Functional capacity assessment (FCA)

What is a functional capacity assessment (FCA)?

A functional capacity assessment (FCA) is a report, usually written by an occupational therapist, that describes how a person's disability affects their ability to do everyday activities and what support they need to do them. NDIS participants and applicants use FCAs as evidence for access requests, plan reassessments and requests for supports such as Supported Independent Living or assistive technology. A good FCA turns "I need help at home" into specific, observed needs, hours and recommendations.

"FCA" is a practice term, not a term defined in the NDIS Act. The idea behind it is in the law, though. Section 24 of the NDIS Act 2013 asks whether an impairment results in substantially reduced functional capacity in six activities, and section 9B defines functional capacity as the person's ability to do an activity without help from other people (apart from commonly used assistive technology or modifications, and age-appropriate help for children), looking past their environmental and personal circumstances as far as possible.

So an FCA is the clinician's answer to the NDIA's question: what can this person do, what can't they do, and what support would close the gap?

What an FCA covers

There is no single NDIA template for an FCA, but strong reports follow the same logic. They usually assess the six activity areas from the Act and describe function in real situations, not just in a clinic.

A thorough FCA also includes:

• Background: diagnoses, history, living situation, current paid and informal supports, and the person's goals.
• Methods: interviews, observation in the person's environment, and standardised assessment tools chosen by the clinician, with scores explained in plain language.
• Risks: what happens without support, such as falls, missed medication, hospital admissions or breakdown of informal care.
• Recommendations: specific supports, hours, support ratios, therapy, equipment or home modifications, each linked to a finding and a goal.

When an FCA is used in the NDIS

FCAs show up at several points in a participant's journey:

• Access requests. Evidence of how an impairment reduces functional capacity supports an access request, alongside evidence of the diagnosis.
• Plan reassessments. An updated FCA is common evidence that support needs have changed significantly, which is the test for a requested plan reassessment. Under section 50 of the Act, the NDIA can also ask a participant to undergo an assessment and provide the report when it varies or reassesses a plan (see the NDIA's plan reassessment page).
• Home and living requests. The NDIA's SIL operational guideline lists allied health assessments such as an FCA among the evidence it uses to decide Supported Independent Living funding, alongside behaviour support assessments and reports on daily support needs.
• Assistive technology and home modifications. Functional findings explain why equipment or modifications are needed; a separate specialist AT or home modification assessment may also be required.

How participants and families can prepare

The assessment is only as good as the information the clinician sees. Before the appointment it helps to:

• Keep a short diary for a week or two: what help was needed, when, for how long and who gave it, including overnight.
• Gather existing reports from doctors, therapists, schools or previous providers, so the clinician doesn't start from scratch.
• Be specific about bad days. If needs change with health, mood, fatigue or seizures, say how often harder days happen and what they look like.
• Describe what family really does. Unpaid help is easy to forget because it is routine. List it, and say honestly whether it can continue.
• Ask to see the draft or the findings. Many clinicians will talk through findings before finalising, which is the time to correct factual errors.

Providers who already support the person, such as a support worker team or a SIL provider, can help with consent by supplying factual records like progress notes, incident reports and rosters that show the support actually delivered.

Who does an FCA and how it is funded

Occupational therapists write most FCAs because their training covers everyday function across all six activity areas. Other professionals assess function in their own fields, for example a speech pathologist for communication and swallowing, a physiotherapist for mobility, or a psychologist for cognition and behaviour, and their reports can sit alongside an OT's FCA.

For participants with a plan, an FCA is usually paid from capacity building funding, most often the Improved Daily Living Skills category, using the relevant therapy support item. The current items and price limits are in the NDIS pricing schedule (pricing arrangements); look them up in the NDIS price guide rather than relying on old figures. Three practical rules apply:

1. Assessment and report-writing time are both billable when the service agreement says so and the time is spent on that participant's support.
2. NDIA-requested reports have their own claim type. When the NDIA itself asks for a report, for example for a reassessment, therapy items have an "NDIA requested report" variant (claim type REPW) listed in the support catalogue.
3. Before joining the NDIS there is no plan to pay from. Evidence for an access request is usually funded privately, through health services or by existing treating professionals.

FCA vs support needs assessment and other assessments

From April 2027, participants start moving to new framework plans. Under that model the NDIA uses a support needs assessment: a guided conversation with a trained, accredited NDIA assessor, made up of a core needs assessment, a personal and environmental circumstances questionnaire, targeted assessments for complex needs, and instructions to assessors (Department fact sheet). The fact sheet says targeted assessments draw on evidence from health and allied health professionals, so independent clinical reports are likely to remain useful, but the NDIA's assessment, not a private FCA, will be the basis for working out a new framework budget.

Access is a separate track. The Government has said that how people apply for the NDIS won't change before 1 January 2028, and that a standardised functional capacity assessment for new applicants is planned after that. Until then, access decisions continue to rely on evidence from treating professionals, including functional assessments. Check the Department's reform pages for the current position before relying on any date.

What providers writing FCAs should know

For allied health providers, an FCA is a high-stakes document: a delegate who has never met the participant will make funding decisions from it. A few practices make reports more useful and easier to defend:

• Agree the scope in writing. State the purpose, expected hours for assessment, travel and report writing, and the support item in the service agreement before you start.
• Use the Act's language. Organise findings by the six activity areas and describe function the way section 9B does: without help from other people, apart from commonly used equipment.
• Quantify. How often, how long, how many workers, what happens without support. Numbers a delegate can turn into hours and ratios are more persuasive than adjectives.
• Keep records. Keep assessment notes, scores and the final report with the participant's file, as you would any clinical record, and note what was observed versus reported.
• Check consent. Confirm who the report can be shared with, such as the NDIA, a support coordinator or a SIL provider, before sending it on.

Common FCA mistakes

• Describing the diagnosis, not the function. The NDIA needs to know what the person can and can't do, how often, and with how much help.
• Writing about a good day. For episodic or fluctuating conditions, describe the range, including bad days and how often they happen.
• Counting unpaid family help as "independent". Under section 9B, functional capacity is measured without help from other people, so describe what informal supports currently do and whether they can continue.
• Recommendations with no reasoning. "24/7 support" or "more therapy" without findings, frequency and expected outcomes is hard for a delegate to accept.
• Not linking to goals. Supports that clearly connect to the participant's goals and to building capacity are easier to justify as reasonable and necessary.
• Using an old report. If needs have changed, an FCA from years ago may undermine the case for change rather than support it.