Physical Disability & I-CAN v6

A practical guide for participants, carers, and allied health professionals

Disclaimer: This article reflects publicly available information about the I-CAN v6 framework developed by the Centre for Disability Studies (CDS). The NDIA uses a customised version for the NDIS Support Needs Assessment. This guide does not constitute professional disability support advice.

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Physical disability encompasses an enormous range of conditions — spinal cord injury, multiple sclerosis, motor neurone disease, muscular dystrophy, limb difference, post-polio syndrome, chronic pain conditions, acquired physical injuries, and many others. What they share for I-CAN v6 purposes is this: the assessment measures how your condition affects your daily functioning, not what your diagnosis is.

This guide covers how the I-CAN v6 assessment works for physical disability, which domains carry the most weight, how to describe your needs accurately across the full 12 domains, and how to build a preparation document that gives your assessor a complete and accurate picture.

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The Four Core Domains for Physical Disability

While all 12 domains are assessed, four typically carry the greatest weight for people with physical disability.

Domain 1: Mobility

Mobility is almost always the central domain for physical disability, and where the most detailed preparation tends to matter most.

The I-CAN v6 Mobility domain covers four sub-areas: Transfers & Positioning, Carrying Moving & Handling Objects, Walking & Moving, and Transport.

What to prepare:

Transfers & Positioning: How do you move between surfaces — bed to chair, chair to toilet, in and out of vehicles? Do you require physical assistance, a hoist, a sliding board, or supervision? How long does each transfer take, and what is the risk if it is unsupported?

Walking & Moving: Can you walk? For how long and how far, reliably and safely? In what conditions — flat surfaces only, with what aid, with what fatigue consequence? What happens when you exceed your limits?

Transport: Can you use public transport independently? Drive? What access requirements does your vehicle need? Are there environments you cannot access at all?

The "cost" of mobility: This is one of the most frequently under-documented aspects of physical disability. Many people with physical disability can perform mobility tasks — but at a cost. Document what a demanding mobility day costs: the fatigue, the pain, the recovery time, the things you cannot do for the rest of the day.

Domain 3: Self Care

Self Care covers eating and drinking, personal hygiene, toileting, and dressing.

What to prepare:

• Morning self-care routine: how long, what assistance, what aids
• Can you shower or bathe independently? What equipment?
• Dressing: fine motor limitations, inability to manage fasteners, time required
• Toileting: frequency of assistance needed, equipment
• The fatigue cost of morning self-care: what can you not manage afterward?

Be honest about what you actually manage, not what you theoretically could manage. Many people present their best performance at an assessment. The I-CAN v6 needs your typical experience.

Domain 2: Domestic Life

Domestic Life covers shopping, cooking, cleaning, and household maintenance.

Physical disability affects domestic life through a combination of fine motor limitations, mobility constraints, fatigue, and safety risks.

What to prepare:

• Shopping: physical access to shops, ability to carry items, transport to get there
• Cooking: can you stand at a stove safely? Lift pots? Manage appliances? What adaptive equipment do you use?
• Cleaning: can you vacuum, mop, or manage laundry? What is the physical cost?
• What does not get done when support is unavailable?

Domain 12: Physical Health

Physical Health is the most granular of the 12 domains — it has 10 sub-areas specifically because physical health needs are complex and varied.

What to prepare:

• Your physical health conditions and their ongoing management requirements
• Medications: complexity, monitoring requirements, administration support needs
• Medical appointments: how many per month, what support is needed to attend
• Pain: location, typical severity, frequency, functional impact
• Fatigue: separate from pain — its own significant functional impact for many conditions
• The cumulative daily burden of health management

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The Remaining Eight Domains

Physical disability does not stop at Mobility, Self Care, Domestic Life, and Physical Health. These four often carry the most weight, but the remaining eight domains are assessed and funded too.

Domain 4: Community, Social & Civic Life

Transport and physical access barriers are central here. Document what community activities you participate in, what prevents participation, whether you can manage finances independently, and whether you need someone to advocate on your behalf.

Domain 5: Communication

Usually intact for physical disability, but relevant if your condition affects speech (as with some neurological conditions), or if fatigue severely impacts communication capacity later in the day.

Domain 6: Learning & Applying Knowledge

Relevant if you are studying, or if an acquired physical disability has disrupted an educational pathway. Document current or aspired learning participation and the barriers your disability creates.

Domain 7: General Tasks and Demands

Daily routine management, medication management, and safety. Physical disability often creates significant routine complexity — care schedules, medication regimens, pressure management, positioning routines. Document this clearly.

Domain 8: Life Long Learning

Vocational goals and the physical barriers that prevent pursuing them. If physical disability has disrupted employment or prevents the employment you aspire to, document the specific barriers and what support would enable vocational participation.

Domain 9: Interpersonal Interactions & Relationships

Usually less affected by physical disability, but relevant if fatigue, pain, or mobility barriers significantly limit social engagement and relationship maintenance.

Domain 10: Behaviours of Concern

Rarely relevant for physical disability unless an acquired neurological condition affects emotional regulation.

Domain 11: Mental & Emotional Health

Living with physical disability carries a significant mental health burden — particularly for people with acquired disability, progressive conditions, or chronic pain. Document anxiety, depression, and psychological impact clearly. These are legitimate and important support needs.

