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 a clavicle injury claim, the diagnosis is only the starting point. The records should connect initial and healed-position X-rays or CT and records of malunion, non-union, fixation or resection with the worker's practical limits, including lifting, carrying, shoulder straps, overhead reach and pressure over hardware. If the insurer disputes whether the fracture has healed with a rateable residual condition, 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 para 1.24: the effect on activities of daily living must not be used to increase or reduce an upper-extremity impairment calculated under the applicable upper-limb method.
- NSW Guidelines paras 1.26 and 2.8: values are rounded at each conversion stage; digit impairment converts to hand impairment, hand and other regional values convert to upper-extremity impairment, and AMA5 Table 16-3 converts upper-extremity impairment to WPI.
- NSW Guidelines paras 2.5 and 2.20: active movement is measured with a goniometer or inclinometer, passive movement is recorded for clinical comparison only, unreliable readings should be repeated, and the uninjured opposite limb may provide the worker's normal baseline.
- NSW Guidelines paras 2.8-2.13: values within one joint are added, same-limb regional values must be expressed in a common unit before combination, a deficit caused solely by a peripheral nerve lesion is not also rated as abnormal movement, and strength is used only in rare permitted cases.
- NSW Guidelines paras 2.14-2.21: NSW modifies the shoulder, biceps, impingement, joint-surface fracture, epicondylitis and CRPS methods in AMA5 Chapter 16.
- NSW Guidelines para 2.4: maximum upper extremity impairment is 60% WPI, equivalent to amputation through the shoulder.
What injuries or conditions may be assessed?
Clavicle injury can involve shaft fracture, distal or proximal fracture, AC or sternoclavicular disruption, malunion, non-union or resection arthroplasty.
- An uncomplicated healed fracture is not rated as though the clavicle had been resected. Residual joint, movement, nerve or vascular impairment needs its own supported method.
- Shoulder symptoms should also be separated from cervical radiculopathy and a named peripheral nerve lesion.
Symptoms and findings that matter
For clavicle injury, flexion means lifting the arm forward and overhead; extension means reaching backwards; abduction means lifting sideways; and adduction means bringing the arm towards the body.
When clavicle injury affects rotation, external rotation can limit reaching behind the head or washing hair, while internal rotation can limit reaching behind the back or dressing. These examples explain function, not an extra percentage.
The NSW examination for clavicle injury measures internal and external rotation with the arm abducted to 90 degrees and the elbow flexed to 90 degrees, or at the worker's maximum symmetrical abduction if 90 degrees is not possible.
Only repeatable active shoulder movement is converted for clavicle injury. Passive movement, imaging, pain and daily activities provide clinical context but cannot replace the prescribed calculation.
What investigations are usually relevant
Investigations for clavicle injury may include repeat active flexion, extension, abduction, adduction, internal rotation and external rotation measurements and ultrasound or MRI identifying cuff, labral, biceps or joint pathology and whether it matches the examination. Each result should answer a defined clinical question and be read with the examination, diagnosis and history.
- Operation reports for repair, stabilisation, tenodesis, clavicle resection or arthroplasty and follow-up imaging where relevant.
- Physiotherapy records showing whether movement has stabilised and whether the measurements are consistent over time.
How WPI is assessed for this body part
For clavicle injury, the assessor first identifies whether repeatable active shoulder movement or a specific diagnosis-based NSW rule best describes the accepted impairment. Surgery or an MRI label does not select a percentage by itself.
Flexion, extension, abduction, adduction, internal rotation and external rotation values for clavicle injury are added within the shoulder before the upper-extremity result is converted through AMA5 Table 16-3.
If clavicle injury includes a named nerve lesion, movement caused solely by that lesion is not rated again. Sensory and motor nerve findings instead follow the applicable named-nerve method.
Strength is only a rare alternative in a pain-free clavicle injury assessment where reduced movement does not adequately reflect the deficit; it is not added to duplicate pain or movement loss.
Reaching, dressing and washing-hair examples help describe clavicle injury, but NSW paragraph 1.24 prevents an activities-of-daily-living adjustment to the calculated upper-extremity result.
Table and value examples
Isolated distal clavicle resection arthroplasty
5% upper extremity impairmentThis is an upper extremity value and must be converted and combined correctly; it is not a general AC joint injury rating.
Source: NSW Guidelines para 2.14 modification to AMA5 Table 16-27
Isolated proximal clavicle resection arthroplasty
8% upper extremity impairmentThis applies to an isolated proximal clavicle resection and is not a rating for an uncomplicated clavicle fracture or tenderness alone.
Source: NSW Guidelines para 2.14 modification to AMA5 Table 16-27
Maximum sternoclavicular joint impairment
25% upper extremity impairment or 15% WPIThis is the maximum for a qualifying sternoclavicular joint disorder, not a default rating for clavicle pain or an uncomplicated fracture.
Source: NSW Guidelines para 2.14 modification to AMA5 Table 16-26
Maximum upper extremity impairment
60% WPIThis is the upper extremity maximum, not the expected rating for ordinary shoulder, elbow, wrist or hand claims.
Source: NSW Guidelines para 2.4
Worked assessment illustrations
These examples paraphrase the assessment reasoning in the source material. They explain method only and are not predicted outcomes.
