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 Median, ulnar, radial, axillary and digital nerve injury
Upper limb nerve WPI needs the named nerve, the distribution of symptoms and objective sensory or motor impairment. Numbness, tingling and weakness matter clinically, but the rating must follow the peripheral nerve or digital nerve method without double counting ROM or grip loss.
What injuries can happen to this body part?
- Median nerve injury or compression, including carpal tunnel where applicable
- Ulnar nerve injury at the elbow or wrist, including ring and little finger symptoms
- Radial nerve injury affecting wrist/finger extension or dorsal hand sensation
- Axillary nerve injury after shoulder dislocation or surgery
- Digital nerve laceration or neuroma after hand or finger trauma
Symptoms and findings that matter
- The named nerve and whether the problem is sensory, motor or mixed
- Clinical distribution matching anatomy and objective examination findings
- EMG/NCS where relevant, plus clinical sensory and motor testing
- Manual muscle testing for motor deficit and sensory grade for sensory loss
- Overlap with cervical radiculopathy, CRPS, hand/finger digital nerve method or musculoskeletal ROM
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 nerve WPI needs the named nerve, the distribution of symptoms and objective sensory or motor impairment. Numbness, tingling and weakness matter clinically, but the rating must follow the peripheral nerve or digital nerve method without double counting ROM or grip loss.
- Assessment source: NSW Guidelines Chapter 2 paragraphs 2.9 to 2.10 and AMA5 Chapter 16 nerve tables 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
- A pure upper limb nerve injury is not usually rated again through abnormal motion for that same upper extremity.
- Nerve injury may affect hand function, grip reliability and tool use, but WPI needs the adopted nerve method and objective deficit.
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.
Upper limb nerve and carpal tunnel rules
Sole peripheral nerve injuryIf the upper extremity impairment results solely from a peripheral nerve injury, do not also rate abnormal motion for that same upper extremity.
Peripheral nerve tablesUse AMA5 Table 16-15 together with Tables 16-10 and 16-11 for peripheral nerve lesions, as adopted by NSW.
Clinical judgementThe examiner must choose an appropriate percentage within the severity range. The maximum value is not applied automatically.
Carpal tunnel after surgeryPost-operative carpal tunnel syndrome is assessed in the same way as carpal tunnel without operation.
Grip strength and ROM in CTSWhere carpal tunnel is assessed as a nerve condition, grip loss and loss of ROM are usually not separately rated for CTS itself.
Digital nerve and finger sensory method
Digital nervesEach finger has radial-side and ulnar-side digital nerves. The affected side, finger, and length of sensory loss matter.
Two-point discriminationDigital nerve sensory loss is determined by static two-point discrimination: 6 mm or less is no sensory impairment; 7 mm to less than 15 mm is partial sensory loss; inability below 15 mm is total sensory loss.
Conversion pathDigital impairment is converted to hand impairment, then upper extremity impairment, then WPI using AMA5 Tables 16-1 to 16-3 as adopted.
Example onlyA full-length partial ulnar digital nerve loss in a ring finger is given in the AMA companion example as 10% ring finger impairment, converting to 1% hand, 1% UEI and 1% WPI.
Neuroma example onlyA painful digital neuroma example with 50% sensory deficit of the index radial digital nerve converts to 15% index finger impairment, 3% hand, 3% UEI and 2% WPI.
Practical WPI examples
- Ulnar nerve symptoms in the ring and little fingers should be separated from cervical radiculopathy and from a digital nerve laceration.
- An axillary nerve deficit after dislocation should not be hidden inside a generic shoulder pain page.
- For peripheral nerve lesions, AMA5 Table 16-15 is used with Tables 16-10 and 16-11 as adopted by NSW.
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
- EMG/NCS, neurologist or hand surgeon notes, sensory maps, motor testing, muscle wasting notes, operative records and work-task evidence
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 non-specific tingling a ratable nerve injury
- Counting sensory deficit under both nerve and hand ROM methods
- Confusing digital nerves with the major median, ulnar or radial nerves
Assessment source
Assessment source: Assessment source: NSW Guidelines Chapter 2 paragraphs 2.9 to 2.10 and AMA5 Chapter 16 nerve tables 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 Upper Limb Nerve Injury WPI Assessment
The assessment scope for Upper Limb Nerve Injury 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 Nerve Injury
- 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.