What should be checked before relying on a WPI figure?
Check maximum medical improvement, the body area, objective findings, the NSW Guideline chapter and any NSW modification before relying on a percentage.
Can this page calculate your percentage?
No. WPI depends on an assessor, maximum medical improvement, objective findings and the NSW Guidelines. This page is general information only.
Permanent impairment assessment
How permanent impairment is assessed for Traumatic brain injury, concussion and post-concussion symptoms
Traumatic brain injury WPI focuses on stable neurological function, not the fact that a head strike or concussion occurred. Concussion symptoms can be real and disruptive, but WPI usually depends on objective assessment of consciousness/awareness, cognition, communication, behaviour, movement, cranial nerve or other neurological function.
What injuries can happen to this body part?
- Concussion or mild traumatic brain injury after a fall, strike, vehicle incident or assault
- Moderate or severe traumatic brain injury with loss of consciousness, post-traumatic amnesia or intracranial pathology
- Post-concussion symptoms such as headache, dizziness, fatigue, memory difficulty, concentration difficulty or vestibular symptoms
- Cranial nerve, balance, gait, movement, language or behavioural changes after head trauma
- Cognitive and emotional changes overlapping with psychological injury, pain, sleep or medication effects
Symptoms and findings that matter
- Acute injury records, imaging and diagnosis
- Glasgow Coma Scale, post-traumatic amnesia and CT/MRI findings where available
- Neuropsychology, neurology, rehabilitation or occupational therapy findings at MMI
- Consciousness/awareness, cognition/memory, language/communication, emotional or behavioural change
- Gait, station, coordination, movement disorder, cranial nerve or vestibular impairment
- Medication, fatigue, sleep and psychiatric overlap
- Whether symptoms are better assessed under another chapter or require legal review
What investigations are usually relevant?
- Treating specialist report and final impairment assessment at maximum medical improvement
- Imaging, pathology, audiology, ophthalmology, respiratory, nerve or functional testing that fits the body system
- Operative reports, discharge summaries, rehabilitation records and objective clinical measurements where relevant
How WPI is assessed for this body part
- Traumatic brain injury WPI focuses on stable neurological function, not the fact that a head strike or concussion occurred. Concussion symptoms can be real and disruptive, but WPI usually depends on objective assessment of consciousness/awareness, cognition, communication, behaviour, movement, cranial nerve or other neurological function.
- Assessment source: NSW Guidelines Chapter 5 nervous system. For traumatic brain injury, the Guidelines require a severe/high-energy head impact context and clinical evidence such as significant verified GCS abnormality, post-traumatic amnesia or significant intracranial pathology.
- The assessor should explain maximum medical improvement, the body-system chapter, the method selected, any NSW modification, and why the objective findings fit that method.
How movement affects the assessment
- ROM is not the main method for traumatic brain injury. Movement and gait may matter if they reflect neurological impairment, balance, coordination or brain injury consequences.
- Neck, shoulder or spine injuries from the same accident should be assessed under their own chapters and not hidden inside a concussion page.
NSW nervous system assessment rules
Brain and central nervous systemCerebral functions are considered by domains such as consciousness/awareness, cognition, communication, emotional/behavioural change, movement and cranial nerve findings.
Peripheral nervesPeripheral nervous system impairment is assessed through the relevant upper extremity, lower extremity or spine method rather than as a vague neurological label.
Do not double-rateThe assessor should be specific and avoid rating the same functional loss under overlapping cognitive, behavioural, musculoskeletal or nerve categories.
Objective evidenceStable clinical findings, specialist examination and relevant testing matter. Symptoms by themselves may affect capacity but may not establish WPI.
NSW traumatic brain injury source checks
Clinical trigger for TBI assessmentFor traumatic brain injury, the NSW Guidelines refer to evidence of severe/high-energy head impact plus at least one of significant verified Glasgow Coma Scale abnormality, significant post-traumatic amnesia, or significant intracranial pathology on CT/MRI.
Neuropsychology contextNeuropsychological testing should be considered with the overall history, examination and radiology; it should not be used in isolation.
Mild symptomsHeadache, fatigue, dizziness or poor concentration after concussion can be real, but WPI requires stable impairment supported by the Guideline method.
Practical WPI examples
- A short-lived concussion with normal imaging and no stable objective deficit may still affect treatment and work capacity, but may not produce ratable WPI.
- A severe TBI assessment may need neuropsychology, neurology, rehabilitation records and evidence about ADL, employment, supervision needs and cognitive reliability.
- Neuropsychological test results should be read with the history, examination and radiology, not as a standalone number.
- Poor concentration may arise from TBI, pain, medication, sleep disturbance or psychological injury; the evidence should explain the cause rather than assume it.