Illustration 1
Clavicle injury: reduced shoulder movement in several planes
Assumed facts: Assume a healed clavicle injury leaves measurable shoulder restriction after fracture alignment, joint involvement and any nerve symptoms have been reviewed. At maximum medical improvement, repeat active measurements record 156 degrees flexion, 20 degrees extension, 140 degrees abduction, 40 degrees adduction, 50 degrees external rotation and 40 degrees internal rotation.
Method: For this clavicle injury illustration, Using the corresponding AMA5 shoulder-motion figures, the assumed losses contribute 1%, 2%, 2%, 0%, 1% and 3% upper-extremity impairment. Values for the same shoulder joint are added: 1 + 2 + 2 + 0 + 1 + 3 = 9% upper-extremity impairment.
Illustrative outcome: This shows how the relevant clavicle injury findings move through the upper-limb conversion process. AMA5 Table 16-3 converts 9% upper-extremity impairment to 5% WPI. NSW paragraph 1.24 does not permit an extra uplift or reduction for activities of daily living. This paraphrased illustration is not an estimate for any individual claim.
Source: NSW Guidelines paras 1.24, 1.26, 2.5, 2.8 and 2.14; AMA5 Figures 16-40 to 16-46 and Table 16-3
What usually does not increase WPI
Pain, tenderness, weakness complaints or an imaging label without a stable measurable impairment.
Passive movement loss used as though it were active movement impairment.
Grip or other strength loss used to duplicate pain, restricted movement, deformity or nerve loss.
An activities-of-daily-living adjustment added to or subtracted from the calculated upper-extremity value.
The same functional loss counted once under a nerve method and again as restricted movement.
Evidence checklist
The records for clavicle injury should include the accepted injury description and any dispute notice identifying the body part and diagnosis and repeat active range-of-motion measurements and opposite-side comparison where appropriate. They are most useful when the diagnosis, examination and practical restrictions are consistent.
- Imaging, operative reports and treatment records for the actual tendon, joint, fracture or arthroplasty condition.
- Sensory mapping, motor testing, static two-point discrimination or electrodiagnostic evidence where a nerve lesion is alleged.
- Work-duties and therapy records explaining the practical movement or nerve function affected.
How this injury commonly happens at work
Work-related clavicle injury can arise through a fall onto the shoulder and vehicle or machinery impact. The chronology should identify the actual task or event and when symptoms or function changed.
Work-related clavicle injury can arise through a heavy object striking the shoulder girdle. The chronology should record the actual task or event and the point at which symptoms or function changed.
Common insurer disputes
For clavicle injury, an insurer may dispute whether the fracture has healed with a rateable residual condition and whether pain arises from the fracture, AC joint or sternoclavicular joint. The written decision should be answered with evidence directed to those reasons.
Further disputes about clavicle injury may concern whether resection or joint instability is actually documented and whether movement loss is reproducible. 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 clavicle injury may involve fracture care, fixation, hardware review or resection where clinically supported. The request should explain the expected functional benefit and its connection to the accepted injury.
Weekly payments and work capacity
Capacity evidence for clavicle injury should address lifting, carrying, shoulder straps, overhead reach and pressure over hardware. Proposed duties must be sustainable for the proposed hours, not merely possible once.
How NSW Work Injury Claim can help
For clavicle injury, a claim review can help to separate diagnosis, work exposure and capacity evidence and test suitable duties against actual hand, wrist, elbow or shoulder demands. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.
For clavicle injury, a claim review can help to review treatment denial reasons and IME assumptions and plan WPI or dispute steps where appropriate. 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 clavicle injury claims
How can work cause or aggravate clavicle injury?
For clavicle injury, the relevant work history may include a fall onto the shoulder, vehicle or machinery impact, and a heavy object striking the shoulder girdle. 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 clavicle injury?
For clavicle injury, the assessor first identifies whether repeatable active shoulder movement or a specific diagnosis-based NSW rule best describes the accepted impairment. Surgery or an MRI label does not select a percentage by itself. For clavicle injury, flexion means lifting the arm forward and overhead; extension means reaching backwards; abduction means lifting sideways; and adduction means bringing the arm towards the body. 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 a clavicle injury assessment?
A clavicle injury assessment commonly needs the accepted injury description and any dispute notice identifying the body part and diagnosis, repeat active range-of-motion measurements and opposite-side comparison where appropriate, imaging, operative reports and treatment records for the actual tendon, joint, fracture or arthroplasty condition, and sensory mapping, motor testing, static two-point discrimination or electrodiagnostic evidence where a nerve lesion is alleged. 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 clavicle injury?
For clavicle injury, common issues include whether the fracture has healed with a rateable residual condition, whether pain arises from the fracture, AC joint or sternoclavicular joint, and whether resection or joint instability is actually documented. 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 clavicle injury affect weekly payments and suitable duties?
Capacity evidence for clavicle injury may need to address lifting, carrying, shoulder straps, overhead reach and pressure over hardware. 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 clavicle injury automatically receive a fixed WPI percentage?
No. For clavicle injury, one verified example is isolated distal clavicle resection arthroplasty: 5% upper extremity impairment, under NSW Guidelines para 2.14 modification to AMA5 Table 16-27. That value applies only when its stated criteria are met. Pain, tenderness, weakness complaints or an imaging label without a stable measurable impairment.
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.