Quick answer
What this means in practice
The 2026 guideline framework makes work capacity evidence more important, not less. If an insurer says you can perform suitable employment, the decision should be tested against real duties, current restrictions, sustainable hours, travel, earnings and treating evidence.
- A work capacity decision should be tested against the actual decision and reasons, not a generic idea of "light duties".
- Capacity evidence should deal with sustainability, attendance, pain flare-ups, medication, travel and psychological symptoms where relevant.
- PIAWE and earning-capacity issues can overlap, but they are not the same evidence problem.
- Respond before a weak capacity assumption becomes embedded in rehabilitation reports and payment decisions.
What the insurer is usually trying to decide
A work capacity assessment often asks whether the worker has no current work capacity, current work capacity, or capacity for suitable employment. It may affect weekly payments, rehabilitation planning and how the insurer describes earning capacity.
The practical fight is usually not whether a worker can do one task once. It is whether the proposed work is safe, suitable and sustainable in the real labour market.
Evidence that may help
- Current and earlier certificates of capacity showing how restrictions changed.
- Treating GP, specialist and allied health reports addressing actual duties and sustainable hours.
- Job descriptions, rosters, travel demands, lifting requirements, pace, break needs and supervision requirements.
- Medication, fatigue, sleep, pain flare-up and psychological symptom evidence where relevant.
- Rehabilitation-provider notes and recovery at work plans that should match medical restrictions.
- Pay records and job-market material if earning capacity is being asserted.
Common insurer assumptions to test
- Assuming administrative or light work exists without checking skills, licences, location, travel and wages.
- Treating a short capacity certificate as permission for broader duties than the doctor intended.
- Ignoring psychological symptoms, medication effects or pain flare-ups.
- Using a rehabilitation report that overstates what happened at work or during a trial.
If payments are reduced or stopped after a work capacity decision, preserve the notice date and get the review pathway checked quickly.
Official sources checked
This guide is based on SIRA and NSW Government sources available at the update date above. It is general information only and is not legal advice.
Frequently asked questions
Is a work capacity assessment the same as an IME?
No. An IME report may be used as evidence, but a work capacity decision should also be tested against treating evidence, duties, wages, rehabilitation records and suitable employment assumptions.
What if I can do some tasks but not full-time work?
Capacity is often about sustainable work, not isolated tasks. Evidence should address hours, breaks, fatigue, pain, travel, attendance and safety.
Can psychological symptoms matter in a physical injury claim?
Yes, if they affect sustainable capacity and are properly recorded. The evidence should explain how symptoms affect work, not just name a diagnosis.
Need help applying this to a live claim?
If an insurer has issued a notice, scheduled an assessment, reduced payments, refused treatment, or raised the 2026 reforms in your claim, get the documents checked before the issue hardens.