A significant period of change
The disability sector is facing another major round of NDIS reform. The proposed legislation has sparked widespread discussion among Occupational Therapists, participants and advocacy groups, with many working to understand what the changes could mean in practice.

Importantly, the reforms are not yet law. The legislation must still progress through consultation and parliamentary processes, creating an opportunity for the disability community to provide feedback and advocate for change.

A shift towards standardisation
Many of the proposed reforms introduce more standardised approaches to eligibility, funding and decision-making. While consistency may improve administrative efficiency, disability support often relies on understanding individual circumstances, environments and goals.

For Occupational Therapists, this tension between standardisation and individualisation sits at the heart of many concerns. The proposed changes raise questions about how effectively future systems will reflect the complexity of people’s lives and support needs.

Changes to NDIS access and eligibility
Several proposed reforms focus on how people access the NDIS and demonstrate eligibility. These include changes to functional capacity assessments and stronger expectations around treatment history before support can be approved. Together, these measures could reshape how disability-related needs are assessed and understood.

A new approach to functional capacity
The draft legislation proposes assessing functional capacity without considering assistive technology or support from others.

For Occupational Therapists, this represents a significant departure from established practice. Functional capacity is rarely understood in isolation. Environmental barriers, informal supports and assistive technology all influence how a person participates in daily life. Removing these factors risks creating an incomplete picture of disability and support needs.

The challenges may be even greater for people with complex, overlapping or fluctuating disabilities, where function can vary significantly depending on context and available supports.

Treatment requirements and access barriers
The proposed legislation would also strengthen requirements for participants to demonstrate they have explored available treatments before accessing the NDIS.

While intended to clarify eligibility, concerns have been raised about how this would work in practice. Access to treatment can be limited by geography, cost or service availability, and some people may reasonably choose not to pursue interventions that carry significant risks or side effects. Questions also remain about how treatment, rehabilitation and capacity-building supports will be distinguished, particularly for people with complex or long-term conditions.

Funding and support decisions
Beyond eligibility, the proposed reforms could influence how supports are funded and which interventions participants can access.

One of the most discussed changes is the introduction of powers that could allow funding limits to be applied across categories of NDIS supports. While current discussion has focused on therapy funding, the proposed mechanism could potentially be used more broadly. This raises concerns about whether future funding decisions will continue to reflect individual circumstances and goals.

The legislation would also provide the NDIA with greater authority to determine which interventions are considered evidence-based. Although evidence-informed practice is essential, research often takes time to catch up with emerging interventions and assistive technology. A lack of extensive evidence does not necessarily mean a support is ineffective, particularly when strong clinical outcomes are being achieved.

There are concerns that stricter interpretations of evidence could reduce participant choice and limit access to supports that are currently delivering meaningful benefits.

The growing role of automation
The legislation also expands the use of automated decision-making processes within the NDIS.

While automation may improve efficiency, disability support decisions often require nuanced understanding of individual circumstances. Maintaining appropriate human oversight will be critical to ensure decisions remain fair, transparent and responsive to participant needs.

Why Occupational Therapist engagement matters
Occupational Therapists bring valuable expertise to conversations about disability, function and participation. Their day-to-day experience provides important insight into how legislative changes may affect people in real-world settings.

As consultation continues, feedback from practitioners can help highlight practical implications and ensure participant experiences remain central to policy discussions. Organisations such as the OT Society for Hidden and Invisible Disabilities (OTSI) and Occupational Therapy Australia are actively supporting advocacy efforts and providing resources to help clinicians understand the proposed reforms.

Looking ahead
The proposed NDIS reforms have the potential to reshape eligibility, funding and service delivery across the disability sector. While many questions remain unanswered, the consultation process offers an important opportunity for Occupational Therapists and participants to contribute to the conversation.

Understanding the proposed changes now will help practitioners, providers and participants prepare for whatever comes next. The decisions made in the coming months may influence disability support and Occupational Therapy practice for years to come.

Key takeaways for OTs
• The proposed NDIS legislation is still under consultation and has not yet become law.
• Many of the reforms reflect a broader shift towards more standardised decision-making.
• Proposed functional capacity assessments may place less emphasis on environmental factors and supports.
• Stronger treatment requirements could create barriers for some participants seeking access.
• Changes to funding powers and evidence requirements may affect participant choice and support flexibility.
• Increased automation highlights the need for ongoing human oversight in decision-making.
• Occupational Therapist perspectives remain critical in shaping the future direction of disability policy.

Links
🖥️ FREE NDIS Insights: Unpacking the Proposed NDIS Bill and Impact to OTs & Participants: https://www.verveotlearning.com.au/free-ndis-insights-unpacking-the-proposed-ndis-bill-impact-to-ots

🔗 Securing the NDIS for Future Generations Bill: https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22legislation%2Fbills%2Fr7487_first-reps%2F0000%22;rec=0

🔗 Explanatory Memorandum: https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22legislation%2Fems%2Fr7487_ems_35e6531f-c440-4faf-98d6-7c7ddd8bd539%22

🔗 Make a Submission: https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/NDISFutureGenBill