NDIS Assistive Technology Assessments: Writing Reports That Justify Equipment Funding

Understanding the NDIA Decision Framework

Before writing an AT report, it is essential to understand how the NDIA evaluates assistive technology requests. The assessment framework centres on several key questions:

• Does the participant have a functional limitation related to their disability?
• Does the requested equipment directly address that functional limitation?
• Has the participant trialled the equipment (or equivalent) with documented outcomes?
• Is this the most appropriate and cost-effective option that meets the participant's needs?
• Does the equipment meet the 'reasonable and necessary' criteria under the NDIS Act?

Your report must answer every one of these questions with specific evidence. A report that describes the equipment's features without connecting them to the participant's functional needs will not succeed.

The AT Report Structure

1. Participant Profile and Functional Presentation

Begin with a comprehensive description of the participant's current functional status. This is not a medical history — it is a functional profile that describes what the participant can and cannot do in their daily environments.

Cover all relevant functional domains:

• Mobility: How does the participant currently move within their home, community, and workplace? What distances can they cover? What surfaces and terrains do they encounter? What are the specific points of failure in their current mobility?
• Self-care: Which personal care tasks can the participant complete independently, with assistance, or not at all? Where does equipment need to bridge the gap?
• Domestic tasks: Meal preparation, cleaning, laundry, shopping — which tasks are affected and how?
• Community participation: How does the current limitation affect the participant's ability to access education, employment, social activities, and appointments?
• Safety: Are there falls risks, pressure injury risks, manual handling risks for carers, or other safety concerns that the equipment addresses?

Use specific, observable language. 'Has difficulty with mobility' is insufficient. 'Currently uses a manual wheelchair but cannot self-propel beyond 20 metres due to bilateral upper limb weakness, requiring a carer to push for all community access and within the home for distances beyond the bedroom-to-bathroom transfer' is what planners need to see.

2. Current Equipment and Supports

Document what the participant currently uses and why it is no longer adequate. This includes:

• Existing assistive technology (type, age, condition, funding source)
• Manual handling supports currently provided by carers
• Environmental modifications already in place
• Why current equipment or supports are insufficient (changed needs, equipment deterioration, growth in the case of children, progressive condition)

This section establishes the case for change. If the participant already has a wheelchair, the report must explain why it no longer meets their needs rather than simply requesting a new one.

3. Functional Assessment Findings

Present your assessment findings systematically. For each functional area, document:

• Assessment method: Standardised assessment tools (e.g., FIM, WeeFIM, COPM, GAS), clinical observation, participant and carer interview, environmental assessment
• Current performance level: Quantified wherever possible. Use timed measurements, distance measurements, FIM scores, pain scales, fatigue ratings
• Functional goal: What the participant aims to achieve with the equipment
• Gap analysis: The specific, measurable gap between current performance and the goal

For example: 'Shower transfer: Currently requires full physical assistance of one carer using a standing hoist. Transfer takes approximately 8 minutes with reported pain of 6/10 (participant) and significant manual handling risk for the carer. Goal: Independent or supervision-level shower transfer with reduced pain and eliminated manual handling risk.'

4. Equipment Trial Documentation

The equipment trial is where many AT reports either succeed or fail. The NDIA expects documented evidence that the participant has used the recommended equipment (or a closely equivalent product) with measurable outcomes.

Structured trial documentation should include:

• Trial dates, location, and duration: At minimum, two separate trial sessions. Home-based trials are stronger than clinic-only trials because they demonstrate real-world applicability.
• Baseline measurements: Quantified performance before the trial. Use the same metrics you will measure during the trial.
• Trial measurements: Quantified performance during equipment use. Direct comparison to baseline.
• Specific equipment trialled: Make, model, configuration settings, accessories used during trial.
• Participant feedback: Direct quotes from the participant about their experience. 'It felt much more stable' is acceptable, but 'I could get to the shops by myself for the first time in two years' is compelling.
• Carer feedback: Impact on carer burden, manual handling requirements, time saved.
• Observed functional changes: Tasks completed during the trial that could not be completed without the equipment.

Example of strong trial documentation:

'Trial 1 (15 January 2026, participant's home): Trialled [Brand X powered wheelchair] with tilt-in-space and elevating leg rests. Participant independently navigated from bedroom to kitchen (12 metres, two doorways, one 90-degree turn) in 45 seconds without assistance. Comparable journey in current manual wheelchair with carer pushing: 3 minutes including repositioning. Participant independently accessed kitchen bench at elevated seat height to prepare a cup of tea — task not currently possible. Reported pain: 2/10 (compared to 6/10 baseline in current wheelchair after equivalent activity duration). Trial duration: 90 minutes with no reported fatigue (compared to 30-minute tolerance in current wheelchair).'

