This is a worked example, written to show how we would approach an assessment of this kind. It does not describe a real person or a real assessment. Support decisions are made by the NDIA and depend on individual circumstances.

The situation

Consider a referral from a support coordinator ahead of a plan review. A man is living semi-independently in a granny flat behind his mother’s house, four years after a motorbike accident. Physically he has recovered well. His existing plan contains a small amount of support, and his last report describes him as largely independent. His mother has asked for a review because, in her words, she is exhausted and cannot say why.

What the first hour tends to suggest

In situations like this the person is often welcoming, articulate and clear that they do not need much help, and can describe their week accurately in general terms. Asked to make a coffee, they do it without difficulty. On that evidence alone, the existing report would look correct. This is exactly where an interview-based assessment stops.

What we would do instead

We would assess across two visits, one late morning and one at about four in the afternoon, because cognitive fatigue is central here and a single morning appointment cannot see it.

In the morning, the question is not whether a familiar task can be completed, but whether anything begins without being suggested. We would look at what the kitchen shows: food bought, unopened and past its date is a more reliable account of the week than any description of it. In the afternoon, we would look at the same tasks again, because the difference between ten in the morning and four in the afternoon is frequently the most important finding in a brain injury assessment.

Who we would speak to, and why

With consent, we would speak separately with his mother and his support worker. In this pattern a family member commonly describes something the participant has not mentioned at all: crossing the yard six or seven times a day to start meals, prompt medication, check the stove and redirect when something has been half done. Care of that kind often stops being recognised as care and simply becomes somebody’s day.

Where the participant has not described any of it, that is rarely concealment. Reduced insight is a consequence of the injury, and the person genuinely may not experience those prompts as help they need. Recording that divergence, rather than resolving it, is the point.

What the report would set out

The gap between demonstrated capability and actual daily performance, with observed examples rather than adjectives. The initiation failure. The afternoon fatigue pattern, evidenced across two observation points rather than asserted. The hours of informal supervision being absorbed by one person. And critically, the support required described as prompting, supervision and set-up rather than physical assistance, because those are different support profiles at different intensities and costs.

It would name the consequence directly: an unsupervised stove, unmanaged medication, and an informal arrangement carried by one person that is not sustainable.

Why that is defensible

Because every finding would name what was observed, when it was observed, and who else independently described it. That is our evidence standard applied to a brain injury, and it is what makes a report difficult to decline on the grounds that the case was not made.