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How to Describe Fluctuating Conditions

Many physical disabilities — particularly MS, chronic pain, post-polio, and fatigue conditions — do not present consistently. Some days are relatively manageable; others are not.

The cardinal rule for fluctuating conditions: describe your range, not your average.

What the assessor needs to know:

1. What a good day looks like — what you can manage
2. What a difficult day looks like — what you cannot manage
3. How often each type of day occurs — in a typical week or month
4. What triggers difficult periods — if identifiable
5. How long difficult periods last and what the recovery looks like

Document this over time — four weeks of a daily diary before your assessment builds a specific, credible picture that a single session cannot replicate.

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Safety Considerations in Physical Disability

Safety is a specific, assessable dimension of the I-CAN v6 that is often under-prepared for in physical disability cases. The assessment explicitly considers safety risks — not to penalise the participant, but because unmanaged safety risks are themselves a support need that the plan should address.

Common safety considerations for physical disability:

Fall risk. Many people with physical disability have elevated fall risk — from balance impairment, lower limb weakness, fatigue, or mobility aid use. Document your fall history specifically: how many falls in the past 12 months, what caused them, what the consequences were (injury, inability to get up, time on the floor before help arrived). A fall that resulted in lying on the floor for hours is powerful evidence of a safety support need.

Inability to self-rescue or call for help. If your physical disability means you cannot get up without assistance, cannot reach a phone, or cannot effectively summon help in an emergency, this is a safety consideration that affects what support is reasonable and necessary.

Fire and kitchen safety. If fatigue, tremor, or limited upper limb function creates kitchen safety risks — including leaving appliances on, inability to manage a fire, or reduced reaction capacity — document any incidents and the current risk management in place.

Medication safety. Complex medication regimens, particularly where timing is critical or where dosing errors carry serious consequences, are a legitimate safety consideration. Document what happens if support for medication management is not provided.

Overnight safety. For participants who require repositioning, pressure management, respiratory monitoring, or other overnight support, document the risk if overnight care is not provided.

How to describe safety considerations:

Be specific rather than general. Not "I could have an accident" but "I have fallen while transferring from my wheelchair to the bed on three occasions in the past year, twice requiring ambulance assistance. Without a support worker present for all transfers, this risk is unmanaged."

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Cross-Domain Consistency: Why It Matters

The I-CAN v6 is designed to be internally consistent. If Mobility is rated at Level 4 (high support needs), the assessor should expect Domestic Life to be at least Level 3 — because someone who cannot move independently cannot cook, clean, or shop without support.

This cross-domain logic also flows to Self Care. If you need substantial mobility assistance, the assessor should expect substantial self-care support needs too.

For your preparation document, this means: make sure the picture you describe across domains is coherent. If you describe significant mobility limitations in one section, ensure that the downstream functional impacts on self-care, domestic life, and community access are also described.

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Evidence That Carries Weight

The supporting documents that matter most for physical disability I-CAN v6 assessments:

Occupational therapy functional assessment — the most valuable document. Ask your OT specifically for a functional summary framed in I-CAN domain terms, not just rehabilitation goals or equipment recommendations. Describe what you can and cannot do in daily life activities, not just your diagnosis.

Physiotherapy assessment — particularly important for documenting mobility limitations, fatigue, pain, and transfer ability.

Medical specialist letters — relevant for describing the condition and its trajectory, but less useful without functional-impact language. Ask your specialist to describe how the condition affects daily functioning, not just diagnosis and treatment.

Daily care diaries or support worker logs — specific, dated records of what assistance was provided and why. These can be more powerful than clinical reports because they document real daily life rather than a clinical snapshot.

What is less useful: Reports focused entirely on diagnosis and treatment without functional description. School reports (unless they document disability-related barriers). Old reports more than two years out of date without a current update.

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Preparing Your Documentation

Start a daily diary now. Four weeks of brief daily notes — what you could manage, what you needed help with, pain and fatigue levels, what did not get done — builds specific, credible evidence that no assessor can dismiss.

Ask your OT for a pre-assessment report. The best OT reports for I-CAN purposes describe what you can and cannot do across the domain areas in plain functional terms, with frequency and severity. Ask specifically for this framing.

Document equipment and what it does and doesn't enable. Your wheelchair, walker, shower chair, or other aids enable certain things — but they do not enable everything. Document both what your technology enables and what it still cannot do. The gap between current equipment and what full participation would require is relevant to your plan.

Do not describe your best performance as your typical performance. The I-CAN v6 assesses typical daily functioning. Assessors see many people who manage better in the assessment room than in daily life. Your preparation document is the place to ensure the assessor has the full, realistic picture.

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ICANReady guides you through all 12 I-CAN domains with prompts designed to help you describe the genuine functional impact of physical disability — including the aspects most often missed, such as fatigue, the "cost" of daily activities, and fluctuating conditions. Build your preparation document before your assessment.

Try ICANReady free →

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Sources: Centre for Disability Studies I-CAN v6 framework, NDIA Support Needs Assessment information (ndis.gov.au), Disability Advocacy Network Australia (dana.org.au)