This level of specificity is achievable when observations are recorded systematically during the trial. Many OTs find that dictating observations immediately after each trial, while still at the participant's home, produces far more detailed and accurate documentation than writing notes hours or days later. Using a clinical documentation tool like Grounded Scribe to structure trial dictations into report-ready sections can significantly reduce the time between trial and report submission.

5. Feature Matching and Product Recommendation

This section must demonstrate that you have considered alternatives and selected the most appropriate option based on the participant's specific needs.

For each key feature of the recommended equipment, explain:

• Why this feature is needed: Link to assessment findings. 'Tilt-in-space function is required due to the participant's documented pressure injury history (Grade 2 sacral pressure injury, June 2025) and inability to independently perform weight shifts.'
• Why simpler or cheaper alternatives are insufficient: 'A standard powered wheelchair without tilt-in-space was considered but would not address the pressure management needs identified in the assessment. The participant's seating tolerance in a standard powered wheelchair during trial was limited to 45 minutes before skin redness was observed, compared to 3+ hours with tilt-in-space.'
• Supplier quotes: Include at minimum two quotes for comparable products where possible.

6. Cost-Effectiveness Argument

The NDIA is not looking for the cheapest option. They are looking for the most cost-effective option that meets the participant's needs. Your report should argue:

• Reduced carer support costs: If the equipment enables greater independence, quantify the current carer hours that would be reduced or eliminated. 'Current manual handling for transfers requires 2 carer-assisted transfers daily at approximately 15 minutes each. The recommended ceiling hoist would enable independent transfers, saving approximately 30 minutes of funded carer time daily (182.5 hours annually).'
• Reduced health system costs: If the equipment prevents hospital admissions (e.g., pressure injuries, falls), reference this.
• Equipment longevity: State the expected lifespan of the equipment and the amortised annual cost.
• Comparison to alternatives: Show that the recommended option provides better value over its lifespan than cheaper alternatives that would need earlier replacement or supplementary supports.

7. Reasonable and Necessary Criteria

As with all NDIS-funded supports, explicitly address the legislative criteria:

• Related to disability: The functional limitation requiring the AT is a direct consequence of the participant's disability.
• Effective and beneficial: Trial evidence demonstrates measurable functional improvement.
• Value for money: Cost-effectiveness argument as outlined above.
• Not a substitute for other systems: The equipment is not the responsibility of the health system, education system, or employer.
• Most appropriate support: Therapy alone cannot achieve the same functional outcome.

Common AT Report Mistakes

Describing the device instead of the person. A report that reads like a product brochure rather than a clinical assessment will not succeed. Lead with the participant's functional needs; the equipment recommendation flows from those needs.

Insufficient trial documentation. 'The participant trialled the wheelchair and found it suitable' is not trial documentation. Specific measurements, comparisons to baseline, and functional tasks completed during the trial are required.

Ignoring alternatives. If you recommend a $12,000 powered wheelchair, the NDIA will ask whether a $3,000 manual wheelchair with a power-assist add-on was considered. Address this proactively.

Late submission. Participants may wait months for equipment because the report was not completed promptly after assessment and trials. Efficient documentation workflows that capture trial data in real time reduce the gap between clinical work and report submission.

Missing environmental assessment. Recommending a powered wheelchair without confirming it fits through the participant's doorways, can navigate their ramps, and can be charged in their home is a fundamental oversight. Include environmental measurements.

Building Efficiency Into the Process

AT reports are among the most time-intensive documents in occupational therapy practice. The most effective strategy for reducing report writing time is capturing data at the point of assessment rather than reconstructing it later.

During home visits and equipment trials, record quantitative measurements on a structured data sheet (distances, times, FIM scores, pain ratings). Immediately after the visit, dictate qualitative observations: how the participant responded, what functional tasks they attempted, where difficulties arose, what the carer reported. This combination of structured data and dictated observations provides the raw material for a comprehensive report without relying on memory.

The goal is a report that secures the equipment the participant needs, on the first submission, without consuming an entire working day of the therapist's time. Systematic documentation from the point of assessment makes this achievable.

Disclaimer

*Grounded Scribe is a documentation tool that assists practitioners in structuring their clinical notes. All AI-generated content must be reviewed, edited, and approved by the practitioner before it becomes part of the clinical record. The practitioner retains full professional responsibility for the accuracy, completeness, and clinical appropriateness of all documentation.*

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