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 coccyx injury claim, the diagnosis is only the starting point. The records should connect x-ray, CT or MRI establishing whether a fracture healed in a truly displaced position and early and later clinical records describing local tenderness, sitting tolerance and treatment response with the worker's practical limits, including continuous sitting, driving and exposure to vehicle or machinery vibration and whether the worker can change posture and take clinically supported breaks. If the insurer disputes whether imaging proves a healed truly displaced fracture rather than an undisplaced or uncertain injury, 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 4.42 and Table 4.3: coccyx fracture and excision values are listed in the pelvic-fracture table, which replaces AMA5 Table 15-19.
What injuries or conditions may be assessed?
Coccyx injury claims may involve a bruised coccyx, fracture, displaced healed fracture, persistent coccydynia or, rarely, excision of the coccyx.
- The WPI question is not simply whether the coccyx is sore. The assessor needs to know whether there is a healed, truly displaced fracture or whether the coccyx has been excised.
- Conservative treatment, injections and ongoing tenderness should be documented, but they are not the same as a displaced healed fracture or excision rating.
Symptoms and findings that matter
Imaging should show whether there was a fracture and whether it healed in a truly displaced position.
Clinical notes should describe sitting tolerance, local tenderness and treatment response, while separating symptoms from lumbar or sacroiliac causes.
If excision has occurred, operation notes should confirm the procedure and the reason for it.
What investigations are usually relevant
Investigations for coccyx injury may include coccyx X-ray, CT or MRI evidence showing fracture position and healing and specialist notes explaining coccydynia, injections, sitting limitation and whether surgery was considered or performed. Each result should answer a defined clinical question and be read with the examination, diagnosis and history.
- Operation report if excision of the coccyx occurred.
How WPI is assessed for this body part
Coccyx WPI is narrow. A healed, truly displaced coccyx fracture and excision of the coccyx are treated differently.
A sore coccyx without a truly displaced healed fracture may not attract a coccyx percentage rating.
Excision is different from conservative treatment; do not treat injections or physiotherapy as equivalent to surgical excision.
Table and value examples
Fractures of the coccyx: (i) healed and truly displaced fracture
1% WPIThe fracture must be both healed and truly displaced. Tenderness, pain when sitting, or an undisplaced healed injury does not automatically satisfy this row.
Source: NSW Guidelines Table 4.3
Fractures of the coccyx: (ii) excision of the coccyx
5% WPIThis applies to surgical excision of the coccyx, not conservative treatment, injections or cushions.
Source: NSW Guidelines Table 4.3
Worked assessment illustrations
These examples paraphrase the assessment reasoning in the source material. They explain method only and are not predicted outcomes.
Illustration 1
Painful coccyx without a truly displaced healed fracture
Assumed facts: A worker has persistent tenderness and pain when sitting after a fall. Imaging shows a healed coccyx injury but does not establish a truly displaced fracture, and the coccyx has not been excised.
Method: NSW Table 4.3 provides 1% WPI only for a healed, truly displaced coccyx fracture and 5% WPI for excision. Symptoms and treatment history do not replace either table requirement.
Illustrative outcome: On the assumed facts, the specific coccyx rows are not automatically satisfied. Other accepted pelvic, sacroiliac or spinal conditions must be assessed under their own method. This illustration is not an estimate for any individual claim.
Source: NSW Guidelines Table 4.3
What usually does not increase WPI
A sore coccyx without a truly displaced healed fracture may not attract a coccyx rating.
A history of injections, cushions or physiotherapy is not the same as excision of the coccyx.
Lumbar, sacroiliac or pelvic symptoms should not be double-counted as coccyx impairment unless separately accepted and assessed.
Evidence checklist
The records for coccyx injury should include the accepted coccyx injury description and insurer decision and coccyx X-ray, CT or other appropriate imaging showing whether a fracture healed in a truly displaced position. They are most useful when the diagnosis, examination and practical restrictions are consistent.
- Clinical and specialist records describing local tenderness, sitting tolerance, treatment and alternative lumbar, pelvic or sacroiliac explanations.
