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 respiratory injury claim, the diagnosis is only the starting point. The records should connect respiratory diagnosis, imaging and specialist opinion and valid FVC, FEV1, FEV1/FVC and diffusion-capacity results where applicable with the worker's practical limits, including exertion, stairs, respirator use, dust or fume exposure, heat and shift recovery and whether duties can be sustained without unsafe breathlessness or exposure. If the insurer disputes which respiratory diagnosis is accepted, 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 8, paras 8.3-8.4 and 8.15-8.16: respiratory disorders other than asthma use AMA5 Table 5-12, with valid physiological testing and a reasoned whole-number selection within Classes 2-4.
- NSW Guidelines paras 8.5-8.7: asthma uses the modified AMA5 Tables 5-9 and 5-10 score from repeat testing under maximal treatment; bronchial challenge testing and PC20 are not scored.
- NSW Guidelines para 8.12: pneumoconiosis is dealt with under the separate NSW dust-diseases legislation rather than the ordinary Chapter 8 WPI pathway.
Occupational conditions and exposure patterns
Respiratory injury may involve accepted occupational asthma, fixed obstructive or restrictive lung disease, impaired gas transfer, inhalation injury, infection-related lung damage or another diagnosed respiratory condition.
- The claim should distinguish an acute inhalation event from disease attributed to cumulative dust, fume, smoke or chemical exposure because causation and the assessment pathway can differ.
- Pneumoconiosis, including relevant silica- or asbestos-related disease, is dealt with under the separate NSW dust-diseases legislation rather than the ordinary Chapter 8 permanent-impairment method.
Symptoms and findings that matter
FVC measures the forcefully exhaled volume after a full breath. FEV1 measures the amount exhaled in the first second, while the FEV1/FVC ratio helps identify airflow obstruction.
DCO or DLCO measures gas transfer from the lungs into the blood. Anaemia and other conditions can distort the result, so an isolated low DCO requires clinical explanation rather than automatic classification.
Exercise capacity may be expressed as VO2 max or METs where clinically available, but NSW does not require exercise testing routinely for every assessment.
Valid spirometry requires acceptable and repeatable effort. Symptoms, imaging and work exposure remain relevant to diagnosis and causation but do not replace the prescribed physiological measurements.
What investigations are usually relevant
Investigations for respiratory injury may include respiratory-specialist report identifying the accepted diagnosis, maximum medical improvement, test quality and applicable NSW/AMA5 method and repeatable spirometry with FVC, FEV1 and FEV1/FVC, including bronchodilator testing where relevant. Each result should answer a defined clinical question and be read with the examination, diagnosis and history.
- DCO/DLCO and clinically indicated exercise testing, interpreted with haemoglobin, obesity and other factors that may affect validity.
- Imaging, medication, exacerbation and treatment records linked to a dated occupational exposure or incident history.
- For asthma, at least three consistent and repeatable tests over six months while receiving maximal treatment with adequate compliance.
How WPI is assessed for this body part
NSW Chapter 8 applies AMA5 Chapter 5 with modifications. Respiratory disorders other than asthma generally use AMA5 Table 5-12; asthma uses the modified Tables 5-9 and 5-10 scoring method.
Table 5-12 considers valid FVC, FEV1, FEV1/FVC, DCO and available exercise-capacity results. Except for the special Class 1 gateway, the highest supported class reached by a valid factor determines the respiratory class.
Class 1 is 0% WPI, Class 2 is 10-25%, Class 3 is 26-50%, and Class 4 is 51-100%. For Classes 2-4, the assessor selects and explains a whole-number point within the range from the complete clinical circumstances; one low test does not automatically select the top of a class.
For asthma, the score uses the best post-bronchodilator FEV1, percentage FEV1 change and minimum medication. NSW excludes bronchial-challenge testing and PC20 from the impairment score.
Table and value examples
AMA5 Table 5-12 respiratory classes
Class 1: 0%; Class 2: 10-25%; Class 3: 26-50%; Class 4: 51-100% WPIThe class comes from valid physiological factors; the precise point within Classes 2-4 requires reasoned clinical selection.
Source: AMA5 Table 5-12, subject to NSW Chapter 8
Class 1 exercise gateway
VO2 max at least 25 ml/kg/min or more than 7.1 METsThis is the specific exercise gateway for Class 1 and does not make exercise testing compulsory in every assessment.
Source: AMA5 Table 5-12, subject to NSW Chapter 8
DCO below 40% predicted
Class 4, 51-100% WPITest validity and cause still require review; the result does not automatically select a particular point within Class 4.
Source: AMA5 Table 5-12
Residual lung cancer after treatment
Respiratory Class 4The NSW rule fixes the class but not an automatic point within its 51-100% range.
Source: NSW Guidelines para 8.14
Worked assessment illustrations
These examples paraphrase the assessment reasoning in the source material. They explain method only and are not predicted outcomes.
Illustration 1
The most severe valid physiological factor selects the respiratory class
Assumed facts: Assume stable accepted occupational lung disease and repeatable testing after treatment: FVC is 64% predicted, FEV1 is 46% predicted and DCO is 51% predicted. Clinically available exercise testing falls within Class 2.
