Overview for NSW injured workers
Start with the dispute, not just the diagnosis
May be relevant when
Benefits to check
Legal help is useful when
How this affects your claim in practice
In an achilles tendon injury claim, the diagnosis is only the starting point. The records should connect ultrasound or MRI describing rupture, partial tear, tendinopathy, bursitis, gap size, retraction or chronic change where reported and orthopaedic, sports physician, podiatry or physiotherapy notes explaining diagnosis, mechanism, treatment options and return-to-work limits with the worker's practical limits, including standing, walking distance, stairs, ladders, slopes, uneven ground, driving, footwear and load carrying and duties that avoid sudden push-off, prolonged walking, unsafe site access, unsupported ladder use or footwear that conflicts with treatment advice. If the insurer disputes whether the Achilles problem was a sudden rupture, a partial tear, tendinopathy or an aggravation of pre-existing change, the response should address that reason directly.
Assessment source
- NSW Guidelines for the Evaluation of Permanent Impairment, paras 1.8-1.12: NSW Guidelines control the assessment method and AMA5 is used only where adopted and not modified.
- NSW Guidelines para 1.12: AMA5 Chapter 18 pain is excluded; chronic pain is assessed through the underlying diagnosed condition, while CRPS is assessed under the relevant NSW method.
- NSW Guidelines para 1.15: assessment should usually wait until maximum medical improvement, meaning the condition is stable and unlikely to change substantially in the next year.
- NSW Guidelines Chapter 3 applies AMA5 Chapter 17 only as modified by NSW. Paragraphs 3.2-3.7 require the most specific valid method, selection of the highest valid evaluation where more than one method applies, common units before combination, and a 40% WPI lower-limb maximum.
- NSW Guidelines para 1.24: activities of daily living must not be used to increase or reduce a calculated lower-extremity impairment. Functional examples explain the measurement; they are not an extra percentage.
- NSW Guidelines paras 3.8-3.15 and corrected AMA5 Tables 17-4 and 17-6: true leg length, gait, unilateral atrophy and manual muscle testing each have their own measurement and non-combination requirements.
- NSW Guidelines paras 3.16-3.18: inconsistent range-of-motion findings are invalid; values from different movement planes within one joint are added; joint ankylosis uses the corrected NSW optimum-position table and positional additions.
- NSW Guidelines paras 3.19-3.24: arthritis means radiological cartilage loss for impairment purposes. It cannot be assumed from pain, and the arthritis method cannot be combined with gait, atrophy, strength or range of motion.
- NSW Guidelines paras 3.10-3.15 and 3.32-3.35: gait is a last resort; gait, atrophy, muscle testing and peripheral-nerve methods can duplicate lower-limb function and must follow Table 17-2 non-combination rules; CRPS uses the NSW Chapter 17 method rather than AMA5 Chapter 18 pain.
- NSW Guidelines paras 3.26-3.30 and Tables 3.2-3.4: NSW modifies diagnosis-based estimates, tibial plateau fracture, patello-femoral and ankle replacement, tibia-os calcis angle and persistent plantar fasciitis. Hip and total-knee replacements use AMA5 Tables 17-33 to 17-35 subject to the NSW corrections.
What injuries or conditions may be assessed?
Achilles conditions include insertional or mid-substance tendinopathy, partial tear, complete rupture, avulsion, postoperative residual loss and re-rupture.
- A rupture or repair may leave calf atrophy, weakness, ankle movement loss or gait change. Those are separate potential methods, not an automatic percentage for surgery.
- The assessor must distinguish local Achilles pathology from plantar-fascia, ankle-joint, calf muscle and lumbar or peripheral-nerve conditions.
Symptoms and findings that matter
The stable examination may include tendon continuity and length, calf circumference, valid plantarflexion strength, ankle movement and gait. Pain-limited effort or a temporary rehabilitation limp is not a permanent measurement.
For achilles tendon injury, range of motion is normally measured three times in each relevant plane and the greatest valid result is used. If repeated readings or findings between examinations are materially inconsistent, ROM is not a valid impairment parameter.
If true leg length is relevant to achilles tendon injury, manual measurement is an exception to the greatest-reading rule: three readings are averaged. The opposite joint or limb is also compared where it provides a valid baseline.
Where achilles tendon injury is assessed through manual muscle weakness, the examiner uses the six Medical Research Council grades from 0 to 5. Those grades are ordinal rather than evenly spaced, and the NSW method uses AMA5 Table 17-8; electrodiagnostic results do not replace the manual muscle test.
