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 digital nerve injury claim, the diagnosis is only the starting point. The records should connect mapped sensory loss on the radial or ulnar side of the digit and repeat static two-point discrimination with the worker's practical limits, including protective sensation, fine handling, tool safety and precision grip. If the insurer disputes whether a named digital nerve is injured, 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?
Digital nerve injury can follow a laceration, crush injury, fracture or surgery and may affect one or both named digital nerves of a finger or thumb.
- A more proximal median, ulnar or radial nerve lesion uses the named peripheral nerve method rather than the digital-nerve method.
Symptoms and findings that matter
For digital nerve injury, finger and thumb movement is measured joint by joint. Values within one joint are added before the applicable digit result is converted to the hand.
Where digital nerve injury involves a digital nerve, static two-point discrimination helps distinguish partial from total sensory loss and the assessor records the affected nerve length and side.
The digital nerve injury calculation may pass from digit impairment to hand impairment, then upper-extremity impairment and WPI. NSW paragraph 1.26 requires rounding at each stage, not only at the end.
What investigations are usually relevant
Investigations for digital nerve injury may include hand-therapy measurements for each affected joint and digit, including reproducibility and static two-point discrimination mapped to the named digital nerve and compared with the opposite hand where appropriate. Each result should answer a defined clinical question and be read with the examination, diagnosis and history.
- Operation reports for tendon or nerve repair and imaging for fracture, arthritis or joint-surface injury.
- Clinical sensory and motor examination where a more proximal median, ulnar or radial nerve lesion is suspected.
How WPI is assessed for this body part
The digital nerve injury assessment starts at the affected joint, tendon, amputation level or digital nerve. It does not begin with a general percentage for hand pain or reduced dexterity.
Movement values within each digital nerve injury joint are added, then the prescribed AMA5 tables convert digit impairment to hand impairment, hand impairment to upper-extremity impairment and that value to WPI.
Static two-point discrimination is used for a supported digital sensory lesion in digital nerve injury; a proximal median, ulnar or radial nerve deficit instead uses the named-nerve sensory and motor method.
Restricted movement caused solely by the same nerve lesion is not added again in a digital nerve injury calculation, and grip strength is not used to duplicate pain, motion loss or nerve dysfunction.
Fine-motor, dressing or tool-use examples help describe digital nerve injury function, but NSW paragraph 1.24 prevents an ADL adjustment to the calculated upper-extremity value.
Table and value examples
Displaced fracture involving a joint surface
2% upper extremity impairment or 1% WPI where criteria are metThis applies where range-of-motion loss is not enough to rate impairment, movement is painful, and displacement is 2mm or more.
Source: NSW Guidelines para 2.17
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
Digital nerve injury: partial sensory loss in one digital nerve
Assumed facts: Assume a lacerated digital nerve leaves reproducible partial sensory loss after healing and the affected side and length of the nerve are documented. Static two-point discrimination is 8 mm along the full length of the ulnar digital nerve of the ring finger. The assumed examination classifies this as partial, rather than total, sensory loss.
Method: For this digital nerve injury illustration, Using AMA5 Tables 16-5 to 16-7, the assumed deficit produces 10% ring-finger impairment. The digit value converts to 1% hand impairment, then 1% upper-extremity impairment and 1% WPI, with rounding at each stage.
Illustrative outcome: This shows how the relevant digital nerve injury findings move through the upper-limb conversion process. The assessment follows the digital sensory method; a complaint of numbness without reproducible two-point discrimination does not produce the same calculation. This paraphrased illustration is not an estimate for any individual claim.
Source: NSW Guidelines paras 1.26 and 2.8-2.10; AMA5 Tables 16-5, 16-6, 16-7, 16-2 and 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 digital nerve 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 digital nerve injury can arise through laceration from a tool or sharp edge and crush injury or fracture. The chronology should identify the actual task or event and when symptoms or function changed.
Work-related digital nerve injury can arise through surgical injury or scar involving a named digital nerve. The chronology should record the actual task or event and the point at which symptoms or function changed.
Common insurer disputes
For digital nerve injury, an insurer may dispute whether a named digital nerve is injured and whether loss is partial or total. The written decision should be answered with evidence directed to those reasons.
Further disputes about digital nerve injury may concern whether testing is consistent and whether the correct digit-to-hand conversion was used. 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 digital nerve injury may involve nerve repair, desensitisation, sensory re-education and protective strategies where supported. The request should explain the expected functional benefit and its connection to the accepted injury.
Weekly payments and work capacity
Capacity evidence for digital nerve injury should address protective sensation, fine handling, tool safety and precision grip. Proposed duties must be sustainable for the proposed hours, not merely possible once.
How NSW Work Injury Claim can help
For digital nerve 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 digital nerve 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 digital nerve injury claims
How can work cause or aggravate digital nerve injury?
For digital nerve injury, the relevant work history may include laceration from a tool or sharp edge, crush injury or fracture, and surgical injury or scar involving a named digital nerve. 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 digital nerve injury?
For digital nerve injury, the digital nerve injury assessment starts at the affected joint, tendon, amputation level or digital nerve. It does not begin with a general percentage for hand pain or reduced dexterity. For digital nerve injury, finger and thumb movement is measured joint by joint. Values within one joint are added before the applicable digit result is converted to the hand. 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 digital nerve injury assessment?
A digital nerve 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 digital nerve injury?
For digital nerve injury, common issues include whether a named digital nerve is injured, whether loss is partial or total, and whether testing is consistent. 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 digital nerve injury affect weekly payments and suitable duties?
Capacity evidence for digital nerve injury may need to address protective sensation, fine handling, tool safety and precision grip. 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 digital nerve injury automatically receive a fixed WPI percentage?
No. For digital nerve injury, one verified example is displaced fracture involving a joint surface: 2% upper extremity impairment or 1% WPI where criteria are met, under NSW Guidelines para 2.17. That value applies only when its stated criteria are met. Pain, tenderness, weakness complaints or an imaging label without a stable measurable impairment.
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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.