Nerve injury Workers Comp NSW Guide

Overview for NSW injured workers

Start with the dispute, not just the diagnosis

May be relevant when

The applicable test depends on the legal characterisation. A personal injury generally must arise out of or in the course of employment, with employment a substantial contributing factor; a disease or disease aggravation generally requires employment to be the main contributing factor.

Benefits to check

Medical expenses, weekly payments, suitable duties, treatment requests, WPI and any dispute notice already received.

Legal help is useful when

The insurer denies liability, refuses treatment, relies on an IME, reduces weekly payments or disputes permanent impairment.

How this affects your claim in practice

In a nerve injury claim, the diagnosis is only the starting point. The records should connect a neurological diagnosis identifying brain, cord, root, plexus, named peripheral nerve or digital nerve and mapped sensory loss, muscle power, reflexes and functional observations with the worker's practical limits, including protective sensation, dexterity, balance, limb control, endurance and safety-sensitive work and whether weakness is reliable and affects the specific tasks offered. If the insurer disputes whether symptoms arise from a spinal nerve root or a peripheral nerve, the response should address that reason directly.

This information is general in nature and is not legal advice. You should obtain advice about your own circumstances.

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 5 applies AMA5 Chapter 13 subject to NSW modifications. Paragraph 5.4 requires supported consciousness, cognition, communication and neurologically based emotional or behavioural impairments to be evaluated and combined without double-rating.
NSW Guidelines para 5.9: a TBI cerebral assessment requires a severe or high-energy head impact and at least one significant medically verified Glasgow Coma Scale abnormality, post-traumatic amnesia period or intracranial CT/MRI pathology.
NSW Guidelines paras 5.2-5.3: spinal cord injury uses AMA5 Chapter 15 Table 15-6, while peripheral nerves use the relevant upper-extremity, lower-extremity or spine provisions.

What injuries or conditions may be assessed?

Nerve injury is not a single impairment category. The accepted diagnosis must identify the structure or body system affected and the permanent consequence being assessed.

A supported work mechanism: laceration, crush, traction or compression affecting neural tissue.
A supported work mechanism: fracture, dislocation or surgery involving a nerve pathway.
For nerve injury, separate diagnoses and consequential conditions should be recorded individually so that one broad injury label is not used for different assessment methods.

Symptoms and findings that matter

A finding relevant to nerve injury: a neurological diagnosis identifying brain, cord, root, plexus, named peripheral nerve or digital nerve.

A finding relevant to nerve injury: mapped sensory loss, muscle power, reflexes and functional observations.

A finding relevant to nerve injury: EMG or nerve conduction results interpreted with the clinical distribution.

Protective sensation, dexterity, balance, limb control, endurance and safety-sensitive work.

What investigations are usually relevant

Investigations for nerve injury may include a neurological diagnosis identifying brain, cord, root, plexus, named peripheral nerve or digital nerve and mapped sensory loss, muscle power, reflexes and functional observations. Each result should answer a defined clinical question and be read with the examination, diagnosis and history.

EMG or nerve conduction results interpreted with the clinical distribution.
Imaging and operation records showing the anatomical site of injury.

How WPI is assessed for this body part

The assessment method depends on whether the injury is cerebral, spinal cord, nerve root, plexus, peripheral nerve or digital nerve.

Sensory and motor deficits are graded under the method for the affected pathway and converted to WPI where required.

Pain, numbness, imaging or an electrodiagnostic result alone does not complete the impairment calculation.

NSW paragraph 5.3 directs peripheral nervous-system assessment to the relevant upper-extremity, lower-extremity and spine provisions of AMA5.

The sensory-deficit percentage is multiplied by the nerve's maximum sensory value, and the motor-deficit percentage by its maximum motor value. The resulting regional impairments are combined and converted to WPI.

Table and value examples

Axillary nerve illustration

40% sensory deficit x 5% maximum = 2% UEI; 60% motor deficit x 35% maximum = 21% UEI; Combined Values Chart = 23% UEI; Table 16-3 = 14% WPI

This paraphrased example explains the rounded calculation; another worker's grade and nerve maximum may differ.

Source: AMA5 Tables 13-23, 13-24, 16-15 and 16-3; Combined Values Chart; NSW paras 1.26, 2.8 and 5.3

Miscellaneous peripheral nerve, sensory loss only

1% WPI

This NSW table applies only to its listed miscellaneous nerves and an anatomical sensory distribution.

Source: NSW Guidelines Table 5.1

Method illustration

This is a non-numeric illustration of the assessment sequence. It does not predict a WPI result.