An impairment report for achilles tendon injury may need a diagnosis-based estimate, radiological cartilage-loss method, replacement score, true limb-length difference, unilateral atrophy, muscle grade, named-nerve deficit or gait method instead of, or in a limited case alongside, ROM.
What investigations are usually relevant
Investigations for achilles tendon injury may include weight-bearing X-rays, CT, MRI, ultrasound or operation records identifying the actual joint, fracture, tendon, ligament, cartilage, prosthesis or nerve condition and repeat goniometer measurements, stability tests, alignment findings and comparison with the unaffected side where that comparison is valid. Each result should answer a defined clinical question and be read with the examination, diagnosis and history.
- Orthopaedic, rehabilitation and physiotherapy records showing whether the condition has reached maximum medical improvement.
- Certificates of capacity and duties evidence about walking, standing, stairs, kneeling, squatting, driving, lifting and uneven ground. These explain claim impact but do not alter the WPI calculation.
How WPI is assessed for this body part
NSW Chapter 3 has no standalone fixed value for an Achilles tear, rupture or repair. The assessor uses the most specific valid residual method, such as atrophy, manual muscle testing or ankle movement, with gait reserved as a last resort and no duplicate rating.
For achilles tendon injury, NSW Guidelines Chapter 3 applies AMA5 Chapter 17 subject to NSW corrections. The most specific valid method is used, and where more than one valid method applies the highest valid evaluation is generally selected unless Table 17-2 permits a combination.
If ROM is valid for achilles tendon injury, values in different planes of the same joint are added. Regional values in the same limb are expressed in the same unit and combined before conversion to WPI.
For achilles tendon injury, ankle dorsiflexion brings the toes towards the shin; plantarflexion points the foot down; inversion and eversion turn the sole inward and outward. Hindfoot alignment and true ankylosis use separate methods from ordinary movement loss.
Arthritis in an assessment of achilles tendon injury requires radiologically measured cartilage loss. For a knee, only the most impaired compartment is used. Arthritis cannot be combined with gait, atrophy, strength or ROM for the same loss.
For achilles tendon injury, gait remains a last-resort standalone method. Atrophy, manual muscle testing, peripheral nerve impairment and gait can duplicate strength loss and cannot be stacked. A diagnosis-based estimate is combined only where Table 17-2 permits it.
The calculation for achilles tendon injury cannot be changed because of activities of daily living under NSW paragraph 1.24. Functional descriptions help explain the evidence but are not an uplift or deduction.
Table and value examples
Thigh or calf difference 1-1.9 cm
2% WPI (6% LEI)Thigh is measured 10 cm above the patella with the knee extended and muscles relaxed; calf is compared at the same maximum level.
Source: NSW-corrected AMA5 Table 17-6
Thigh or calf difference 2-2.9 cm
4% WPI (11% LEI)Swelling, varicose veins or another condition affecting the comparison limb can invalidate this method.
Source: NSW-corrected AMA5 Table 17-6
Mild ankle motion impairment
3% WPI (7% LEI; 10% foot)Includes plantarflexion capability of 11-20 degrees, flexion contracture of 1-10 degrees, or extension from 10 degrees to neutral.
Source: NSW-corrected AMA5 Table 17-11
Moderate ankle motion impairment
6% WPI (15% LEI; 21% foot)Includes plantarflexion capability of 1-10 degrees or flexion contracture of 11-19 degrees.
Source: NSW-corrected AMA5 Table 17-11
Severe ankle motion impairment
12% WPI (30% LEI; 43% foot)Includes no plantarflexion capability or flexion contracture of 20 degrees or more.
Source: NSW-corrected AMA5 Table 17-11
Worked assessment illustrations
These examples paraphrase the assessment reasoning in the source material. They explain method only and are not predicted outcomes.
Illustration 1
Achilles tendon injury: measured unilateral calf atrophy
Assumed facts: Assume an accepted Achilles rupture has stabilised after treatment and leaves reproducible unilateral calf atrophy, with the opposite calf providing a valid comparison. Assume the accepted condition has reached maximum medical improvement. Both calves are measured at the same maximum level, and the affected calf is reproducibly 2.4 cm smaller while the comparison calf is normal.
Method: For this achilles tendon injury illustration, A 2.4 cm difference falls within the NSW-corrected 2-2.9 cm row. The assessor must first exclude swelling, varicose veins or another condition that makes the opposite calf an invalid comparator.
