Functional Capacity Assessments for NDIS Participants with Physical Disability

Physical disability covers an enormous functional range — from participants with significant mobility impairment but intact independence in cognition and self-management, through to participants whose physical disability is compounded by pain, fatigue, secondary complications or co-occurring cognitive or psychosocial conditions. A high-quality FCA needs to capture not just *what the participant can physically do* but the *cost* of doing it — the pain, fatigue, time and supervision implications that determine genuine reasonable and necessary support.

Our physical disability FCAs are completed by AHPRA-registered Occupational Therapists with specific training in mobility analysis, transfer mechanics, falls risk, pain interaction and complex assistive technology — supported by multidisciplinary clinical oversight from our Director team.

Spinal cord injury (paraplegia and tetraplegia, complete and incomplete), cerebral palsy (adult presentations across all GMFCS levels), acquired and congenital amputation, muscular dystrophy and other neuromuscular conditions, hemiplegia, paraplegia and quadriplegia of any aetiology, post-polio syndrome, spina bifida, arthrogryposis, brittle bone disease, severe chronic pain conditions, fibromyalgia with significant functional impact, and the physical sequelae of stroke and acquired brain injury (assessed under our neurological FCA pathway where neurology is the primary driver).

We also routinely assess participants with chronic-pain-dominant presentations and POTS where physical function is the dominant funding driver.

Step 1 — Secure intake and document review. Submit referral with NDIS plan, prior physiotherapy, orthotic and prosthetic reports, treating-team correspondence and any prior FCAs.

Step 2 — Telehealth clinical interview. Structured video assessment with the participant and (where relevant) family or support worker. Mobility, transfers and equipment use are observed through video walk-through of the home environment.

Step 3 — Functional task observation. Where indicated, we request video of the participant completing key transfers, mobility tasks and AT use. This provides comparable, reviewable evidence that strengthens the report.

Step 4 — Collateral and treating-team input. We integrate input from treating physiotherapist, AT prescriber, orthotist, prosthetist, GP and any community-based clinicians involved in the participant's care.

Step 5 — Report drafting. Comprehensive FCA across the eight NDIS functional domains with quantified support hour recommendations, mobility-specific risk profile and AT justification.

Step 6 — Report issue. Within 5 business days of the final interview, with a 14-day clarification window.

Personal care support — quantified hours for showering, dressing, toileting, transfers and bowel/bladder management, with clear justification for any 2:1 support requirements.

Assistive technology — wheelchairs (manual, powered, sports), pressure care, hoists, slings, shower commodes, environmental control units, communication devices and vehicle modifications. Where AT requires standalone justification, we coordinate with our AT assessment pathway.

Home modifications — ramp access, bathroom modifications, ceiling track hoists, accessible kitchen modifications. Our reports provide the functional evidence that complements a building practitioner's design submission.

Community access support — 1:1 community participation hours where mobility, transfer and safety considerations preclude independent community access.

Therapy supports — physiotherapy, exercise physiology and occupational therapy hours where ongoing functional maintenance is required.

Home and living evidence — where physical support need is significant, our FCA underwrites SIL and SDA applications.

Pain and fatigue are the under-documented drivers of functional impact in physical disability cohorts. A participant who can physically complete a transfer once may be unable to repeat it without recovery time — and may pay for that single transfer with hours of pain or fatigue afterwards. Our FCAs explicitly document these dimensions: time-based capacity, recovery requirements, pain interaction with function, and the cumulative pattern across a day, week and month.

Where the participant lives with significant variability (good days, average days, difficult days), we document each level and the proportion of time spent in each, so the support package reflects genuine need rather than a single snapshot of capacity.