Most people come across a functional capacity assessment (FCA) because someone has told them they need one, usually in the lead-up to a plan review. It can even play a key role in helping someone get the right NDIS funding. What rarely gets explained is that not all FCAs are equal. Two assessments of the same person, written by two different people, can read very differently, and that difference often decides whether the supports someone genuinely needs get funded or not. This brings us to our first point; who can do a functional capacity assessment?
Functional capacity assessments are usually conducted by qualified occupational therapists (OTs), which is our team’s background and area of expertise at Optimal Living Therapy. While other health professionals and medical specialists can complete a functional capacity assessment, OTs conduct most of them because of a holistic focus on daily living.
What makes a good functional capacity assessment (FCA)?
In our experience, the gap between a useful FCA and one that just satisfies a requirement comes down to a handful of things. We want to set those out, because if you’re a support coordinator referring participants, or a participant trying to work out whether the report you’ve received is any good, it helps to know what you’re looking at.
It links what it observes to what it recommends
An FCA is, at its core, a detailed picture of how someone manages across daily life: self-care, mobility, transfers, domestic tasks, communication, getting out into the community, and cognition. That’s one of the reasons it’s important to know who can do a functional capacity assessment, and why OTs are the right choice in many situations. A weaker report stops at describing all of that, a strong one goes the next step and draws a clear line from each functional limitation to a specific support, and then explains why that support is reasonable and necessary.
The NDIS can’t fund a support unless it’s clear the support relates to the person’s disability and that the person genuinely needs it. The clinical reasoning that connects the disability to the need for the recommendation is exactly what the scheme is asking for, and it’s the part that holds up when someone pushes on the report at review. A report that lists problems and then lists supports, without the reasoning that joins them, leaves the planner to make that connection themselves. Often they won’t.
It’s specific, not general
Vague findings don’t fund anything. Saying someone “has difficulty with daily tasks” tells a planner almost nothing. Saying that a person can’t transfer from bed to wheelchair without two people and a hoist, that this is the case every morning and night, and what it means for their safety and their day, tells them a great deal.
The same applies to the recommendations. Specific equipment, specific support hours, specific modifications, each one tied to a goal the participant has actually stated. A qualified OT who can conduct a strong functional capacity assessment will address this directly in their report, and an OT who has assessed a lot of complex presentations knows which details matter and which aren’t going to make an impact in the report. The more concrete the report, the harder it is to disregard and this sort of specificity is also where experience shows.
It uses the right tools, and says why
A thorough FCA draws on standardised assessment tools, but the tools aren’t the point on their own. What matters is that the OT chose them deliberately and can explain what they showed. A report that names its methods, says why those methods were appropriate for this person, and interprets the results back into real daily life reads as considered. A report that lists scores without interpretation doesn’t, and it tends to invite questions rather than answer them.
It maps to the person’s actual goals
NDIS funding follows goals. An assessment that recommends supports without connecting them to what the participant is trying to do, whether that’s living more independently, returning to work, staying safe at home, or being more part of their community, leaves the reader to join those dots. A good FCA does that work inside the report. It shows how each recommendation serves something the person actually wants, rather than presenting a list of supports in a vacuum.
It’s honest about what it doesn’t know
This one is often overlooked but is very important. A strong assessment says clearly where the evidence is limited or where a prognosis is uncertain, rather than glossing over it. An OT who can deliver effective functional capacity assessments considers this. That level of honesty doesn’t weaken a report, it strengthens it, because a reader can trust the parts that are stated firmly precisely because the OT was willing to flag the parts that aren’t. A report that overreaches on every point is easier to challenge than one that’s candid about its limits.
Whether or not it survives scrutiny
Everything above comes down to one thing: whether or not the report holds up under interrogation or scrutiny. If the the evidence is specific, the clinical reasoning evident and the recommendations trace back to genuine need then it is much more likely to do its job properly. If it reads like therapy notes or a description without justification, it tends not to.
For support coordinators, this is the difference between a report that gets a participant what they need the first time and one that triggers another round of back and forth, more waiting, and a participant who loses confidence in the process. This is another reason it’s important to know who can do a functional capacity assessment well; the quality of the OT writing it is not a small detail. It’s most of the outcome.
If you or a participant you work with needs a functional capacity assessment, our occupational therapists complete these regularly and write them to hold up at review. We’re happy to talk through what’s involved. You can call us on (08) 6117 4266, get in touch through our contact page, or submit a referral through our NDIS referral form.
