On a morning in 2019, April Coulson was a healthy, active teenager. By that evening, a bleed on her spinal cord had left her paralysed from the armpits down.

After six months in hospital, April came home in a wheelchair, unable to get out of bed, unable to transfer, barely able to hold herself upright for more than an hour. She needed support workers to shower, dress, and eat. She needed daily intensive physiotherapy, exercise physiology, and occupational therapy — sometimes twice a day.

The NDIS funded all of it.

Years of intensive rehabilitation followed. Pressure sores came and went. Slowly, painstakingly, April built her strength. She stopped needing to be strapped into her wheelchair. She learned to drive a modified car. She transitioned into full-time employment and came off the disability support pension.

"One of the whole reasons that I am where I am today was the support I was receiving," April told the ABC.

This month, the NDIA cut her therapy hours by two-thirds. Against the written recommendations of her doctors, physiotherapists, exercise physiologists, and occupational therapists, a public servant ruled the extra therapy was not "value for money" and suggested support workers and family members could fill the gap instead.

April is 26. She has severe osteoporosis, a condition that puts her at serious risk of fracture during rehabilitation. She has made clear that unqualified replication of her therapy would be dangerous. Every specialist involved in her care has written to the NDIA saying so.

The NDIA has not responded to those letters.

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"The System Is No Longer Fit for Purpose"

April Coulson's case is not an anomaly. It is a pattern.

Dr Martin Laverty, one of the original architects of the National Disability Insurance Scheme and current CEO of disability service provider Aruma, says he is "very concerned" about what is happening to participants across Australia.

Dr Laverty told the ABC that the NDIA is "pulling back on therapeutics, it's pulling back on active overnight support, it's changing the way in which people can access the community," adding that "there's something very wrong with the way in which our assessment for people with disabilities is currently operating."

His verdict was stark: "The system in place today is no longer fit for purpose."

Dr Laverty noted that the federal government plans to introduce a new support needs assessment tool within the next 18 months — referring to the I-CAN v6 framework set to begin rolling out from April 2027.

"The question is: how do we ensure that, between now and the replacement that's on the way, we keep people safe?"

It is the right question. And for tens of thousands of participants like April, the answer matters urgently.

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What Is Happening to NDIS Plans Right Now?

The cuts April experienced are part of a broader shift in how the NDIA is conducting plan reviews. According to the Australian Financial Review, four in ten NDIS plan reviews now result in funding reductions — a significant increase from prior years.

This is happening against the backdrop of the NDIS Amendment (Securing the NDIS for Future Generations) Act 2026, passed in August, which:

• Gives the NDIA new powers to review and revise plans more frequently
• Introduces a framework for automated assessment tools and algorithmic decision-making support
• Requires plans to be linked to "reasonable and necessary" supports determined by formal assessment

The intent of these changes is to make the scheme sustainable. The concern, expressed by advocates and disability experts alike, is that the human cost of implementation is falling on the people least able to bear it.

People like April.

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The Foundational Supports Gap

The government's case for reform rests partly on the argument that the NDIS was never meant to be the only source of disability support in Australia — that a broader ecosystem of foundational supports outside the NDIS would provide a safety net for people transitioning off the scheme.

That ecosystem does not yet exist.

ACIA (Australia's Community Industry Alliance) released a media statement this month making the case plainly: foundational supports for adults cannot wait. While all governments have agreed to jointly fund $10 billion over five years to establish these services, the timing remains unresolved.

ACIA's Chief Executive made the case directly: the success of these reforms depends on one critical factor — foundational supports for adults must be established before the full impact of NDIS reforms is realised. Without that sequencing, the people being transitioned off the NDIS will find themselves without the services that were supposed to replace what they are losing.

Carers Australia CEO Joanna Cave warned that working carers may be forced to reduce their hours to fill gaps that the NDIS used to cover. Her concern was direct: the government has refused to guarantee that NDIS supports will not be removed until alternative services are genuinely available — leaving carers facing difficult decisions with no safety net beneath them.

