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 Shoulder joint, rotator cuff, AC joint, clavicle, labrum and overhead function
Shoulder WPI depends on the actual shoulder problem and the stable functional loss. A useful shoulder page should separate rotator cuff tear, adhesive capsulitis, impingement, dislocation or instability, AC joint injury, clavicle injury, labral injury, biceps tendon rupture, arthroplasty and reduced ROM.
What injuries can happen to this body part?
- Rotator cuff tear, tendinopathy or failed cuff repair affecting lifting and overhead function
- Frozen shoulder or adhesive capsulitis causing capsular restriction in several directions
- Shoulder impingement, bursitis-type symptoms or painful arc symptoms where provocative tests are positive
- Instability, recurrent dislocation, labral injury or Bankart/SLAP-type pathology
- AC joint injury, distal clavicle resection, clavicle fracture, sternoclavicular injury or shoulder arthroplasty
- Long head of biceps rupture or biceps tendon pathology, including cases mixed with rotator cuff disease
Symptoms and findings that matter
- Reliable active shoulder ROM: flexion, extension, abduction, adduction, external rotation and internal rotation
- Whether the shoulder problem is cuff, capsular, impingement, instability, AC/clavicle, labral, biceps, nerve or neck-related
- Whether impingement criteria are met: positive provocative tests, no ROM loss, symptoms for at least 12 months
- Whether biceps rupture is isolated from rotator cuff pathology and ROM loss
- Whether arthroplasty, clavicle resection or sternoclavicular joint modification applies
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
- Shoulder WPI depends on the actual shoulder problem and the stable functional loss. A useful shoulder page should separate rotator cuff tear, adhesive capsulitis, impingement, dislocation or instability, AC joint injury, clavicle injury, labral injury, biceps tendon rupture, arthroplasty and reduced ROM.
- Assessment source: NSW Guidelines Chapter 2 paragraphs 2.14 to 2.20 and AMA5 Chapter 16 upper extremity methods where adopted by NSW.
- 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
- Flexion means lifting the arm forward and overhead, such as reaching to a shelf.
- Abduction means lifting the arm sideways away from the body.
- External rotation affects reaching behind the head, washing hair and many overhead positions.
- Internal rotation affects reaching behind the back, dressing and personal care.
- Extension affects reaching backwards. These movements need reliable active measurement before they become a WPI calculation.
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.
Shoulder ROM in everyday language
FlexionLifting the arm forward and overhead, such as reaching to a shelf.
AbductionLifting the arm sideways away from the body.
External rotationReaching behind the head, washing hair or positioning the arm for overhead tasks.
Internal rotationReaching behind the back, dressing, tucking in clothing or personal care.
ExtensionReaching backwards, for example behind the body or into a rear pocket.
Verified NSW upper limb rows and modifications
Shoulder impingement3% UEI or 2% WPI, only where there are positive provocative tests, no loss of ROM, and symptoms have been present for at least 12 months.
Ruptured long head of biceps3% UEI or 2% WPI where isolated from other rotator cuff pathology. It cannot be combined with rotator cuff impairment or ROM.
Epicondylitis2% UEI or 1% WPI where symptoms have been present for at least 18 months, localised epicondyle tenderness is present, and provocative tests are positive. If ROM loss is also present, use the higher method, not both.
Joint surface fracture fallbackIf a displaced joint-surface fracture has pain with movement and 2 mm or more displacement, but ROM loss is not sufficient to rate, allow 2% UEI or 1% WPI.
Distal clavicle resection arthroplasty, isolatedThe NSW modification changes the AMA5 Table 16-27 figure to 5% UEI.
Proximal clavicle resection arthroplasty, isolatedThe NSW modification changes the AMA5 Table 16-27 figure to 8% UEI.
Sternoclavicular jointThe NSW modification changes the figure to 25% UEI or 15% WPI.
Practical WPI examples
- A rotator cuff tear with stable restricted active ROM is usually analysed differently from an isolated long-head biceps rupture.
- Shoulder impingement is 3% UEI or 2% WPI only where the NSW criteria fit. It is not a value for every painful shoulder.
- Distal clavicle resection arthroplasty has a NSW-modified value of 5% UEI when isolated, but motion impairment may also need analysis where motion is decreased.
- A shoulder arthroplasty or instability operation does not remove the need to check ROM, surgical result, pain, stability and double-counting rules.
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
- Shoulder ultrasound/MRI, X-rays, operative notes, orthopaedic review, physiotherapy ROM sheets, injection response records and work-duty evidence about reaching, lifting and overhead tasks
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 every painful shoulder a rotator cuff WPI case
- Using impingement value when ROM loss is present
- Combining isolated biceps rupture with rotator cuff or ROM impairment when the NSW rule forbids it
- Treating cervical radiculopathy as shoulder impairment without separating the source
Assessment source
Assessment source: Assessment source: NSW Guidelines Chapter 2 paragraphs 2.14 to 2.20 and AMA5 Chapter 16 upper extremity methods where adopted by NSW.
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.
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 Shoulder WPI Assessment
The assessment scope for Shoulder 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 Shoulder
- 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.