A functional capacity assessment looks at how a person’s disability affects their ability to complete everyday activities and participate in their community. It considers what the person can do independently, where they experience difficulty and what assistance, equipment or environmental changes may support them.
The assessment may be used to provide evidence for NDIS access, planning or a request to change an existing plan. However, a functional capacity assessment is not required in every situation and does not guarantee NDIS access, funding or approval of a particular support. Decisions depend on the participant’s individual circumstances and the NDIS criteria.
What Is a Functional Capacity Assessment?
A functional capacity assessment, often called an FCA, is a comprehensive assessment of a person’s ability to function in everyday life.
Rather than focusing only on a diagnosis, an FCA examines the practical impact of a disability. For example, two people with the same diagnosis may have very different abilities, environments, goals and support needs.
An assessment may consider:
- What the person can complete independently
- Activities that require prompting, supervision or physical assistance
- The effect of fatigue, pain, cognition, communication or mobility limitations
- Risks affecting the person’s safety or wellbeing
- Support provided by family members, carers or support workers
- Equipment, assistive technology or environmental changes that may help
- The person’s goals and desired level of independence
The findings are generally documented in a written report containing clinical evidence and recommendations.
What Does a Functional Capacity Assessment Look At?
The NDIS considers six functional domains when examining how a disability affects everyday life:
- Communication: Understanding others and expressing needs, thoughts or information
- Learning: Developing new skills, understanding information and participating in education
- Mobility: Moving around the home and community, completing transfers and using the arms and legs
- Self-care: Dressing, bathing, grooming, eating and using the toilet
- Self-management: Organising daily life, making decisions and managing health, routines or responsibilities
- Social interaction: Building relationships, interacting with others and participating in social or recreational activities
A functional capacity assessment connects these broader areas with the person’s actual daily activities. This may include:
- Dressing, bathing and grooming
- Preparing meals
- Managing medication
- Moving around the home
- Using public or private transport
- Communicating needs
- Managing appointments, money and routines
- Participating in work, education or community activities
- Completing household tasks
- Responding to unexpected situations
- Making decisions and solving everyday problems
The assessor may also consider whether the person can complete an activity safely, reliably, repeatedly and within a reasonable amount of time.
When Might Someone Need an FCA?
A functional capacity assessment may be useful when a participant, family member, treating professional or Support Coordinator needs a clearer understanding of the person’s current functional abilities.
Common situations include:
- Applying for access to the NDIS
- Preparing for a plan reassessment
- Requesting a change to an NDIS plan
- Documenting a significant or ongoing change in functional needs
- Supporting a request for additional daily-living assistance
- Exploring assistive technology
- Considering home modifications
- Preparing evidence about supported living needs
- Identifying risks or gaps in current support arrangements
- Planning for greater independence at home or in the community
An FCA is not always required for NDIS eligibility. The NDIA may accept different forms of evidence depending on the person’s disability, functional impact and circumstances. Supporting information can include reports from treating professionals, standardised assessments, clinical letters, progress notes and statements from carers or support workers.
The most appropriate evidence will depend on why it is being requested.
Who Can Complete a Functional Capacity Assessment?
The appropriate professional depends on the person’s needs and the purpose of the assessment.
For GenPhysio’s service, functional capacity assessments are completed by Occupational Therapists. Occupational Therapists can assess a broad range of everyday activities, including personal care, domestic tasks, routines, cognition, sensory needs, mobility within daily activities, home safety and community participation.
A Physiotherapist may be appropriate when the assessment is primarily focused on physical function, mobility, transfers, balance or movement. Other allied health professionals may also provide relevant functional evidence within their professional scope.
An Occupational Therapy FCA is not automatically more suitable than an assessment from another discipline. The participant’s needs, functional challenges and reason for assessment should guide the choice of professional.
What Happens During an FCA?
The assessment process is tailored to the participant, but it will generally involve several stages.
1. Referral and initial discussion
The Occupational Therapist gathers information about the reason for the assessment, the participant’s goals and the evidence required.
2. Review of existing information
Relevant medical records, therapy reports, NDIS information and support documentation may be reviewed.