Accepted condition and findings: Nerve injury is not a single impairment category. The accepted diagnosis must identify the structure or body system affected and the permanent consequence being assessed. A finding relevant to nerve injury: a neurological diagnosis identifying brain, cord, root, plexus, named peripheral nerve or digital nerve.
Method to apply: The assessment method depends on whether the injury is cerebral, spinal cord, nerve root, plexus, peripheral nerve or digital nerve.
Why no percentage can be assumed: Pain, numbness, imaging or an electrodiagnostic result alone does not complete the impairment calculation.

What usually does not increase WPI

The existence of a dispute about whether symptoms arise from a spinal nerve root or a peripheral nerve does not replace the measurements and criteria required by the controlling impairment method.

The existence of a dispute about whether tingling or weakness follows a recognised anatomical distribution does not replace the measurements and criteria required by the controlling impairment method.

Treatment, time away from work and an imaging or diagnosis label do not by themselves establish the WPI result for nerve injury.

Evidence checklist

The records for nerve injury should include decompression, repair, splinting, medication or neurological rehabilitation where supported. They are most useful when the diagnosis, examination and practical restrictions are consistent.

How this injury commonly happens at work

Work-related nerve injury can arise through laceration, crush, traction or compression affecting neural tissue and fracture, dislocation or surgery involving a nerve pathway. The chronology should identify the actual task or event and when symptoms or function changed.

Work-related nerve injury can arise through spinal injury producing nerve-root or cord symptoms rather than a peripheral lesion. The chronology should record the actual task or event and the point at which symptoms or function changed.

Common insurer disputes

For nerve injury, an insurer may dispute whether symptoms arise from a spinal nerve root or a peripheral nerve and whether tingling or weakness follows a recognised anatomical distribution. The written decision should be answered with evidence directed to those reasons.

Further disputes about nerve injury may concern whether an abnormal test matches the examination and accepted injury. 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 nerve injury may involve specialist review directed to the actual lesion rather than a generic pain label. The request should explain the expected functional benefit and its connection to the accepted injury.

Weekly payments and work capacity

Capacity evidence for nerve injury should address whether weakness is reliable and affects the specific tasks offered and whether driving, machinery or tool duties are safe with the measured deficit. Proposed duties must be sustainable for the proposed hours, not merely possible once.

How NSW Work Injury Claim can help

For nerve injury, a claim review can help to identify the anatomical lesion before selecting an assessment route and compare test results with sensory, motor and reflex findings. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.

For nerve injury, a claim review can help to avoid double-counting movement or weakness already caused by the same nerve deficit. 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 nerve injury claims

How can work cause or aggravate nerve injury?

For nerve injury, the relevant work history may include laceration, crush, traction or compression affecting neural tissue, fracture, dislocation or surgery involving a nerve pathway, and spinal injury producing nerve-root or cord symptoms rather than a peripheral lesion. 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 nerve injury?

For nerve injury, the assessment method depends on whether the injury is cerebral, spinal cord, nerve root, plexus, peripheral nerve or digital nerve. A finding relevant to nerve injury: a neurological diagnosis identifying brain, cord, root, plexus, named peripheral nerve or digital nerve. 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 nerve injury assessment?

A nerve injury assessment commonly needs a neurological diagnosis identifying brain, cord, root, plexus, named peripheral nerve or digital nerve, mapped sensory loss, muscle power, reflexes and functional observations, EMG or nerve conduction results interpreted with the clinical distribution, and imaging and operation records showing the anatomical site of injury. 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 nerve injury?

For nerve injury, common issues include whether symptoms arise from a spinal nerve root or a peripheral nerve, whether tingling or weakness follows a recognised anatomical distribution, and whether an abnormal test matches the examination and accepted injury. 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 nerve injury affect weekly payments and suitable duties?

Capacity evidence for nerve injury may need to address protective sensation, dexterity, balance, limb control, endurance and safety-sensitive work, whether weakness is reliable and affects the specific tasks offered, and whether driving, machinery or tool duties are safe with the measured deficit. 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 nerve injury automatically receive a fixed WPI percentage?

No. For nerve injury, one verified example is axillary nerve illustration: 40% sensory deficit x 5% maximum = 2% UEI; 60% motor deficit x 35% maximum = 21% UEI; Combined Values Chart = 23% UEI; Table 16-3 = 14% WPI, under AMA5 Tables 13-23, 13-24, 16-15 and 16-3; Combined Values Chart; NSW paras 1.26, 2.8 and 5.3. That value applies only when its stated criteria are met. Pain, numbness, imaging or an electrodiagnostic result alone does not complete the impairment calculation.

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.

Request a claim review Call (02) 7233 3661

Nerve injury workers compensation NSW