Evidence checklist
- A clear diagnosis and the body area being assessed
- Records showing the condition has reached maximum medical improvement, if that is the issue
- Specialist reports, imaging reports and treating notes relied on by the assessor
- Objective findings on examination, not only symptoms described by the injured person
- A work and treatment chronology explaining the injury, treatment, surgery and recovery path
- Any previous injury, degeneration, congenital issue or non-work cause that needs apportionment considered
- Hospital and emergency notes
- Ambulance records
- GCS and post-traumatic amnesia records
- CT/MRI reports
- Neurologist report
- Neuropsychological testing
- GP notes
- OT/functional assessment
- Rehabilitation notes and return-to-work evidence
What usually does not increase WPI
- Assuming a scan result automatically gives a WPI percentage
- Confusing pain, disability or inability to work with permanent impairment
- Ignoring maximum medical improvement before arranging an assessment
- Using an AMA5 table without checking whether the NSW Guidelines modify or replace it
- Double counting the same impairment through two methods when the Guidelines require one method
- Assuming a normal CT rules out every ongoing problem
- Treating a symptom diary as a substitute for clinical findings
- Equating every concussion symptom with WPI
- Ignoring psychological, vestibular, cervical spine or medication overlap
Assessment source
Assessment source: Assessment source: NSW Guidelines Chapter 5 nervous system. For traumatic brain injury, the Guidelines require a severe/high-energy head impact context and clinical evidence such as significant verified GCS abnormality, post-traumatic amnesia or significant intracranial pathology.
This section is source-backed general information. It is not a WPI assessment and is not legal advice.
- SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment: Source for the NSW assessment framework, MMI, AMA5 adoption, NSW modifications and exclusions.
- SIRA nervous system chapter: Source for nervous system assessment concepts including brain, spinal cord and peripheral nerve impairment.
Related injury and claim pages
- Common injury evidence hub
- Work injury claims NSW
- Claim process
- Compensation and entitlements
- Ask about an impairment issue
- NSW Injury Claim Evidence, Documents and Templates - This library helps injured people organise incident, medical, income, correspondence and daily-impact records into a clear working file, without presenting any checklist or template as an official form.
- NSW Injury Claims by Location - NSW Injury Claims accepts enquiries from across NSW. The claim pathway depends on how the injury happened, while phone, online and electronic document handling can make an initial enquiry possible without creating a false impression of premises in every region.
- Peripheral Nerve Injury WPI Assessment NSW - Neurological permanent impairment assessment guide with NSW Guideline source notes.
Need a practical claim check?
If an impairment percentage, medical assessment or insurer decision is affecting your NSW injury claim, send the decision or report for a practical review. This is general information only and does not guarantee any result.
Request a free claim checkAssessment scope for Concussion and Post-Concussion WPI Assessment
The assessment scope for Concussion and Post-Concussion WPI Assessment should be stated precisely before any percentage is considered. The file should identify whether that label describes the primary diagnosed condition, a symptom of another injury, a regional overview or one component of a broader impairment. Findings from another body area or diagnosis should not be transferred without explanation. The report should connect the stated condition to the correct NSW Guideline chapter, objective findings, treatment history and any permitted combination or apportionment method. This distinction is particularly important where similar page labels cover different clinical questions.
- Confirm the diagnosis and body area being assessed as Concussion and Post-Concussion
- Separate condition-specific findings from overlapping symptoms or injuries in another body area
- Check that the selected NSW Guideline chapter and method match the condition actually assessed
- Explain any combination, apportionment or exclusion rather than relying on the page label alone
Clinical boundary for this WPI guide
This guide focuses on concussion and persistent post-concussion symptoms. The file should preserve the initial event, early symptoms, recovery trajectory and investigations used to exclude or identify another cause. Headache, dizziness, fatigue, concentration and sleep complaints need careful clinical context; they do not automatically establish permanent brain impairment. A broader traumatic-brain-injury method may be relevant only where diagnosis and objective functional evidence support it.
- Document acute concussion features and the symptom course over time
- Keep vestibular, vision, headache, sleep and cognitive treatment records
- Consider alternative medical or psychological explanations recorded by clinicians
- Do not assume persistent symptoms automatically establish permanent brain impairment
Start with maximum medical improvement
Permanent impairment should generally be assessed when the condition is stable and unlikely to change substantially in the next year. Treatment, surgery and rehabilitation history may affect whether the timing is appropriate.
Use the NSW Guidelines first
The NSW Guidelines adopt AMA5 in many areas, but NSW modifications prevail. Do not assume an AMA5 table applies without checking the NSW chapter and any public SIRA clarification.
Keep the assessment practical
A useful assessment file separates diagnosis, objective findings, surgery history, work capacity issues, apportionment questions and the body-area method used by the assessor.
Ask about an impairment issueDocuments and records
Injury evidence to organise early
The useful records depend on how the injury happened, when symptoms were recorded and how treatment or work capacity changed.
- Date, location and short description of the injury event
- Medical certificates, reports, scans, treatment records or hospital documents
- Employer, insurer, police, incident or venue records where relevant
- Photos, witness details, dashcam or other supporting material if available
- Income, superannuation, work capacity or leave records where relevant
- Letters, emails, claim numbers and decisions already received
Common questions
Injury evidence questions
Short general answers only. The right next step depends on the facts, dates and documents.
Is WPI the same as being unable to work?
No. WPI is a medical impairment measure. Work capacity, weekly payments, damages, treatment disputes and TPD issues are separate questions, although the evidence may overlap.
Does pain alone create a WPI percentage?
Not by itself. NSW workers compensation excludes AMA5 Chapter 18 on pain. Chronic pain is assessed through the underlying diagnosed condition where the Guidelines permit it.
Can secondary psychological symptoms be added to physical WPI?
In NSW workers compensation, secondary psychiatric or psychological impairment is not assessed as permanent impairment. Primary psychological impairment is assessed separately and is not combined with physical WPI.
Injury pathway enquiry
Not sure which claim type matches the injury?
Start with how the injury happened, what medical records exist and how work or daily activity has changed. The same injury can sit in different pathways.