Aim: To develop an equitable system for allocating equipment, aids and appliances to adults with disabilities based on assessment of need and capacity to benefit for use by occupational therapists, who are the main professional group involved in assessing and prioritising applications. Methods: An assessment tool was developed, pilot tested and field tested at four sites in New South Wales. Assessments were undertaken in parallel with existing systems. Feedback on use of the tool was obtained from those conducting the assessments and those making decisions to fund applications for equipment based on the assessments. Results: One hundred and six assessments were undertaken. Applications for bed, sleeping and seating equipment and equipment to assist with mobility, toileting, showering and transfers accounted for 94.2% of equipment requested. Provision of equipment was expected to have greatest impact on the physical effort and safety of carers and the safety and quality of life of applicants. Regression analysis identified assessment items that explain variation between applicants and that can avoid unnecessary data collection. Conclusions: The assessment tool provides a standardised method for assessing requests for equipment based on the twin concepts of need and capacity to benefit. The results support the use of both concepts as the foundation of the assessment process. Further development is required, particularly to move to the next stage of using the assessment tool as the basis for prioritising applications for equipment. © 2008 The Authors. Journal compilation © 2008 Australian Association of Occupational Therapists.