3. Interview with the participant and support network
The therapist speaks with the participant and, where appropriate, family members, carers, support workers or other treating professionals.
4. Observation of everyday activities
The participant may be observed completing relevant tasks in their home or another everyday environment.
5. Assessment of strengths, barriers and risks
The therapist considers what the participant can do, what makes activities difficult and what support may be required.
6. Consideration of the environment
The home, school, workplace or community environment may be reviewed to identify accessibility barriers or safety concerns.
7. Discussion of goals
The assessment considers the participant’s priorities and the activities they would like to complete more independently.
8. Preparation of the report
The Occupational Therapist documents the assessment findings, clinical reasoning and recommendations.
9. Review of findings
Where appropriate, the therapist discusses the report and recommendations with the participant or referrer.
An assessment may take place over more than one appointment. Depending on the participant’s needs and the purpose of the assessment, some components may also be completed by telehealth where clinically appropriate.
What Is Included in an FCA Report?
A functional capacity assessment report may include:
- The participant’s background and reason for assessment
- Relevant disability, health and support information
- Current living arrangements
- Functional strengths and limitations
- The impact of disability on everyday activities
- Environmental or accessibility barriers
- Current formal and informal supports
- Identified risks
- Participant goals
- Results from relevant assessment tools
- Recommended supports or strategies
- Assistive technology or home-modification considerations
- Evidence and clinical reasoning supporting the recommendations
- Recommendations for further assessment or review
The report should explain how the participant’s disability affects their everyday function. Recommendations should be connected to identified needs, risks and goals rather than presented as a general list of services.
The NDIA makes the final decision about access, plan changes and funded supports. An FCA may provide evidence for consideration, but the report does not guarantee that a recommendation will be approved.
How Can an FCA Support an NDIS Plan or Review?
A current FCA may help demonstrate how a participant’s disability affects their life and what has changed since earlier evidence was prepared.
The report may provide evidence relating to:
- Existing support needs
- Changes in functional capacity
- Increased or reduced assistance requirements
- Risks arising from gaps in support
- Recommendations for therapy
- Assistive technology
- Home modifications
- Daily-living assistance
- Community participation
- Capacity-building supports
- Future living arrangements
Current NDIS guidance states that a plan reassessment may be appropriate when there has been a significant change and the existing plan no longer meets the participant’s needs. The information and evidence required will depend on the reason for the requested change.
Participants should speak with their my NDIS contact, Support Coordinator or relevant treating professional if they are unsure what evidence is needed.
FCA vs OT Assessment vs Assistive Technology Assessment
These assessments can overlap, but they have different primary purposes.
| Assessment | Main purpose |
|---|---|
| Functional Capacity Assessment | Reviews broader everyday functioning and support needs across multiple areas of life |
| Occupational Therapy assessment | Examines a particular occupational, daily-living or participation need |
| Assistive technology assessment | Determines whether specific equipment or technology is suitable, safe and clinically justified |
For example, an FCA may identify that a participant has difficulty showering safely. A separate assistive technology assessment may then examine whether a particular shower chair or other item is suitable.
Learn more about assistive technology assessments.
How to Prepare for an FCA
Participants and referrers can prepare by gathering information that helps the Occupational Therapist understand the person’s daily life.
Useful information may include:
- Existing medical and allied health reports
- Current NDIS plan information
- A list of daily challenges
- Current medications
- Details of formal and informal supports
- Information from family, carers or support workers
- Examples of safety concerns or changes in function
- Details of equipment currently used or being considered
- The participant’s goals and priorities
It can also help to think about activities that are possible on a good day compared with a difficult day. This provides a more complete picture of whether the participant can perform activities safely and consistently.
How to Refer for an Occupational Therapy FCA
GenPhysio provides community-based NDIS Occupational Therapy, allowing relevant activities and environmental factors to be assessed in the setting where the participant lives and completes everyday tasks.
Participants, families, Support Coordinators and other referrers can submit an online referral for an Occupational Therapy functional capacity assessment.
Once the referral is received, the GenPhysio team can discuss the reason for the assessment, the participant’s needs and the appropriate assessment pathway. Service availability and assessment options may vary by location.
Refer for an Occupational Therapy Functional Capacity Assessment
