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 hamstring injury claim, the diagnosis is only the starting point. The records should connect ultrasound or MRI identifying muscle, tendon, origin and extent of injury and specialist and physiotherapy findings for tenderness, strength and stretch tolerance with the worker's practical limits, including walking speed, stairs, bending, lifting, pushing, running and sudden balance recovery and sitting tolerance where proximal hamstring symptoms are relevant. If the insurer disputes whether the condition is an acute tear, tendinopathy, referred lumbar pain or a pre-existing problem, 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?
Hamstring injuries include muscle strain or tear, proximal tendon avulsion, partial or complete tendon rupture, insertional tendinopathy, postoperative residual loss and associated sciatic nerve involvement.
- A repair or avulsion may affect hip extension, knee flexion, sitting tolerance and strength, but the operation name is not a fixed WPI value.
- The assessor must separate hamstring pathology from lumbar radiculopathy, hip-joint pathology and pain-limited effort before using a lower-limb method.
Symptoms and findings that matter
Relevant stable findings may include reproducible thigh atrophy, valid manual muscle grade, hip or knee movement and a separate anatomically matching named-nerve deficit. Each method must meet its own criteria.
For hamstring 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 hamstring 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 hamstring 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 hamstring 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 hamstring 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 percentage for a hamstring tear, avulsion or repair. A valid residual consequence is assessed through the permitted atrophy, muscle, joint-movement or peripheral-nerve method, without double counting.
For hamstring 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 hamstring 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.
Arthritis in an assessment of hamstring 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 hamstring 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 hamstring 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
Worked assessment illustrations
These examples paraphrase the assessment reasoning in the source material. They explain method only and are not predicted outcomes.
Illustration 1
Hamstring injury: measured unilateral thigh atrophy
Assumed facts: Assume an accepted proximal hamstring injury has stabilised after treatment and leaves reproducible unilateral thigh atrophy. At maximum medical improvement, both thighs are measured 10 cm above the patella with the knees extended and muscles relaxed. The affected thigh is reproducibly 2.4 cm smaller and the comparison limb is normal.
Method: For this hamstring 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 limb an invalid comparator.
Illustrative outcome: This shows how the selected hamstring 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
A hamstring tear on imaging, repair surgery, sitting pain or reduced work tolerance does not create a fixed percentage without a valid stable finding.
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 hamstring injury should include MRI or ultrasound identifying the muscle or tendon, tear extent, retraction and chronicity where reported and operation and rehabilitation records for avulsion repair or other treatment. They are most useful when the diagnosis, examination and practical restrictions are consistent.
- Repeat thigh-circumference and manual muscle testing with a valid opposite-limb comparison.
- Hip and knee movement and neurological findings where those are relied upon as separate accepted consequences.
- Evidence that pain-limited effort, lumbar radiculopathy and general deconditioning have been distinguished from the selected method.
How this injury commonly happens at work
Work-related hamstring injury can arise through sprinting, slipping or sudden lengthening under load and forceful lifting or pulling with the hip flexed and knee extending. The chronology should identify the actual task or event and when symptoms or function changed.
Work-related hamstring injury can arise through a fall or direct blow causing an avulsion, tear or contusion. The chronology should record the actual task or event and the point at which symptoms or function changed.
Common insurer disputes
For hamstring injury, an insurer may dispute whether the condition is an acute tear, tendinopathy, referred lumbar pain or a pre-existing problem and whether imaging matches the mechanism and examination. The written decision should be answered with evidence directed to those reasons.
Further disputes about hamstring injury may concern whether duties require speed, stride length or lifting beyond the current rehabilitation stage. 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 hamstring injury may involve progressive loading and physiotherapy, with surgical review for supported avulsion or persistent tendon pathology and return-to-running or heavy-work testing where relevant to the job. The request should explain the expected functional benefit and its connection to the accepted injury.
Weekly payments and work capacity
Capacity evidence for hamstring injury should address walking speed, stairs, bending, lifting, pushing, running and sudden balance recovery and sitting tolerance where proximal hamstring symptoms are relevant. Proposed duties must be sustainable for the proposed hours, not merely possible once.
For hamstring injury, capacity evidence should address whether the worker can repeat the task without loss of strength or control. 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 hamstring injury, a claim review can help to link the mechanism and imaging to the specific hamstring structure and document objective recovery rather than pain alone. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.
For hamstring injury, a claim review can help to compare staged duties with lifting, stride, running and sitting demands. 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 hamstring injury claims
How can work cause or aggravate hamstring injury?
For hamstring injury, the relevant work history may include sprinting, slipping or sudden lengthening under load, forceful lifting or pulling with the hip flexed and knee extending, and a fall or direct blow causing an avulsion, tear or contusion. 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 hamstring injury?
For hamstring injury, NSW Chapter 3 has no standalone percentage for a hamstring tear, avulsion or repair. A valid residual consequence is assessed through the permitted atrophy, muscle, joint-movement or peripheral-nerve method, without double counting. Relevant stable findings may include reproducible thigh atrophy, valid manual muscle grade, hip or knee movement and a separate anatomically matching named-nerve deficit. Each method must meet its own criteria. 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 hamstring injury assessment?
A hamstring injury assessment commonly needs MRI or ultrasound identifying the muscle or tendon, tear extent, retraction and chronicity where reported, operation and rehabilitation records for avulsion repair or other treatment, repeat thigh-circumference and manual muscle testing with a valid opposite-limb comparison, and hip and knee movement and neurological findings where those are relied upon as separate accepted consequences. 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 hamstring injury?
For hamstring injury, common issues include whether the condition is an acute tear, tendinopathy, referred lumbar pain or a pre-existing problem, whether imaging matches the mechanism and examination, and whether duties require speed, stride length or lifting beyond the current rehabilitation stage. 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 hamstring injury affect weekly payments and suitable duties?
Capacity evidence for hamstring injury may need to address walking speed, stairs, bending, lifting, pushing, running and sudden balance recovery, sitting tolerance where proximal hamstring symptoms are relevant, and whether the worker can repeat the task without loss of strength or control. 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 hamstring injury automatically receive a fixed WPI percentage?
No. For hamstring 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. A hamstring tear on imaging, repair surgery, sitting pain or reduced work tolerance does not create a fixed percentage without a valid stable finding.
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