Method: On the assumed Table 5-12 thresholds, FVC reaches Class 2, FEV1 and DCO reach Class 3, and exercise capacity reaches Class 2. The highest supported factor therefore places the impairment in Class 3, a 26-50% WPI range.
Illustrative outcome: The assessor must still explain the precise whole-number point from the complete valid test pattern, treatment and functional evidence. Breathlessness alone does not choose the result. This paraphrased illustration is not an estimate for the reader.
Source: NSW Guidelines paras 8.3-8.4 and 8.15-8.16; AMA5 Table 5-12
What usually does not increase WPI
Breathlessness, cough, wheeze, fatigue or exposure history does not establish WPI without a stable accepted diagnosis and valid objective respiratory assessment.
One poor-effort or non-repeatable lung-function result should not be converted into a percentage.
An isolated abnormal DCO with otherwise normal results requires investigation of its cause rather than automatic placement in a respiratory class.
Imaging, medication use or an occupational-disease label does not by itself select a Table 5-12 class or the precise point within a range.
Evidence checklist
The records for respiratory injury should include respiratory-specialist diagnosis, causal opinion and maximum-medical-improvement assessment and complete spirometry tracings and report, including repeatability and bronchodilator results where relevant. They are most useful when the diagnosis, examination and practical restrictions are consistent.
- DCO/DLCO, haemoglobin information and any clinically indicated exercise testing.
- Imaging, medication, exacerbation, hospital and treatment records.
- Task-by-task exposure chronology, safety data, ventilation, respiratory protection and monitoring records.
- The worksheet identifying the selected class, the factor that controls it and the reasons for the precise WPI within any range.
How this injury commonly happens at work
Work-related respiratory injury can arise through acute inhalation of smoke, gas, fumes or chemical aerosol and repeated occupational dust or fibre exposure. The chronology should identify the actual task or event and when symptoms or function changed.
Work-related respiratory injury can arise through a work infection or inflammatory process leaving respiratory consequences. The chronology should record the actual task or event and the point at which symptoms or function changed.
Common insurer disputes
For respiratory injury, an insurer may dispute which respiratory diagnosis is accepted and whether objective test abnormalities are attributable to work. The written decision should be answered with evidence directed to those reasons.
Further disputes about respiratory injury may concern whether symptoms and capacity restrictions are consistent with the measured respiratory function. 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 respiratory injury may involve condition-specific respiratory treatment, monitoring and rehabilitation and exposure avoidance or workplace control measures supported by medical advice. The request should explain the expected functional benefit and its connection to the accepted injury.
Weekly payments and work capacity
Capacity evidence for respiratory injury should address exertion, stairs, respirator use, dust or fume exposure, heat and shift recovery and whether duties can be sustained without unsafe breathlessness or exposure. Proposed duties must be sustainable for the proposed hours, not merely possible once.
For respiratory injury, capacity evidence should address whether oxygen, medication or treatment timing affects attendance. 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 respiratory injury, a claim review can help to identify the accepted respiratory diagnosis and check validity and interpretation of pulmonary tests. The purpose is to identify the precise decision and the evidence needed for the next available step, not to promise an outcome.
For respiratory injury, a claim review can help to align exposure controls and exertional duties with treating restrictions. 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 respiratory injury claims
How can work cause or aggravate respiratory injury?
For respiratory injury, the relevant work history may include acute inhalation of smoke, gas, fumes or chemical aerosol, repeated occupational dust or fibre exposure, and a work infection or inflammatory process leaving respiratory consequences. 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 respiratory injury?
For respiratory injury, NSW Chapter 8 applies AMA5 Chapter 5 with modifications. Respiratory disorders other than asthma generally use AMA5 Table 5-12; asthma uses the modified Tables 5-9 and 5-10 scoring method. FVC measures the forcefully exhaled volume after a full breath. FEV1 measures the amount exhaled in the first second, while the FEV1/FVC ratio helps identify airflow obstruction. 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 respiratory injury assessment?
A respiratory injury assessment commonly needs respiratory-specialist diagnosis, causal opinion and maximum-medical-improvement assessment, complete spirometry tracings and report, including repeatability and bronchodilator results where relevant, DCO/DLCO, haemoglobin information and any clinically indicated exercise testing, and imaging, medication, exacerbation, hospital and treatment records. 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 respiratory injury?
For respiratory injury, common issues include which respiratory diagnosis is accepted, whether objective test abnormalities are attributable to work, and whether symptoms and capacity restrictions are consistent with the measured respiratory function. 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 respiratory injury affect weekly payments and suitable duties?
Capacity evidence for respiratory injury may need to address exertion, stairs, respirator use, dust or fume exposure, heat and shift recovery, whether duties can be sustained without unsafe breathlessness or exposure, and whether oxygen, medication or treatment timing affects attendance. 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 respiratory injury automatically receive a fixed WPI percentage?
No. For respiratory injury, one verified example is ama5 table 5-12 respiratory classes: Class 1: 0%; Class 2: 10-25%; Class 3: 26-50%; Class 4: 51-100% WPI, under AMA5 Table 5-12, subject to NSW Chapter 8. That value applies only when its stated criteria are met. Breathlessness, cough, wheeze, fatigue or exposure history does not establish WPI without a stable accepted diagnosis and valid objective respiratory assessment.
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.