The reasonable and necessary test
The NDIS Act, together with the applicable Rules, sets out the 'reasonable and necessary' requirements the NDIA applies to every support request. To be funded, a support must: be related to the participant's disability, represent value for money, be likely to be effective and beneficial, take into account informal supports already available, and be most appropriately funded through the NDIS rather than another service system. A high-quality FCA answers every one of those requirements in the body of the report — that's why an FCA is a central document in any plan-build decision.
NDIS support categories explained
NDIS plans contain three top-level funding categories: Core Supports (everyday assistance, consumables, transport, social and community participation), Capacity Building Supports (improved daily living, employment, relationships, learning, health and wellbeing, choice and control, life skills, supported independent living planning) and Capital Supports (assistive technology and home modifications). A Functional Capacity Assessment provides the line-by-line evidence the planner uses to determine which categories receive funding and at what intensity — including stated supports, in-kind allocations and unspent funding carry-over decisions.
Plan reviews: scheduled, unscheduled, change of circumstance
Three pathways trigger an NDIS plan review: a scheduled review (at the end of the existing plan period), an unscheduled review (initiated by the participant due to a change in circumstance, such as deterioration, relocation, family breakdown or carer loss), and a change of situation review (a streamlined process for minor adjustments). Each pathway requires a different evidence package — but all three benefit from a current Functional Capacity Assessment that explicitly addresses the functional change driving the review.
Internal Review and ART appeals
If a participant disagrees with a planning decision, they have 3 months to lodge a request for internal review. If still unsuccessful, they have a further 28 days to lodge an application with the Administrative Review Tribunal (ART). Both processes rely heavily on independent functional evidence — and an FCA that pre-dates the original planning decision is significantly more persuasive than one written after the fact. FCA Reports Australia regularly produces reports specifically scoped for internal review and ART pathways.
Common evidence mistakes that cost funding
Most rejected funding requests share the same evidence flaws: vague descriptors ('needs help with self-care' rather than 'requires verbal prompting and physical assistance for showering, dressing and meal preparation 6+ hours per day'), missing severity ratings, recommendations untethered from documented function, outdated reports (more than 12 months old), or evidence written by a clinician who has not directly assessed the participant. A defensible FCA avoids every one of these traps with structured methodology.
- The reasonable and necessary test under the NDIS Act drives every NDIA funding decision.
- FCAs provide evidence for all three plan categories: Core, Capacity Building, Capital.
- Plan reviews, internal reviews and ART appeals all require current functional evidence.
- Reports older than 12 months are routinely discounted at plan-build.
- Vague functional language is the #1 cause of denied funding requests.
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