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 Thoracic spine, rib-level symptoms and trunk function
Thoracic spine WPI is assessed under the spine method, but the practical evidence is different from ordinary low-back or neck complaints. The assessor usually needs the fracture, disc, postural or neurological issue clearly identified and stable at MMI.
What injuries can happen to this body part?
- Thoracic compression fracture, burst fracture, fracture-dislocation or post-traumatic kyphosis
- Thoracic disc protrusion or stenosis with rib-level symptoms or neurological findings where supported
- Post-surgical thoracic fixation, decompression or fusion with stable residual findings
- Thoracic pain with trunk movement restriction, chest wall symptoms or postural limitation that must be tied to objective findings
- Spinal cord, bowel, bladder, gait or respiratory consequences requiring separate nervous-system review where clinically connected
Symptoms and findings that matter
- Thoracic level, fracture or disc diagnosis and whether the condition is stable
- Chest wall, rib-level, trunk rotation or postural limits where function is relevant
- Objective neurological signs if thoracic radiculopathy or spinal cord involvement is alleged
- Deformity, collapse, kyphosis, fixation or fusion if a fracture or surgery occurred
- Whether bowel, bladder, gait or cord signs require nervous-system analysis instead of an ordinary DRE-only approach
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
- Thoracic spine WPI is assessed under the spine method, but the practical evidence is different from ordinary low-back or neck complaints. The assessor usually needs the fracture, disc, postural or neurological issue clearly identified and stable at MMI.
- Assessment source: NSW Guidelines Chapter 4, AMA5 thoracic spine DRE Table 15-4 where adopted, and NSW Table 4.2 where thoracic surgery modifiers apply.
- 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
- Thoracic movement can affect twisting, reaching across the body, deep breathing tolerance, lifting posture and prolonged sitting.
- Thoracic movement evidence can describe function, but the NSW spine chapter excludes the ROM model for WPI assessment.
NSW spine assessment rules
DRE methodThe NSW spine chapter says spinal impairment is evaluated using diagnosis-related estimates (DREs).
DRE vs ROMAMA5 contains a ROM model in some contexts, but the NSW spine chapter says the ROM model should not be used for NSW spine WPI. Movement observations may still help describe DRE clinical findings, such as asymmetric movement.
ImagingImaging can support the diagnosis, but imaging alone is insufficient for a DRE category except for spinal fractures.
RadiculopathyRequires objective neurological findings. Radiating pain, pins and needles or a scan report alone are not the same as radiculopathy.
Electrodiagnostic testingEMG/NCS may help clinicians investigate symptoms, but SIRA says electrodiagnostic verification of radiculopathy should be disregarded when placing the worker into a DRE category.
Surgery modifiersSIRA Table 4.2 gives public NSW modifiers for relevant spinal surgery scenarios; the operation itself must fit the Guideline wording.
Spine DRE category concepts, without guessing percentages
DRE IUsually no significant clinical findings. Do not use this guide to infer a percentage without the relevant AMA5 table.
DRE IIUsually minor objective findings, resolved radiculopathy, non-verifiable radicular complaints, or structural findings that fit the table.
DRE IIIOften relevant where radiculopathy is present or where the table criteria otherwise place the worker in category III.
DRE IVOften relevant where alteration of motion segment integrity, fusion-type criteria or higher-grade fracture criteria apply, depending on the region and NSW method.
DRE VCan involve radiculopathy plus alteration of motion segment integrity, but NSW modifies post-fusion radiculopathy treatment through Table 4.2.
SIRA Table 4.2 public spine surgery modifier rows
Spinal surgery with residual symptoms and radiculopathyCervical 3% WPI, thoracic 2% WPI, lumbar 3% WPI, subject to the Guideline criteria.
Second and further levelsAdd 1% WPI for each additional level in cervical, thoracic or lumbar regions, where the Guideline permits it.
Second operation2% WPI in cervical, thoracic or lumbar regions, where the Guideline permits it.
Third and subsequent operations1% WPI each in cervical, thoracic or lumbar regions, where the Guideline permits it.
Practical WPI examples
- A stable compression fracture with no neurological findings is assessed differently from a burst fracture with deformity or cord involvement.
- Thoracic pain after a fall may affect work capacity even if the permanent impairment rating is technical and source-dependent.
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
- Thoracic X-ray/CT/MRI, fracture clinic notes, operative records, rehabilitation reports and neurological findings if present
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
- Applying lumbar assumptions to a thoracic injury
- Ignoring cord or bowel/bladder evidence where it is clinically connected
Assessment source
Assessment source: Assessment source: NSW Guidelines Chapter 4, AMA5 thoracic spine DRE Table 15-4 where adopted, and NSW Table 4.2 where thoracic surgery modifiers apply.
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 spine chapter: Source for NSW spine assessment rules, DRE method, radiculopathy criteria and surgery modifiers. The NSW spine chapter excludes the ROM model.
- SIRA DRE definitions of clinical findings: Source for clinical findings used to place a spine condition into a DRE category.
- SIRA Table 4.2 spine surgery modifiers: Public NSW surgery modifier rows for DRE categories following spine surgery.
- SIRA Table 4.2 interpretation note: Source for how surgical modifiers following spine surgery should be read and applied.
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.
- Lumbar Spine WPI 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 Thoracic Spine WPI Assessment
The assessment scope for Thoracic Spine 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 Thoracic Spine
- 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.