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 Brain, spinal cord, peripheral nerves and neurological function
Neurological WPI needs objective impairment of nervous system function. Symptoms matter clinically, but an assessment usually needs reliable findings about cognition, communication, motor function, sensation, reflexes, coordination, gait, bladder, bowel, sexual function, cranial nerves or peripheral nerve deficit.
What injuries can happen to this body part?
- Traumatic brain injury or concussion with stable cognitive, communication, behavioural or movement consequences
- Spinal cord, cauda equina or bilateral nerve root injury with gait, limb, bladder, bowel or sexual-function consequences
- Peripheral nerve injury affecting sensation, power, reflexes or named nerve function
- Cranial nerve injury affecting facial sensation, mastication, swallowing, smell, taste, hearing, vision or shoulder/neck function
- Neurological overlap with pain, psychological injury, musculoskeletal injury or medication effects
Symptoms and findings that matter
- The neurological structure involved: brain, spinal cord, nerve root, peripheral nerve or cranial nerve
- Objective motor, sensory, reflex, coordination, cognitive, communication, cranial nerve or gait findings
- Neuropsychology, neurology or rehabilitation evidence where relied on
- Whether EMG/NCS, imaging or specialist testing supports and matches the clinical picture
- Whether symptoms overlap with psychiatric injury, pain or another body system
- Whether the Guideline requires choosing the largest valid category rather than adding overlapping deficits
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
- Neurological WPI needs objective impairment of nervous system function. Symptoms matter clinically, but an assessment usually needs reliable findings about cognition, communication, motor function, sensation, reflexes, coordination, gait, bladder, bowel, sexual function, cranial nerves or peripheral nerve deficit.
- Assessment source: NSW Guidelines Chapter 5 nervous system, read with the affected body-region chapter. NSW directs peripheral nerve injuries back to the relevant upper limb, lower limb or spine 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
- ROM usually belongs to a musculoskeletal chapter. Neurological WPI focuses on nervous-system function unless the same injury also requires a separate musculoskeletal assessment.
- The assessor should explain why a limitation is neurological rather than pain-limited, mechanical, psychological or due to another body system.
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.
NSW spinal cord, cauda equina and neurogenic function rules
Spinal cord injury methodSpinal cord injuries are assessed using the AMA5 spine chapter spinal cord method as adopted by NSW, then combined with the corresponding DRE spinal impairment where applicable.
Bowel/bladder/sexual dysfunctionFor spinal cord, cauda equina, bilateral nerve root or lumbosacral plexus injury, bowel, bladder and sexual-function issues require objective evidence of the neurological injury.
Sexual function cautionLoss of sexual function is not assessed without other objective neurological findings. It is not simply rated as an ADL complaint.
Cord versus nerve rootSpinal cord/corticospinal injury is different from single nerve-root compression or peripheral nerve injury and should not be described as ordinary sciatica.
NSW radiculopathy criteria, in practical terms
Criteria countThe NSW Guidelines generally require two or more criteria, with at least one major criterion, before radiculopathy is concluded.
Reflex, motor or sensory findingsLoss or asymmetry of reflexes, anatomically localised weakness, or reproducible sensory impairment can be relevant when they fit the nerve root distribution.
Nerve tension, wasting and imagingPositive nerve root tension, muscle wasting/atrophy, and imaging consistent with the clinical signs can also be relevant.
Pain aloneRadicular pain or sensory symptoms that follow an anatomical pathway but cannot be verified by neurological findings do not alone constitute radiculopathy.
Practical WPI examples
- A traumatic brain injury assessment may look at cognitive function, language, memory, concentration and documented neurological deficit.
- A peripheral nerve injury assessment should identify the nerve, distribution and objective sensory or motor loss.
- A spinal cord injury assessment may need evidence about gait, motor loss, bladder, bowel or sexual dysfunction where relevant.
- MRI findings alone are not enough if symptoms and clinical signs do not match the alleged neurological level.
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
- Neurologist reports
- Neuropsychology reports
- Rehabilitation records
- EMG/nerve conduction studies where obtained
- MRI/CT reports
- Sensory maps, motor testing and reflex findings
- OT or functional assessment where cognition or ADL is affected
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 scan excludes every neurological problem
- Using imaging alone when symptoms/signs do not match
- Adding overlapping neurological and musculoskeletal ratings without checking the correct method
- Treating radiating pain alone as radiculopathy
Assessment source
Assessment source: Assessment source: NSW Guidelines Chapter 5 nervous system, read with the affected body-region chapter. NSW directs peripheral nerve injuries back to the relevant upper limb, lower limb or spine 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 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.
- Traumatic Brain 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 Neurological Impairment WPI Assessment
The assessment scope for Neurological Impairment 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 Neurological Impairment
- 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.