Would your OT report hold up at the ART?

If you're not familiar with the Administrative Review Tribunal (ART), it's where participants can go to challenge certain NDIS decisions after they've been through the NDIA's internal review process and haven't achieved the outcome they were seeking.

The ART reviews the decision and considers the evidence available, including the original OT reports and assessments submitted to the NDIA. Sometimes additional evidence is needed. This can include an independent OT assessment to provide a clearer picture of the participant’s functional needs and the supports they're requesting.

Some of the experienced OTs in my team at Verve OT undertake these independent assessments, so we get to see firsthand how clinical evidence is reviewed and questioned. And I have to say, some of the questions that come back really make me think about how OTs are writing our reports in the first place.

When the evidence doesn't tell the full story

I recently reviewed an independent OT assessment report completed by one of my team members for a participant whose NDIS funding decision was being challenged at the ART. The participant has substantial physical support needs that I was able to clearly identify and review in the report.

As I worked through this assessment, I was surprised by some of the questions being raised about the participant’s functional abilities as part of the ART proceedings. Could they contribute to their personal care? Were there aspects of their mobility they could manage independently?

The independent assessment included photographs demonstrating the severity of the participant’s physical impairment, so I struggled to understand why these questions were being asked. I decided to go back and review the original OT report submitted to the NDIA, which had informed the decision being challenged. And that's when I noticed something important. There wasn't a single photograph in the original report.

As an OT, I could interpret the clinical descriptions and understand what severe contractures might mean for someone's functional abilities. But would someone without a clinical background appreciate the significance of those descriptions? I'm not so sure.

Are we making our evidence easy to understand?

I've been reviewing a lot of OT reports lately. I've noticed a tendency to include more and more information, as though longer reports automatically mean stronger evidence.

But our reports aren't necessarily being read by other OTs. They're being reviewed by planners, delegates, lawyers and tribunal members who may not have the clinical knowledge to interpret what we're describing.

If we're documenting severe contractures, have we explained what that means for the participant’s ability to transfer, reposition themselves or participate in personal care? Sometimes a photograph, where appropriate (and obtained with consent) can communicate something more effectively than several paragraphs of clinical terminology.

Our job isn't just to document what we've assessed. It's to make sure the reader understands what those findings mean. And that means thinking carefully about how we present our evidence, not simply how much information we include.

Can we actually justify the therapy we're recommending?

Another recent ART decision raised a different but equally important issue. The tribunal was critical of the evidence supporting the amount of therapy being recommended, questioning whether the reports adequately explained what the intervention was intended to achieve and why it was necessary.

It made me think about how we arrive at our recommendations for weekly or fortnightly therapy. Are we always clearly explaining why a participant needs that particular frequency and duration? What functional outcomes are we expecting, and what evidence supports our recommendations?

Of course, research doesn't always provide definitive answers. In some areas of OT, particularly paeds, the evidence doesn't necessarily tell us what frequency or duration of intervention will produce a particular outcome. That doesn't mean the intervention isn't appropriate, but we need to be able to explain how we've arrived at our recommendations.

And I think that's the question we should be asking ourselves. If someone challenged the recommendations in our report, could we confidently explain the clinical reasoning behind them? Not just why therapy might be beneficial, but why the particular intervention and level of support we're recommending is necessary.

Stronger evidence doesn't necessarily mean more evidence

One of the biggest lessons I've taken from reviewing these matters is that we need to be more deliberate about what we're including in our reports. We don't necessarily need another ten pages of information.

We need to be clearer about functional limitations, more specific about the supports we're recommending and more explicit about the reasoning connecting our assessment findings to those recommendations.

We also need to consider the person reading our report. Have we provided enough information for them to understand the participant’s circumstances? Have we explained why the recommended supports are necessary rather than simply stating that they are?

Ultimately, a well-written OT report should do more than describe someone's functional capacity. It should provide clear, meaningful evidence that supports informed decision-making.

And if you were asked to explain and defend the recommendations in your most recent functional assessment report, how confident would you feel?

Want to better understand your role as an OT in the ART?

If this article has made you think about how your reports and recommendations might be scrutinised at the ART, we've got a workshop coming up that you might find valuable!

NDIS Reviews, the ART and the OT Role is a two-part workshop exploring how the ART process works, where OTs fit in and what you need to understand when your clinical evidence and recommendations are being reviewed or challenged.

Join us live on 3 December and 10 December 2026, with the opportunity to learn, ask questions and strengthen your understanding of this important area of OT practice.

Can't make it live? The sessions will be recorded, so you'll also be able to access the workshop at your own pace! Available in your Verve OT Learning Library for 6 months.

👉 Find out more and register for the workshop