Wed Oct 1

How people are assessed for the NDIS is changing. Here’s what you need to know

Written by: Georgia van Toorn, Research Fellow, ARC Centre of Excellence for Automated Decision-Making and Society, UNSW Sydney

The government has announced ^[1] a new tool to assess the needs of people with disability for the National Disability Insurance Scheme (NDIS).

Instead of a having to gather and submit medical reports, new applicants and existing participants being reassessed will have an interview with an National Disability Insurance Agency (NDIA) assessor.

The government says the new process will make support planning simpler, fairer and more accessible.

But last week’s announcement has left important questions unanswered. Most notably, how will the outcome of these assessments determine the level of support someone gets? And what evidence will be used in place of doctors’ reports?

With minimal consultation so far and little transparency, confidence in the new system is already low.

What’s changing?

The independent NDIS review ^[2] reported to the federal government in December 2023 and recommended a raft of reforms. It found current processes for assessing people for the NDIS supports are unfair and inefficient. Gathering evidence from treating doctors and allied health professionals can be time-consuming, due to long wait times for appointments. Appointments can also be expensive.

As a result, those with the ability and means to collect or purchase additional information are favoured in this process. It also means the scheme often focuses on medical diagnosis and not on the functional impairments that arise from these diagnoses.

From mid-2026, participants aged over 16 will have their needs assessed by an NDIA assessor. This shifts the role of gathering and interpreting information to the agency.

Assessors will be an allied health professional, such as an occupational therapist or social worker, who will use an assessment tool called the Instrument for the Classification and Assessment of Support Needs version 6, or I-CAN ^[3].

I-CAN measures support needs across 12 areas of daily life, including mobility, self-care, communication, relationships, and physical and mental health. Each area is scored on two scales: how often support is needed, and the intensity of the support required.

The assessment, based on self-reported information, is expected to take around three hours.

What we still don’t know

With medical reports no longer required, it’s unclear what kinds of evidence, beyond the information collected through the assessment, will inform the planning process.

The other big unknown is how the I-CAN assessment will translate into setting a budget for participants. This is crucial, as a person’s budget determines the supports they can access. And this shapes their ability to live independently and pursue their goals.

Currently, budget size is determined by identifying the range of supports a person needs and is built line by line. But the NDIS review recommended ^[4] more flexibility. Instead of getting separate amounts for therapy, equipment and support workers, the review argued a participant should get one overall budget they can use across all their needs.

While the idea of flexibility sounds promising, it means little without an adequate budget.

Potential conflicts also arise when the NDIA both judges need and allocates funding, but has an incentive to contain costs.

Recent reforms to operational rules about what should be included as an NDIS support ^[5] will also constrain this flexibility.

Standardisation at what cost?

These changes are partly aimed at controlling NDIS spending through a more standardised and efficient planning process.

They echo the Morrison government’s failed attempt in 2021 to introduce “independent assessments ^[6]”. Disability groups, the Labor opposition, and state and territory ministers rejected the move, and the government abandoned the plan.

There is a risk the new approach could reduce support and fail to expand choice. Rather than providing the flexibility participants seek, rigid assessments and points-based formulas can easily be repurposed to cap budgets.

The United Kingdom’s experience ^[8] suggests this is a very real possibility for individualised funding schemes such as the NDIS.

In recent months, a number of NDIS participants have already had their eligibility for the scheme re-assessed ^[9] or their funding reduced. The concern is that unless this new process is carefully co-designed and implemented, we may see more cuts.

Disability groups also fear that if aspects of the planning process are automated, algorithms could turn nuanced support needs into rigid calculations. Campaign groups ^[10] have called on the government to halt the use of algorithms, which are already being used in NDIS support planning.

As George Taleporos, the independent chair of Every Australian Counts, has stressed ^[12]:

The NDIS must never reduce us to data points in a secret algorithm – people with disability are not numbers, we are human beings, and our rights must remain at the heart of the Scheme.

Will some groups be disadvantaged by the change?

The new framework was developed without meaningful input from NDIS participants, families and carers, and advocacy groups are concerned the tool may not be fit for purpose for some groups.

A self-report tool such as I-CAN poses particular risks ^[13] for autistic people with complex communication needs, high support requirements, and those who rely on masking to navigate social situations. Each of these factors raises the risk the tool won’t capture real support needs.

For culturally and linguistically diverse communities and First Nations people with disability, these issues are compounded by language, cultural and accessibility barriers.

A three-hour-long interview will place a heavy cognitive and emotional load on all NDIS participants. It’s possible this could compromise the accuracy of responses.

Some people in the disability community ^[15] have called for the ability for participants to be able to bring additional evidence from the professionals who know them well to the assessment process, so it doesn’t miss important information about them.

While we await more detail, it’s crucial the government consults closely with the disability community to ensure people with disability are not left worse off.