NSW Work Injury Claim

NSW Work Injury Claim

Pelvic fracture workers compensation NSW

A pelvic fracture claim should connect a specific diagnosis to the work task or incident and to the worker's current restrictions. Relevant work features may include a fall from height, vehicle or forklift impact, and being crushed or pinned by machinery or materials. The useful records include initial and healed-position pelvic X-rays or CT showing displacement, hospital, orthopaedic, trauma and operation records, and evidence of sacroiliac dislocation, fixation or ankylosis where present. Insurer disputes often focus on whether the fracture healed without displacement and the measured residual displacement at maximum medical improvement, while weekly payments and suitable duties depend on practical limits such as standing, walking, stairs, kneeling, squatting, driving and load carrying and safe duties that avoid unsafe mobility demands.

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Pelvic fracture workers compensation evidence review with medical reports, treatment notes, certificate of capacity and workplace duties documents.

Key legal and assessment sources

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 pelvic fracture claim, the diagnosis is only the starting point. The records should connect initial and healed-position pelvic X-rays or CT showing displacement and hospital, orthopaedic, trauma and operation records with the worker's practical limits, including standing, walking, stairs, kneeling, squatting, driving and load carrying and safe duties that avoid unsafe mobility demands. If the insurer disputes whether the fracture healed without displacement, 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 paras 4.1 and 4.5: spinal impairment is assessed using the diagnosis-related estimates (DRE) method. The AMA5 spine range-of-motion model in sections 15.8-15.13 must not be used in NSW workers compensation.
  • NSW Guidelines paras 4.14-4.15: alteration of motion segment integrity (AOMSI) is established from the permitted radiographic or structural findings and must relate to trauma, not developmental or degenerative change alone.
  • NSW Guidelines paras 4.18, 4.20-4.21 and 4.27-4.29: the DRE category depends on supported clinical findings. Imaging alone, and radiating pain alone, do not establish radiculopathy; EMG is not the NSW category differentiator.
  • NSW Guidelines paras 4.30-4.38 and Tables 4.2-4.3: special NSW rules apply to fractures, spinal surgery, pelvis, sacroiliac injury and coccyx injury.
  • AMA5 Chapter 15 Tables 15-3, 15-4 and 15-5 provide the lumbar, thoracic and cervical DRE ranges, subject to the NSW modifications.

What injuries or conditions may be assessed?

Pelvic injury can include non-displaced or displaced pelvic-bone fracture, bilateral pubic-rami fracture, pubic-symphysis separation, sacroiliac dislocation or fracture-dislocation, joint fixation or ankylosis and acetabular fracture.

  • The assessment uses the radiological appearance at maximum medical improvement, regardless of whether surgery occurred. Acetabular fracture is assessed through restricted hip movement rather than the residual-displacement rows.
  • Multiple qualifying pelvic injuries are assessed separately and combined, subject to the 20% WPI maximum in NSW Table 4.3.

Symptoms and findings that matter

Red-flag neurological features such as bladder, bowel, saddle sensation, walking tolerance or spinal cord signs require specialist evidence before any WPI pathway is chosen.

For pelvic fracture, flexion means bending forward, extension bending backward, lateral flexion bending sideways, and rotation turning the neck or trunk. These observations help classify the injury but are not converted through the excluded AMA5 spine ROM model.

Possible radiculopathy in a pelvic fracture claim generally needs at least two supported criteria, including a major clinical sign such as reflex asymmetry, localised weakness, reproducible dermatomal sensory loss, a nerve-tension sign or muscle wasting.

Imaging for pelvic fracture should match the level, side and clinical pattern. A degenerative or disc finding can exist without establishing the accepted injury or a higher DRE category.

Where pelvic fracture has been treated surgically, the operation type, level count, repeat procedures and residual objective neurological findings must be documented separately.

What investigations are usually relevant

Investigations for pelvic fracture may include surgical notes, admission records and post-operative imaging are central where fusion, fracture fixation or decompression is alleged and MRI or CT showing the spinal level, disc, canal, foraminal or fracture findings. Each result should answer a defined clinical question and be read with the examination, diagnosis and history.

