I-CAN v6 and Spinal Cord Injury

What NDIS participants with SCI need to know

Disclaimer: This article reflects publicly available information about the I-CAN v6 framework as at July 2026. It does not constitute professional disability support, medical, or legal advice. For personalised guidance, contact the NDIA on 1800 800 110, your Support Coordinator, or a disability advocacy organisation.

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Spinal cord injury (SCI) — whether from trauma, disease, or surgical complication — typically produces some of the highest support needs captured in the NDIS. For complete tetraplegia, almost every I-CAN domain is affected at high or very high levels. For paraplegia or incomplete injuries, the pattern is more varied but still involves complex, multi-domain needs.

The I-CAN v6 assessment is well-suited to capturing SCI support needs when preparation is thorough — because the framework's domain structure maps well onto the daily functional realities of living with spinal cord injury. The challenge is ensuring the assessment receives the full picture, including secondary conditions, equipment dependency, and the consequences of support failures.

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Complete vs Incomplete Injury: What It Means for I-CAN

Complete SCI means no sensory or motor function below the level of injury. Functional capacity is largely determined by the injury level:

• Tetraplegia (C1–C8): all four limbs affected; typically very high support needs across almost all domains
• High paraplegia (T1–T6): upper limbs functional; lower limbs affected; moderate-to-high support needs across mobility, domestic life, physical health
• Low paraplegia (T7–L5): increasing upper body function; focused support needs mainly in mobility and physical health

Incomplete SCI means some preservation of sensory or motor function below the injury level. Functional presentation varies enormously — from near-complete functional independence to needs approaching those of complete injuries. The key for I-CAN preparation with incomplete injuries is describing what you can and cannot do in actual daily life, not just injury classification.

What this means for preparation: Injury level and completeness are useful background context, but they are not what the I-CAN v6 measures. The assessment measures your actual daily functional capacity. Prepare in functional terms.

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The Key Domains for Spinal Cord Injury

Domain 1: Mobility

Mobility is typically the most heavily affected domain for SCI participants.

What to document:

• Your primary mobility method (power wheelchair, manual wheelchair, walking aids, or combination)
• Transfers: what transfers are required in daily life, what assistance is needed, what equipment
• Community access: what environments are accessible, what are not, what transport you can use
• Equipment dependency: what would happen if your power chair failed or your hoist was unavailable
• Fatigue: for incomplete SCI, how far can you travel before fatigue limits further mobility
• The "cost" of mobility: what you cannot do after an exhausting mobility day

Domain 3: Self Care

For tetraplegia, self-care is typically among the most support-intensive domains.

What to document:

• Personal care assistance required: bathing, dressing, grooming, eating
• Bowel and bladder management: how this is managed, how long it takes, what assistance is required
• What happens if attendant care is not available in the morning
• For high-level tetraplegia: ventilator management, positioning, pressure relief needs
• Time: how long the morning routine takes with full assistance

Domain 2: Domestic Life

What to document:

• Cooking: what you can manage with adaptive equipment vs what requires assistance
• Cleaning and laundry: physical limitations, what support is required
• Shopping: transport and physical access requirements
• Home maintenance: what requires assistance or cannot be managed at all

Domain 12: Physical Health

Secondary conditions in SCI are significant, common, and functionally impactful.

Document all relevant secondary conditions:

Neuropathic pain: Describe severity, frequency, functional impact. Neuropathic pain in SCI is often chronic, unpredictable, and significantly affects daily functioning, sleep, and mood. Document how it limits what you can do on affected days.

Pressure injuries: If you have had pressure injuries, document their history, what conditions led to them, how they affected your functioning, and what preventive management is currently required (regular repositioning, pressure-relieving equipment, skin checks).

Autonomic dysreflexia (for injuries above T6): Describe frequency of episodes, triggers, consequences, and what management is in place. Autonomic dysreflexia is a medical emergency — its presence and the support needed to manage it is relevant evidence.

Respiratory conditions: For cervical injuries, document any respiratory management requirements.

Urinary tract infections: If recurrent UTIs are part of your health picture, document their frequency and functional impact.

Fatigue: Neurological fatigue in SCI is distinct from physical tiredness and is under-documented. Describe how fatigue affects your daily functional capacity and what activities are prevented or curtailed by it.

Domain 4: Community, Social & Civic Life

What to document:

• Physical access barriers to community participation
• Transport requirements for community access
• What community activities you currently participate in and what prevents full participation
• Financial management and advocacy needs

Domain 11: Mental & Emotional Health

Rates of depression and anxiety are significantly elevated in people with SCI, particularly in the years following injury.

What to document: Any mental health conditions, their functional impact, current treatment. The psychological burden of managing a high-level physical disability is real and belongs in the preparation document.

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Documenting Attendant Care Needs Accurately

Attendant care is one of the most significant areas of NDIS funding for many SCI participants, and one of the most important to document accurately.

A good attendant care documentation covers:

• What care tasks are performed and by whom
• How long each task takes
• What happens if care is not provided (health consequences, safety risks)
• The skill level required for each task (standard personal care vs high-intensity clinical care)
• Any tasks where the absence of care has previously resulted in a medical emergency

For high-intensity care (ventilator management, tracheostomy care, complex bowel management), document the specific training required of support workers, what happens if untrained workers provide care, and any incidents where inadequately trained workers created risk.

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Equipment and Assistive Technology

SCI participants often have significant equipment dependency — power wheelchairs, hoists, standing frames, shower commode chairs, modified vehicles, and more.

For each piece of equipment, document:

• What functional capacity it enables
• What you cannot do without it
• The consequences of equipment failure (power chair battery dies, hoist breaks down)
• What backup plans or emergency arrangements exist

The gap between current equipment and full participation: Document not only what your current equipment enables but what is still not possible with it — or what would be possible with better equipment. This gap is relevant to plan funding.

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Cross-Domain Consistency

The I-CAN v6 is internally consistent. If Mobility is rated at Level 5 (continuous need), the assessor should expect Self Care and Domestic Life to be at Level 4–5 as well — because someone who cannot move independently cannot bathe, dress, cook, or clean without equivalent support.

Ensure your preparation document creates a coherent picture. If you describe very high mobility needs, describe the corresponding domestic and self-care support needs in equal detail.

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Evidence That Carries Weight

Spinal rehabilitation OT assessment: The most valuable document. Should describe functional capacity across I-CAN domain areas with specific detail about daily assistance requirements.

Attendant care assessment: A formal assessment of attendant care hours required, by function, across the day and week.

Spinal specialist or rehabilitation physician letter: Describing injury level, secondary conditions, functional trajectory, and medical management requirements.

Secondary condition documentation: Medical records and specialist letters describing neuropathic pain, pressure injury history, autonomic dysreflexia management, respiratory conditions.

Equipment prescription records: Documenting current equipment, functional justification, and any equipment needs that remain unmet.

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ICANReady guides you through all 12 I-CAN domains with prompts designed to help you describe the full functional impact of spinal cord injury — including secondary conditions and equipment dependency — in the specific language the assessment needs.

Try ICANReady free →

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Sources: Centre for Disability Studies I-CAN v6 framework, Spinal Cord Injuries Australia (scia.org.au), NDIA support needs assessment guidance (ndis.gov.au), Disability Advocacy Network Australia (dana.org.au)