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 Upper limb complex regional pain syndrome
Upper limb CRPS is not assessed as generic chronic pain. NSW excludes AMA5 Chapter 18. CRPS must first satisfy the NSW Table 17.1 diagnostic criteria and then be assessed through the NSW method for loss of motion and sensory, pain or motor components as applicable.
What injuries can happen to this body part?
- CRPS 1 after wrist, hand, finger, shoulder or arm trauma without a specific injured nerve
- CRPS 2 where there is objective evidence of injury to a specific nerve
- CRPS-like symptoms that may instead be disuse, neuropathy, vascular change, infection, psychiatric overlay or another diagnosis
Symptoms and findings that matter
- Continuing pain disproportionate to the causal event
- Symptoms and signs in sensory, vasomotor, sudomotor/oedema and motor/trophic categories
- Diagnosis present for at least one year for CRPS 1, verified by more than one examining physician
- Exclusion of other diagnoses that better explain the signs and symptoms
- Loss of upper limb joint motion and sensory/pain or motor components under the NSW method
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
- Upper limb CRPS is not assessed as generic chronic pain. NSW excludes AMA5 Chapter 18. CRPS must first satisfy the NSW Table 17.1 diagnostic criteria and then be assessed through the NSW method for loss of motion and sensory, pain or motor components as applicable.
- Assessment source: NSW Guidelines Chapter 2 paragraph 2.21 and Chapter 17 chronic pain/CRPS method.
- 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
- CRPS can reduce finger, wrist, elbow or shoulder movement, but ROM is only one part of the NSW CRPS method.
- The assessor must record signs observed at the impairment evaluation, not just symptoms reported earlier.
CRPS upper limb NSW method
No Chapter 18 pain ratingNSW excludes AMA5 Chapter 18. CRPS is not assessed as generic chronic pain.
Rateable diagnosisUse NSW Table 17.1 to decide whether CRPS is a rateable diagnosis and exclude other diagnoses that better explain the signs and symptoms.
CRPS 1 timing and verificationFor CRPS 1, the diagnosis must have been present for at least one year, verified by more than one examining physician, and other possible diagnoses excluded.
Upper limb conversionFor upper limb CRPS, combine eligible loss of motion and sensory/pain or motor components as the NSW method permits, then convert upper extremity impairment to WPI using AMA5 Table 16-3.
NSW upper extremity assessment rules
Main methodAMA5 Chapter 16 applies to upper extremity WPI, subject to the NSW modifications in Chapter 2 of the SIRA Guidelines.
Stable diagnosisThe impairment must be permanent and stable, with a defined diagnosis confirmed by examination.
ROM reliabilityActive ROM is used for impairment calculation. Passive ROM can help clinical examination, but inconsistent ROM should not be used as a valid parameter.
ConversionUpper extremity impairment is converted to WPI using AMA5 Table 16-3 as adopted by NSW.
No double countingThe same loss should not be counted twice through ROM, nerve, strength, diagnosis-based or surgery methods.
Practical WPI examples
- A painful wrist after fracture is not automatically CRPS. The NSW diagnostic criteria need symptoms and signs across the required categories.
- CRPS 2 requires objective evidence of injury to a specific nerve before using the CRPS 2 method.
- NSW excludes AMA5 Chapter 18, so a standalone chronic-pain chapter rating should not be added.
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
- Pain specialist notes, rehabilitation records, serial examination findings, photographs where clinically relevant, ROM measurements, sensory findings and reports excluding alternative diagnoses
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
- Calling any severe pain CRPS
- Using Chapter 18 pain rating despite the NSW exclusion
- Ignoring the one-year and more-than-one-physician requirements for CRPS 1
Assessment source
Assessment source: Assessment source: NSW Guidelines Chapter 2 paragraph 2.21 and Chapter 17 chronic pain/CRPS method.
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 upper extremity chapter: Source for NSW upper extremity assessment rules and AMA5 Chapter 16 adoption/modification points.
- SIRA chronic pain and CRPS chapter: Source for NSW CRPS diagnostic criteria and assessment method; AMA5 Chapter 18 is excluded.
Related injury and claim pages
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 Upper Limb CRPS WPI Assessment
The assessment scope for Upper Limb CRPS 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 Upper Limb CRPS
- 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 is confined to CRPS affecting an upper limb. The assessment file should identify the affected side and whether the findings involve the hand, wrist, forearm or the limb more broadly. It should preserve the examination findings used to support the diagnosis, compare them with the opposite limb where clinically appropriate, and separate CRPS-related impairment from an underlying fracture, tendon, joint or nerve injury that may require its own method.
- Specify the affected upper limb and anatomical area examined
- Record sensory, vasomotor, sudomotor, motor and trophic findings rather than pain alone
- Keep photographs or serial clinical observations taken during treatment where available
- Check whether the original upper-limb injury is assessed separately or within the same 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.