  • Neurological examination recording power, reflexes, sensation and nerve-root distribution.
  • Operation reports and post-operative specialist reviews if surgery occurred.
  • Certificates of capacity and duties evidence showing sitting, standing, bending, lifting, driving and attendance limits.

How WPI is assessed for this body part

A non-displaced healed pelvic fracture is 0% WPI. For pelvic-bone fracture, residual displacement below 1 cm is 2% WPI, 1-2 cm is 5% WPI and more than 2 cm is 8% WPI under NSW Table 4.3.

Pelvic and sacro-iliac fracture/dislocation ratings use NSW Guidelines Table 4.3. Ordinary sacroiliac pain without a table condition is not rated under those rows.

NSW Guidelines Chapter 4 assesses pelvic fracture under the diagnosis-related estimates (DRE) method, using AMA5 Chapter 15 only as modified by NSW.

NSW paragraphs 4.5 and 4.13 exclude the AMA5 spine range-of-motion model. Multilevel disease, recurrence or surgery therefore does not switch a pelvic fracture assessment to ROM.

For pelvic fracture, DRE I is 0% WPI. DRE II requires qualifying findings beyond symptoms alone, while DRE III commonly concerns objective radiculopathy or another specifically listed fracture or post-decompression condition. Within one spinal region, competing findings select the highest valid DRE category; they are not added as separate WPI values.

A pelvic fracture assessment reaches DRE IV only where the evidence supports alteration of motion segment integrity (AOMSI), fusion or specified severe fracture findings. AOMSI is established from permitted structural or radiographic evidence, not ordinary bedside movement loss.

DRE V is reserved for its severe neurological and structural criteria. Persisting radiculopathy after fusion is handled through NSW Table 4.2 rather than automatically moving pelvic fracture to DRE V.

Any arm or leg symptoms attributed to pelvic fracture must match objective nerve-root findings. Radiating pain, an MRI label or one abnormal test does not by itself establish radiculopathy.

Table and value examples

Non-displaced healed pelvic fracture

0% WPI

A healed non-displaced pelvic fracture does not attract a pelvic-fracture WPI under this row.

Source: NSW Guidelines Table 4.3

Pelvic bone fracture residual displacement

<1cm 2% WPI; 1-2cm 5% WPI; >2cm 8% WPI

The value depends on radiological residual displacement at maximum medical improvement.

Source: NSW Guidelines Table 4.3

Sacro-iliac joint dislocation or fracture-dislocation

<=1cm displacement 8% WPI; >1cm displacement 12% WPI; internal fixation/ankylosis 5% WPI

Use this for sacro-iliac dislocation or fracture-dislocation, not ordinary low back or SIJ pain without the table condition.

Source: NSW Guidelines Table 4.3

Multiple pelvic joints internally fixed or ankylosed

Two out of three joints 8% WPI; all three joints 10% WPI

This is a pelvic-joint fixation/ankylosis row and should not be applied to unrelated pelvic pain.

Source: NSW Guidelines Table 4.3

Maximum for multiple pelvic fractures

20% WPI

Multiple pelvic injuries are assessed separately and combined, capped by the pelvic fracture maximum.

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

Pelvic fracture with measured residual displacement

Assumed facts: Assume a pelvic fracture has stabilised with 1.5 cm residual displacement shown on the radiological assessment at maximum medical improvement.

Method: NSW Table 4.3 uses the healed radiological appearance. A residual displacement between 1 cm and 2 cm falls in the specified pelvic-bone row.

Illustrative outcome: That row is 5% WPI. Another fracture pattern, sacroiliac injury or combination of pelvic injuries requires its own Table 4.3 analysis; this is not an individual estimate.

Source: NSW Guidelines Table 4.3

What usually does not increase WPI

Back or neck pain alone, without an assessable spinal diagnosis or objective findings, usually does not increase WPI.

Degenerative scan wording by itself is not a rating; the assessment must link the accepted injury to clinical findings.

Radiating pain without objective radiculopathy usually should not be treated as radiculopathy for WPI.

A work capacity restriction is not the same as a permanent impairment percentage.