- The operation report if excision of the coccyx was performed; injections, cushions and physiotherapy do not establish excision.
- A permanent impairment report identifying the precise NSW pelvic-table row rather than deriving a percentage from pain alone.
How this injury commonly happens at work
Work-related coccyx injury can arise through a fall directly onto the buttocks or a hard edge and a crush or vehicle incident causing a documented coccyx fracture. The chronology should identify the actual task or event and when symptoms or function changed.
Work-related coccyx injury can arise through prolonged seated work that aggravates symptoms after an accepted traumatic coccyx injury and a work injury followed by persistent coccydynia and, rarely, surgical excision. The chronology should record the actual task or event and the point at which symptoms or function changed.
Common insurer disputes
For coccyx injury, an insurer may dispute whether imaging proves a healed truly displaced fracture rather than an undisplaced or uncertain injury and whether symptoms arise from the coccyx or another spinal or pelvic condition. The written decision should be answered with evidence directed to those reasons.
Further disputes about coccyx injury may concern whether ongoing pain and treatment history have been mistaken for a table criterion and whether an alleged excision is supported by an operation report. 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 coccyx injury may involve activity modification, cushions, physiotherapy, medication or injection where clinically supported and specialist review of persistent coccydynia and alternative sources of pain. The request should explain the expected functional benefit and its connection to the accepted injury.
Further management of coccyx injury may involve coccygectomy only where the treating evidence supports surgery; conservative care is not equivalent to excision. 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 coccyx injury should address continuous sitting, driving and exposure to vehicle or machinery vibration and whether the worker can change posture and take clinically supported breaks. Proposed duties must be sustainable for the proposed hours, not merely possible once.
For coccyx injury, capacity evidence should address whether duties account for associated lumbar, pelvic or sacroiliac restrictions. 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 coccyx injury, a claim review can help to verify the exact imaging description and whether the fracture is truly displaced after healing and check whether the insurer or assessor has confused symptoms with the table criterion. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.
For coccyx injury, a claim review can help to separate coccyx impairment from lumbar, sacroiliac or pelvic conditions and compare sitting and driving duties with the documented functional limits. 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 coccyx injury claims
How can work cause or aggravate coccyx injury?
For coccyx injury, the relevant work history may include a fall directly onto the buttocks or a hard edge, a crush or vehicle incident causing a documented coccyx fracture, and prolonged seated work that aggravates symptoms after an accepted traumatic coccyx injury. 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 coccyx injury?
For coccyx injury, coccyx WPI is narrow. A healed, truly displaced coccyx fracture and excision of the coccyx are treated differently. Imaging should show whether there was a fracture and whether it healed in a truly displaced position. 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 coccyx injury assessment?
A coccyx injury assessment commonly needs the accepted coccyx injury description and insurer decision, coccyx X-ray, CT or other appropriate imaging showing whether a fracture healed in a truly displaced position, clinical and specialist records describing local tenderness, sitting tolerance, treatment and alternative lumbar, pelvic or sacroiliac explanations, and the operation report if excision of the coccyx was performed; injections, cushions and physiotherapy do not establish excision. 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 coccyx injury?
For coccyx injury, common issues include whether imaging proves a healed truly displaced fracture rather than an undisplaced or uncertain injury, whether symptoms arise from the coccyx or another spinal or pelvic condition, and whether ongoing pain and treatment history have been mistaken for a table criterion. 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 coccyx injury affect weekly payments and suitable duties?
Capacity evidence for coccyx injury may need to address continuous sitting, driving and exposure to vehicle or machinery vibration, whether the worker can change posture and take clinically supported breaks, and whether duties account for associated lumbar, pelvic or sacroiliac restrictions. 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 coccyx injury automatically receive a fixed WPI percentage?
No. For coccyx injury, one verified example is fractures of the coccyx: (i) healed and truly displaced fracture: 1% WPI, under NSW Guidelines Table 4.3. That value applies only when its stated criteria are met. A sore coccyx without a truly displaced healed fracture may not attract a coccyx rating.
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.
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