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 Respiratory, cardiovascular, digestive, urinary, endocrine, skin and scarring
Body system impairment assessments often use AMA5 as adopted by NSW, subject to any NSW modification. These pages should explain what the assessor measures without pretending a percentage can be predicted from the diagnosis alone.
What injuries can happen to this body part?
- Respiratory impairment after dust, chemical, smoke, infection or other occupational exposure
- Digestive or abdominal consequences after trauma, surgery, medication or treatment complications
- Urinary, reproductive, bladder or sexual-function impairment after pelvic, spinal cord, cauda equina, nerve or treatment-related injury
- Cardiovascular or endocrine consequences where work contribution or treatment consequences are medically supported
- Skin, burn and scarring impairment after healed burns, lacerations, dermatitis, chemical exposure or surgical scarring
Symptoms and findings that matter
- The body system affected and the confirmed diagnosis
- Objective testing such as lung function, cardiac testing, pathology, specialist reports or skin/scarring assessment where relevant
- Functional stability at MMI and treatment outcome
- Whether the impairment is work-related or caused partly by non-work factors
- Whether the chapter method converts the body-system result to WPI
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
- The assessment should start by naming the affected system, not by using a broad phrase such as "whole person impact".
- The assessor then applies the NSW-adopted chapter method for that system and explains any NSW modification.
- Where one event causes multiple body-system complaints, the report should separate the accepted injury from non-work causes and avoid double counting the same functional loss.
How movement affects the assessment
- ROM is usually not the main method for respiratory, digestive, urinary, cardiovascular or endocrine impairment.
- For skin and scarring, movement restriction may matter if a scar limits a joint or daily activity, but the assessor should explain whether it is rated under the skin method, a limb method, or another permitted approach.
- Functional complaints still matter for work capacity and treatment disputes even where they do not create a separate WPI rating.
Other body-system WPI source checks
Identify the system firstRespiratory, digestive, urinary, cardiovascular, endocrine and skin impairments use different methods. The diagnosis name alone is not the method.
Use objective testingSpecialist reports and system-specific testing are usually more important than a broad statement that the injury affects daily life.
Check NSW modificationAMA5 is used only where NSW adopts it. The assessor should check whether the NSW Guidelines modify, replace or exclude the AMA5 approach.
Do not double countA symptom should not be counted under two overlapping body systems unless the Guidelines permit separate ratings.
NSW respiratory assessment rules
Objective respiratory testingRespiratory impairment is usually classified through pulmonary function testing under standard conditions and specialist clinical assessment.
AsthmaOccupational asthma assessment requires consistent repeat lung function testing over a six-month period and evidence of maximal treatment/compliance; bronchial challenge testing is not performed as part of the impairment assessment.
Non-work contributionPre-existing disease and lifestyle factors such as smoking must be considered and any deduction should be recorded by the assessor.
Dust diseasesPneumoconiosis is excluded from this Guideline pathway because dust diseases are dealt with under dust diseases legislation.
Digestive system WPI source checks
Body-system chapterDigestive impairment should be assessed through the digestive system chapter where the condition is stable and the chapter method fits the accepted injury.
Objective investigationsEndoscopy, imaging, pathology, operative findings, nutrition records or specialist examination may be needed. Symptoms alone do not identify the WPI method.
Treatment stabilityHospital admission or surgery history is not the percentage. The assessment should describe the stable residual impairment after treatment.
Work capacity separate from WPIDigestive symptoms may affect attendance, fatigue, diet, medication or bathroom access, but WPI still follows the body-system method.
Urinary and reproductive WPI source checks
Specialist evidenceUrinary, bladder, reproductive or sexual-function impairment usually needs urology, rehabilitation, neurological or other specialist evidence, depending on the cause.
Neurogenic functionWhere bladder, bowel or sexual-function symptoms are said to arise from spinal cord, cauda equina, bilateral nerve root or lumbosacral plexus injury, objective neurological evidence is needed.
Not an ADL labelLoss of function should not be rated from a broad activities-of-daily-living complaint without the body-system or neurological method being identified.
Separate overlapping causesPain, medication effects, psychological symptoms and non-work urological conditions should be separated from the accepted injury where possible.
Cardiovascular WPI source checks
Cardiac or vascular testingCardiovascular assessment usually depends on objective testing such as ECG, echocardiogram, stress testing, vascular imaging or specialist examination.
Stable post-treatment resultA cardiac event, vascular injury or procedure does not set a fixed WPI. The stable residual function and treatment outcome matter.
Causation and contributionWork-related contribution, pre-existing disease, constitutional risk and non-work factors should be addressed rather than assumed.
Capacity and WPI are differentA worker may have real work restrictions even where the permanent impairment method is technical and specialist-driven.
Endocrine WPI source checks
Pathology and specialist evidenceEndocrine impairment usually requires objective pathology, medication history and endocrinology evidence rather than symptoms alone.
Stable managementThe assessment should explain whether the condition is stable at MMI and what treatment or control is still required.
Complications matterSecondary complications, medication consequences or multi-system effects may need separate specialist explanation if they are relied on.
Work link must be explainedWhere the endocrine issue is alleged to be work-related or treatment-related, causation should be stated carefully and supported by medical reasoning.
NSW skin, scar and burn assessment rules
Whole skin systemThe skin is treated as a single organ. Non-facial scarring is assessed as one overall impairment rather than adding each scar separately.
Scar can rate 0%A scar may be present and still rate 0% WPI. Uncomplicated standard surgical scars do not of themselves rate impairment.
TEMSKIThe NSW TEMSKI method divides minor skin impairment in class 1 into 0-4% WPI categories on a best-fit basis. More than 4% requires a specialist trained in skin assessment.
ADL and treatmentSkin impairment considers signs/symptoms, limitation in activities of daily living and treatment requirements, not appearance alone.
Practical WPI examples
- A respiratory impairment assessment may need lung function testing and exposure history.
- A skin or scarring assessment needs visible, stable findings and the correct chapter method, not just photographs immediately after injury.
- Cardiovascular or endocrine impairment may need specialist evidence about causation and stability.
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
- Specialist reports, objective test results, exposure records, photographs after healing where relevant and medication history
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
- Predicting WPI from a diagnosis name alone
- Assessing before the condition is stable
- Using a generic impairment statement without identifying the NSW body-system method
Assessment source
Assessment source: Assessment source: NSW Guidelines body-system chapters and AMA5 only where adopted by NSW. The assessor should identify the correct system chapter first, then explain objective testing, stability and causation.
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.
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.
- Spine Permanent Impairment Assessment NSW - Spine 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 Digestive, Urinary, Cardiovascular and Endocrine WPI Assessment
The assessment scope for Digestive, Urinary, Cardiovascular and Endocrine 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 Digestive, Urinary, Cardiovascular and Endocrine
- 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
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.