing a well-constructed letter of instruction are the two most direct ways to influence the quality of the evidence your client’s matter will rely on.

Legal representatives considering instructing an independent occupational therapist for NDIS review or ART matters are welcome to make an enquiry with Sina OT.