Getting Funding for Intimacy Aids After Injury or Disability: What Most Schemes Look For

Louise Whitton, Occupational Therapist

One of the questions we get asked most often — usually by a clinician trying to write up a request — is simply: how do I actually justify this? Not because anyone doubts intimacy matters. It's more that most people haven't had to write this particular kind of request before, and it's genuinely different from justifying a shower chair or a wheelchair cushion.

I want to be upfront about something: I know the NSW iCare system well, because that's where the bulk of my clinical work sits. Other states run their own compensable schemes, and while the underlying logic tends to be similar, the specific process, forms, and thresholds vary. If you're working under a scheme I haven't mentioned by name, the principles below will still largely apply — but it's always worth checking the specific guidance for the scheme you're working under, because the details do differ.

The common thread across most schemes

Whether it's iCare in NSW, the NDIS nationally, or another state-based compensable scheme, most funding decisions come back to some version of the same test: is this reasonable and necessary in relation to the person's injury or disability. The wording differs slightly scheme to scheme, but the underlying question is consistent — does this piece of equipment relate clearly to the person's injury-related needs, and is it a reasonable way of meeting them?

The NDIS is national, so its criteria apply the same way regardless of which state someone lives in. Most other compensable schemes — workers compensation, lifetime care, transport accident schemes, and similar — are state-specific, and each has its own forms, approval pathways, and quirks. What tends to be consistent, though, is that a well-justified request gets across the line faster than a bare request for a product, regardless of which scheme is reading it.

What tends to help, regardless of the scheme

Based on what we see work well, a handful of things consistently strengthen a request:

Reference pre-injury life, and what's changed

Schemes respond to a clear before-and-after. What role did intimacy and sexual expression play in this person's life before the injury or onset of disability, and how has that been affected? This doesn't need to be lengthy or clinical — it just needs to establish that this is a genuine area of function that has been impacted, the same way you'd describe a change in mobility or self-care.

Show that injury-related needs have specifically been considered

A generic "the person would like a vibrator" reads very differently to a request that explains why this particular product suits this particular person's hand function, sensation, positioning, or other injury-related factors. The equipment should clearly follow from the person's specific presentation, not be a general want.

Address safety directly

Most schemes want reassurance that a request won't introduce new risk. It's worth explicitly noting that the person's safety has been considered, and that using this equipment won't place them at increased risk — particularly where there are relevant risk factors like autonomic dysreflexia, skin integrity, or reduced sensation. (We've written more on this in our safety basics article, if that's useful background.)

Show the fit with the person's environment, limitations, and goals

Rather than presenting a product in isolation, it helps to frame it in terms of the person's actual environment and what they're trying to achieve — their functional limitations, their living situation, and their stated intimacy goals. This is what separates a considered request from an off-the-shelf one.

Where relevant, show partner involvement

If the person has a partner and it's appropriate to do so, noting that the partner has been included in exploring options can strengthen a request — it demonstrates the equipment fits a real relational context, not just an individual want, and that decisions haven't been made in isolation.

A quick note on tone

None of this needs to read as clinical or detached. If anything, requests that sound like they came from someone who actually knows the person tend to land better than ones that sound like a form has been filled in on autopilot. Write it the way you'd write any other equipment justification — grounded in the person, not just the product.

If you're not sure where to start

If you're a clinician putting together a request and you're not sure how to frame it, or you want a second set of eyes on the product side of things, get in touch. We can't advise on scheme-specific approval criteria outside of what we know well, but we can help make sure the product side of the request is clear, appropriate, and easy for a funding body to say yes to.

About the author

Louise Whitton is an occupational therapist and the founder of Focus on Intimacy. She has spent the past fifteen years working in catastrophic injury management across regional NSW, and leads a team of allied health clinicians and nurses at Focus on Function in Tamworth, Armidale and Gunnedah.