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A Functional Capacity Assessment (FCA) is a detailed look at what you can and cannot do in everyday life, and why. For people living with a heart or lung condition, it describes how breathlessness, fatigue and reduced fitness affect daily activities — and what support or equipment would help. It provides the evidence the National Disability Insurance Scheme (NDIS) uses to build or review a plan.
What it is
An FCA is a structured assessment of your functional abilities across daily life — mobility, self-care, endurance, and participation in home, work and community activities.1 For cardiorespiratory conditions it pays particular attention to how far and how long you can be active before symptoms limit you, and how that affects your independence.2 The result is a clear, evidence-based report.
What it involves
- A conversation about your history, goals, daily routine and the tasks you find difficult.
- Standardised measures — for example a walking test such as the Six-Minute Walk Test, strength and balance checks, and validated questionnaires, with breathlessness rated on the modified Borg scale.
- Observation of everyday tasks where relevant — such as walking, stairs, or carrying.
- A written report describing your capacity, the impact of your condition, and recommendations for supports, equipment or therapy.
How it supports an NDIS plan
The report gives your planner or support coordinator objective evidence of your functional needs. It can help justify funding for therapy, exercise programmes, equipment or assistance, and provides a baseline to measure progress against at your next review.
What the report can and cannot do is worth being clear about. Deciding what is “reasonable and necessary” is the NDIA's decision, not the assessor's. The Agency funds a support only where it is satisfied the support meets all of the NDIS funding criteria — that it relates to your disability, helps you pursue your plan goals, helps you take part socially and economically, represents value for money, is likely to be effective and beneficial having regard to current good practice, takes account of what it is reasonable to expect family, carers and community to provide, and is an NDIS support for you.3 An assessment supplies evidence against those criteria; it does not make the funding decision.
The NDIA is explicit that it takes expert opinion into account but does not automatically fund everything a health professional recommends, because every support must still meet all the criteria — a therapist may recommend equipment as effective and beneficial, but where something cheaper achieves the same outcome the recommendation may not represent value for money.3 That is not a reason to skip the assessment; it is the reason a good one is specific about function, alternatives and expected benefit rather than simply naming a product. The Agency also notes it does not need an expert report for every support.3
Two further points to expect. Each support must be reasonable and necessary individually and again as a package, so funding one support can reduce another. And if you disagree with a decision, you can ask for an internal review within three months of receiving your plan.3 Note that NDIS law is changing: a new planning framework is being introduced, and current guidance still describes the existing framework.3
References & evidence base
- World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: WHO, 2001.
- Holland AE, Spruit MA, Troosters T, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 2014;44(6):1428–1446.
- National Disability Insurance Agency. Our Guideline – Reasonable and Necessary Supports. Canberra: NDIA. Available at: ndis.gov.au. Describes the current (“old framework”) planning rules; a new planning framework is in development.
References are numbered in citation order (Vancouver/BMJ style) and were current at the time of writing. Guidelines are living documents — verify against the latest version before clinical use.
A functional capacity assessment puts numbers to what a person can actually do, which is what NDIS and aged care funders ask to see.
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