This is not an abstract policy concern. For families like April's, it means her parents and sister are already absorbing the care hours the NDIA has refused to fund — hours that are directly affecting April's independence, health, and ability to hold down full-time work.

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The Case for Thorough Documentation — Now

Dr Laverty's warning about the period between now and the introduction of I-CAN v6 is worth sitting with. For at least the next 18 months — and likely longer — the current assessment framework will remain in place. And the current framework is producing cuts like April's.

In that environment, the most powerful protection any participant has is evidence.

Not just a diagnosis. Not just a GP letter. But a complete, up-to-date picture of what you cannot do independently, how your condition affects your function across different times and contexts, and what specific support inputs make it possible for you to live your life.

This means:

Detailed professional reports — Every therapist, doctor, and specialist involved in your care should be producing reports that go beyond diagnosis and explicitly describe functional limitations in daily activities. A report that says "patient has spinal cord injury" is far less protective than one that says "patient cannot safely perform transfers without two qualified practitioners present due to osteoporosis and fracture risk."

A support diary — A contemporaneous record of when and how your needs manifest day-to-day is often more persuasive in plan reviews and reviews of decisions than any single professional report. The diary doesn't need to be formal — it needs to be consistent and specific.

Documentation of what happens without support — The NDIA's "value for money" framing is dangerous precisely because it treats support costs in isolation. The genuine cost comparison is: what is the cost of funded therapy versus the cost of hospitalisation, carer breakdown, loss of employment, or pressure sore treatment? Your documentation should make this comparison explicit.

A complete functional picture across domains — When I-CAN v6 does arrive, assessors will evaluate support needs across 12 functional domains. Beginning to articulate your needs in those terms now — Mobility, Self Care, Domestic Life, Communication, Mental & Emotional Health, and others — creates continuity between your current evidence base and what the new framework will require.

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What If Your Plan Has Already Been Cut?

If you are in April's situation — facing reductions that contradict your specialists' advice — you have options, and you should use them.

Request an internal review. You have the right to ask the NDIA to review a decision. Submit every piece of professional evidence you have. Be specific about how the decision conflicts with medical recommendations and what the consequences will be if supports are not restored.

Escalate to the Administrative Review Tribunal (ART). If the internal review is unsuccessful, you can apply to the ART for a merits review of the decision. The ART can substitute a new decision for the NDIA's. Many plan review decisions are reversed at this stage when participants are well-supported.

Contact a disability advocate. Independent disability advocates can assist with reviews at no cost to you. The Disability Advocacy Finder can help you find a local service.

Contact your support coordinator. If you have support coordination funded in your plan, your support coordinator can assist you to navigate the review process, gather evidence, and prepare submissions.

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A System in Transition — With Real People Waiting

What April Coulson's story illuminates is the human cost of living through a system in transition.

The I-CAN v6 assessment framework, when implemented well, has the potential to be genuinely better — more structured, more consistent, more focused on functional need than on diagnosis labels or medical terminology that varies between clinicians. Dr Laverty believes in the principle of a better assessment system. So do many in the disability community.

But "better, eventually" is of no comfort to April right now. Or to the family carers working an extra shift to cover what the NDIA withdrew. Or to the disability arts organisations watching community participation funding disappear from October.

The transition will take years. In the meantime, participants deserve the most robust documentation possible — one that makes it as difficult as possible for any decision-maker to dismiss their needs as not "value for money."

That work starts now.

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Sources: ABC News (13 September 2026), ACIA Media Release (7 September 2026), Carers Australia (August 2026), Australian Financial Review (August 2026).

ICANReady is an independent tool designed to help NDIS participants articulate their support needs in the I-CAN v6 framework. It does not provide legal or medical advice. If you are facing a plan review or decision, seek independent advocacy support.