Illustrative outcome: This shows how the selected achilles tendon injury method is applied without an ADL adjustment. The corrected row is 4% WPI (11% LEI). The same strength loss cannot also be rated by gait, manual muscle testing or peripheral nerve impairment. This is an illustration only.
Source: NSW Guidelines paras 3.13-3.15 and corrected AMA5 Table 17-6
What usually does not increase WPI
The rupture diagnosis, repair, boot use or reduced walking tolerance does not create a fixed percentage without a valid stable lower-limb method.
Pain, tenderness, swelling or difficulty walking does not create a percentage without a valid lower-limb method.
A scan label, surgery name or recommendation for surgery is not a fixed WPI result.
Work restrictions, weekly payments and inability to resume the pre-injury job are important claim issues but are not themselves impairment measurements.
Activities of daily living cannot be used to increase or reduce the calculated lower-extremity rating.
Evidence checklist
The records for achilles tendon injury should include ultrasound or MRI identifying tendinopathy, partial tear, rupture, avulsion, gap, retraction or postoperative continuity where reported and operation, booting and rehabilitation records showing the treatment course and maximum medical improvement. They are most useful when the diagnosis, examination and practical restrictions are consistent.
- Repeat calf-circumference, manual plantarflexion strength and ankle movement measurements with a valid opposite-limb comparison.
- Gait and permanent-aid evidence only if no more specific valid Chapter 3 method applies.
- A worksheet showing why atrophy, strength, movement, nerve and gait findings have not been counted twice.
How this injury commonly happens at work
Work-related achilles tendon injury can arise through pushing off suddenly while carrying or restraining a load and slipping, tripping or landing awkwardly from a step, vehicle or platform. The chronology should identify the actual task or event and when symptoms or function changed.
Work-related achilles tendon injury can arise through repeated stairs, ladders, slopes or uneven ground and prolonged standing or walking that aggravates Achilles symptoms. The chronology should record the actual task or event and the point at which symptoms or function changed.
Common insurer disputes
For achilles tendon injury, an insurer may dispute whether the Achilles problem was a sudden rupture, a partial tear, tendinopathy or an aggravation of pre-existing change and whether the condition is legally characterised as a personal injury for which employment was a substantial contributing factor, or as a disease aggravation for which employment was the main contributing factor. The written decision should be answered with evidence directed to those reasons.
Further disputes about achilles tendon injury may concern whether delayed imaging, delayed reporting or a prior sore tendon is being treated as a complete answer without considering the accepted work mechanism and medical causation evidence, whether booting, imaging, injections, surgery or rehabilitation are reasonably necessary at the current stage, and whether suitable duties ignore walking, standing, stairs, ladders, slopes, driving, footwear or site-access restrictions. The decision notice should identify which issue is relied on and the evidence said to support it.
Treatment and surgery issues
Depending on the diagnosis and treating opinion, management of achilles tendon injury may involve immobilisation in a boot, heel lift, physiotherapy and graded loading where clinically supported and orthopaedic review, injections or surgery where the treating evidence supports escalation and explains the expected functional benefit. The request should explain the expected functional benefit and its connection to the accepted injury.
Further management of achilles tendon injury may involve rehabilitation planning that explains calf strength, gait, stairs, footwear, return to driving and safe access to site or vehicle-based work and clear review points if pain, swelling, limp, re-rupture concern or failed graduated duties change the treatment plan. The request should explain why the proposed step is connected to the accepted injury and what functional improvement is expected.
Weekly payments and work capacity
Capacity evidence for achilles tendon injury should address standing, walking distance, stairs, ladders, slopes, uneven ground, driving, footwear and load carrying and duties that avoid sudden push-off, prolonged walking, unsafe site access, unsupported ladder use or footwear that conflicts with treatment advice. Proposed duties must be sustainable for the proposed hours, not merely possible once.
For achilles tendon injury, capacity evidence should address weekly payment decisions where partial capacity is assumed before boot removal, gait recovery, calf-strength testing or safe-driving clearance is reached and return-to-work offers that should be checked against the actual workplace route, parking, stairs, emergency duties and shift length, not just the job title. The question is whether those activities can be performed safely, reliably and for the proposed hours—not whether a task can be attempted once.