Evidence checklist

The records for pelvic fracture should include the accepted injury description and insurer decision identifying each pelvic, pubic-rami, pubic-symphysis, sacroiliac or acetabular condition and centred radiographs, CT or other appropriate imaging showing the healed fracture pattern and measured residual displacement at maximum medical improvement. They are most useful when the diagnosis, examination and practical restrictions are consistent.

  • Operation reports recording fixation, arthrodesis or another pelvic procedure, where performed.
  • Hip movement findings where an acetabular fracture is assessed through restricted hip motion rather than a pelvic-displacement row.
  • Specialist reasoning identifying which pelvic-table rows apply, which separate pelvic impairments may be combined and how the NSW pelvic maximum is observed.

How this injury commonly happens at work

Work-related pelvic fracture can arise through a fall from height and vehicle or forklift impact. The chronology should identify the actual task or event and when symptoms or function changed.

Work-related pelvic fracture can arise through being crushed or pinned by machinery or materials and a high-force blow to the pelvis. The chronology should record the actual task or event and the point at which symptoms or function changed.

Common insurer disputes

For pelvic fracture, an insurer may dispute whether the fracture healed without displacement and the measured residual displacement at maximum medical improvement. The written decision should be answered with evidence directed to those reasons.

Further disputes about pelvic fracture may concern whether sacroiliac or other pelvic joint consequences are separately supported and whether ongoing symptoms arise from the pelvis, hip, spine or another 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 pelvic fracture may involve fracture monitoring, fixation, mobility rehabilitation and specialist review where supported and management of associated hip, sacroiliac, neurological or organ injury where accepted. The request should explain the expected functional benefit and its connection to the accepted injury.

Weekly payments and work capacity

Capacity evidence for pelvic fracture should address standing, walking, stairs, kneeling, squatting, driving and load carrying and safe duties that avoid unsafe mobility demands. Proposed duties must be sustainable for the proposed hours, not merely possible once.

For pelvic fracture, capacity evidence should address travel to work and medication effects where relevant and weekly payment decisions where partial capacity is overstated. 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 pelvic fracture, a claim review can help to clarify diagnosis and mechanism of injury and compare work duties with medical restrictions. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.

For pelvic fracture, a claim review can help to respond to treatment or work capacity disputes and prepare WPI evidence when the condition becomes stable. 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 pelvic fracture claims

How can work cause or aggravate pelvic fracture?

For pelvic fracture, the relevant work history may include a fall from height, vehicle or forklift impact, and being crushed or pinned by machinery or materials. 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 pelvic fracture?

For pelvic fracture, a non-displaced healed pelvic fracture is 0% WPI. For pelvic-bone fracture, residual displacement below 1 cm is 2% WPI, 1-2 cm is 5% WPI and more than 2 cm is 8% WPI under NSW Table 4.3. Red-flag neurological features such as bladder, bowel, saddle sensation, walking tolerance or spinal cord signs require specialist evidence before any WPI pathway is chosen. 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 pelvic fracture assessment?

A pelvic fracture assessment commonly needs the accepted injury description and insurer decision identifying each pelvic, pubic-rami, pubic-symphysis, sacroiliac or acetabular condition, centred radiographs, CT or other appropriate imaging showing the healed fracture pattern and measured residual displacement at maximum medical improvement, operation reports recording fixation, arthrodesis or another pelvic procedure, where performed, and hip movement findings where an acetabular fracture is assessed through restricted hip motion rather than a pelvic-displacement row. 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 pelvic fracture?

For pelvic fracture, common issues include whether the fracture healed without displacement, the measured residual displacement at maximum medical improvement, and whether sacroiliac or other pelvic joint consequences are separately supported. 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 pelvic fracture affect weekly payments and suitable duties?

Capacity evidence for pelvic fracture may need to address standing, walking, stairs, kneeling, squatting, driving and load carrying, safe duties that avoid unsafe mobility demands, and travel to work and medication effects where relevant. 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 pelvic fracture automatically receive a fixed WPI percentage?

No. For pelvic fracture, one verified example is non-displaced healed pelvic fracture: 0% WPI, under NSW Guidelines Table 4.3. That value applies only when its stated criteria are met. Back or neck pain alone, without an assessable spinal diagnosis or objective findings, usually does not increase WPI.

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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