Funding Evidence

10 Evidence Mistakes That Cost NDIS Participants Funding

ASBy Amy-Lynne Simmons· 28 April 2026· 8 min read

Participants with weak or outdated evidence routinely lose tens — sometimes hundreds — of thousands of dollars in annual funding. Here are the 10 most common, expensive mistakes.

Why This List Matters

Most participants who receive a disappointing NDIS plan or a funding reduction are not victims of capricious planning decisions. They are victims of preventable evidence weaknesses. Almost every reduction we see has a clear evidentiary cause — and almost every cause is something that could have been addressed before submission.

Mistake 1 — Outdated FCA

Submitting an FCA more than 12 months old. NDIA planners place very little weight on FCAs that pre-date major life events, deterioration, or significant changes in support arrangements. The general rule: if the participant's life has changed in any material way, the FCA should be re-issued. If 12 months have passed, re-issue regardless.

Mistake 2 — Generic 'Requires Support' Language

Generic descriptors like 'requires support' or 'needs help' carry almost no weight in NDIS planning. Strong evidence uses precise language: 'requires verbal prompting twice daily', 'requires partial physical assistance for showering 5 days per week', '2:1 active overnight support for the 8–10 weeks per year of acute psychosocial episodes'.

Mistake 3 — Conflicting Reports

Submitting multiple reports that contradict each other on support level. The OT says 1:1, the physio says 1:2, the support worker observation suggests 2:1. Conflict reduces the credibility of the entire evidence pack. The role of the FCA is to synthesise these inputs into a single coherent narrative.

Mistake 4 — Missing the Causal Chain

Strong evidence builds an explicit causal chain: diagnosis → impairment → activity limitation → support need → recommended supports. Weak evidence stops at impairment and assumes the planner will fill in the rest. Planners do not fill in the rest — they default to standard hour benchmarks.

Mistake 5 — No Costed Roster of Care for SIL

A SIL application without a costed Roster of Care in 30-minute increments is almost always under-funded. The Roster of Care is what turns clinical opinion into a specific dollar value the planner can approve.

Mistake 6 — Provider-Led Assessment

SIL or SDA assessment completed by the same organisation that will deliver the service carries a perception (and often the reality) of commercial bias. Independent assessment is significantly more credible — and produces better funding outcomes.

Mistake 7 — Ignoring Informal Support Sustainability

The NDIA expects informal supports (family, friends, community) to continue providing the support they currently provide. A defensible evidence pack explicitly addresses sustainability — ageing parents, sibling carers reaching breaking point, partners returning to work, deteriorating informal carer health.

Mistake 8 — Quality-of-Life Framing Without Disability Function

Supports framed as 'helps with quality of life' or 'improves wellbeing' without explicit disability-function linkage are routinely refused as not reasonable and necessary. Every recommended support must connect back to a specific functional impairment.

Mistake 9 — Missing AT Comparative Options

Mid-cost and high-cost AT requests require comparative options evidence — typically two quotes and an explanation of why the recommended item is the most appropriate. Without this, AT requests are routinely deferred or refused.

Mistake 10 — Submitting Just Before the Plan Review

Evidence submitted in the final week before a plan review may not reach the planner in time. Aim to have the full evidence pack with the Support Coordinator at least 6 weeks before the scheduled plan review, with the FCA itself completed at least 8 weeks before.

Where to Start

If you are preparing for a plan review or any major NDIS application, download our free NDIS FCA Evidence Checklist (2026) — it covers all 10 mistakes above and 50 more evidence checkpoints across 7 categories.

NDIS evidence mistakesNDIS funding evidencewhy was my NDIS funding cutNDIS evidence checklist
AS
Amy-Lynne Simmons
· Senior Physiotherapist

Amy-Lynne is a Senior Physiotherapist with cross-sector experience across hospital inpatient settings, community neurological rehabilitation and private practice. She holds a Bachelor of Exercise Science and a Doctor of Physiotherapy, and brings deep clinical depth to complex Functional Capacity Assessments for NDIS participants Australia-wide.

Published 28 April 2026
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