The legislation tightens access to the NDIS by:

• altering the way a person’s needs are assessed
• introducing stricter rules to show a disability is permanent
• allowing automated tools to assess eligibility and plan supports.

But we still don’t know exactly what the new process will look like. Much of the detail has been left to rules, instruments, assessment tools and implementation processes that are still in development.

A new technical advisory group has been set up to advise government. It is expected to complete much of its work by late 2026 and report to government by March 2027. The eligibility changes take effect from January 2028.

People who are already accessing the NDIS will also begin to be reassessed based on the new criteria from 2028. This will happen progressively over three years.

Assessing how your disability impacts daily life

These reforms are designed to move away from assessing NDIS eligibility based on a person’s diagnosis.

Instead, the aim is to have a more consistent and robust approach that assesses a person’s “functional capacity”. This means how much their disability affects their daily life.

A person seeking access to the NDIS needs to demonstrate they have substantially reduced functional capacity and that it’s permanent.

The new assessment process will establish standardised definitions and thresholds for both functional capacity and permanence.

Part of the technical advisory group’s role will be to advise on the criteria and methods used to determine those thresholds. This could involve setting thresholds around particular activities such as dressing, washing, preparing meals or working a paid job.

While there’s a legitimate case for greater consistency in decision-making, standardisation also carries risks. People being assessed often have very different lives and experiences of disability.

The fairness of the system will ultimately depend on how the tools are implemented, and by whom.

It will be harder to show your disability is permanent

Another significant change relates to how a disability is established to be permanent.

The new legislation requires people to have tried all “appropriate treatment options” that could improve or alleviate their impairment. These need to be widely accepted and receive public funding, through Medicare, the Pharmaceutical Benefits Scheme (PBS) or public hospitals.

The technical advisory group will now consider how this requirement should operate in practice.

The difficulty is that what counts as having tried all appropriate options will depend on the availability and accessibility of treatments.

A person’s treatment may be unaffordable (even if partly covered by Medicare or the PBS) or unavailable in their local area, for example, or may be delayed for reasons outside their control. That person may not be seen to have tried “all appropriate treatment”, despite it being practically out of reach.

People may also feel compelled to pursue treatment for the purposes of NDIS eligibility rather than because it’s the most appropriate or effective option for them.