How NSW Work Injury Claim can help
For achilles tendon injury, a claim review can help to identify whether the dispute is about causation, treatment approval, suitable duties, weekly payments or permanent impairment and build a short chronology linking the incident or loading pattern to symptoms, imaging, treatment and capacity certificates. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.
For achilles tendon injury, a claim review can help to compare proposed duties with walking, standing, stairs, ladder, driving, footwear and rehabilitation restrictions and check whether an IME or insurer notice has overlooked delayed imaging, failed duties, staged rehabilitation or the treating specialist opinion. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.
Common questions about achilles tendon injury claims
How can work cause or aggravate achilles tendon injury?
For achilles tendon injury, the relevant work history may include pushing off suddenly while carrying or restraining a load, slipping, tripping or landing awkwardly from a step, vehicle or platform, and repeated stairs, ladders, slopes or uneven ground. A claim still depends on the actual chronology and medical evidence. The records should identify what changed, when symptoms began or worsened, and how the diagnosed condition affects the worker's duties.
How is WPI assessed for achilles tendon injury?
For achilles tendon injury, NSW Chapter 3 has no standalone fixed value for an Achilles tear, rupture or repair. The assessor uses the most specific valid residual method, such as atrophy, manual muscle testing or ankle movement, with gait reserved as a last resort and no duplicate rating. The stable examination may include tendon continuity and length, calf circumference, valid plantarflexion strength, ankle movement and gait. Pain-limited effort or a temporary rehabilitation limp is not a permanent measurement. The assessor must apply the NSW Guidelines to the accepted, stable condition; the diagnosis or an operation does not by itself determine a percentage.
Which records are most useful for an achilles tendon injury assessment?
An achilles tendon injury assessment commonly needs ultrasound or MRI identifying tendinopathy, partial tear, rupture, avulsion, gap, retraction or postoperative continuity where reported, operation, booting and rehabilitation records showing the treatment course and maximum medical improvement, repeat calf-circumference, manual plantarflexion strength and ankle movement measurements with a valid opposite-limb comparison, and gait and permanent-aid evidence only if no more specific valid Chapter 3 method applies. Those records are most useful when they describe the same diagnosis, examination findings, treatment history and practical work restrictions.
What does an insurer commonly dispute about achilles tendon injury?
For achilles tendon injury, common issues include whether the Achilles problem was a sudden rupture, a partial tear, tendinopathy or an aggravation of pre-existing change, whether the condition is legally characterised as a personal injury for which employment was a substantial contributing factor, or as a disease aggravation for which employment was the main contributing factor, and whether delayed imaging, delayed reporting or a prior sore tendon is being treated as a complete answer without considering the accepted work mechanism and medical causation evidence. The response should address the insurer's stated reason with the relevant chronology, clinical findings, investigations and duties evidence rather than relying on the diagnosis alone.
How can achilles tendon injury affect weekly payments and suitable duties?
Capacity evidence for achilles tendon injury may need to address standing, walking distance, stairs, ladders, slopes, uneven ground, driving, footwear and load carrying, duties that avoid sudden push-off, prolonged walking, unsafe site access, unsupported ladder use or footwear that conflicts with treatment advice, and weekly payment decisions where partial capacity is assumed before boot removal, gait recovery, calf-strength testing or safe-driving clearance is reached. A certificate should describe what the worker can do safely and sustainably. Proposed duties should then be checked against those restrictions and the real demands of the job.
Does achilles tendon injury automatically receive a fixed WPI percentage?
No. For achilles tendon injury, one verified example is thigh or calf difference 1-1.9 cm: 2% WPI (6% LEI), under NSW-corrected AMA5 Table 17-6. That value applies only when its stated criteria are met. The rupture diagnosis, repair, boot use or reduced walking tolerance does not create a fixed percentage without a valid stable lower-limb method.
Request a calm claim position review
If you have received an insurer decision or you are unsure how your injury evidence fits together, we can help you identify the issue, organise the documents and consider the next step. Where ILARS funding is approved, eligible legal costs and necessary disbursements may be covered.
Related NSW workers compensation guides
- Lower-limb WPI assessment
- Lump sum WPI claims
- Treatment denied
- Surgery denied
- Hip injury claims
- Hip fracture assessment
- Hip replacement assessment
- Knee injury claims
- Meniscus tear assessment
- Tibial plateau fractures
- Ankle injury claims
- Foot injury assessment
- Lower-limb nerve injury
- Weekly payments
- Work capacity decisions
- IME guide