Overview
How this affects your claim in practice
A primary psychological injury is caused directly by work events or conduct. A secondary psychological condition develops as a consequence of a physical injury or its effects. Classification affects the post-1 July 2026 gateway, weekly payments, treatment and permanent impairment rules. Primary psychological WPI uses PIRS; secondary psychological impairment is not separately compensated under section 66.
- The same diagnosis can be primary in one claim and secondary in another.
- The new relevant-event gateway applies to specified primary injuries first notified on or after 1 July 2026, not to secondary psychological injury.
- A mixed history may require the medical evidence to separate the contribution of a physical injury from later direct workplace events.
- Section 11A and its transitional wording must be checked rather than assumed from the label attached to the condition.
- Secondary symptoms can affect treatment and capacity even though they are excluded from permanent impairment assessment.
Practical review
What to check in this situation
- Identify the first causal sequence rather than relying only on the later diagnosis label.
- For post-1 July 2026 notifications, identify any relevant event or relevant conduct and applicable review pathway.
- Keep section 11A reasonable-management-action analysis separate from secondary consequences of physical injury.
Records that may help
Keep the work-event chronology, physical-injury records, first psychological symptoms, diagnosis, treatment and insurer classification decision.
Next procedural step
Correct a classification error early because applying the wrong injury pathway can distort several entitlements.
The practical difference
Depression after a violent incident may be primary. Depression developing because chronic back pain prevents work may be secondary. If both direct workplace events and physical-injury consequences are alleged, classification may depend on the medical evidence and the extent to which each cause is said to produce the condition.
| Issue | Primary psychological injury | Secondary psychological injury |
|---|---|---|
| Cause | The psychological condition is caused directly by work events. | The psychological condition arises as a consequence of another work-related condition, commonly a physical injury. |
| Typical evidence | A workplace event chronology, contemporaneous reports, witnesses and medical causation evidence. | A physical-injury and treatment chronology showing how pain, restriction, surgery or incapacity led to the condition. |
| Permanent impairment | May be assessed separately under the NSW psychiatric impairment method if the applicable requirements are met. | Must not be assessed for permanent impairment and cannot be added to the physical rating. |
The current primary-injury gateway
For a primary psychological injury first notified on or after 1 July 2026 within the reform scheme, the evidence must identify a mental or psychiatric disorder caused by one or more recognised relevant events, a real and direct connection between those events and employment, and employment as the main contributing factor.
The event category determines procedure. Relevant-conduct claims use a completed claim, interim-entitlement and mandatory internal-review process. Other relevant events generally use the ordinary insurer and PIC process. The post-1 July 2026 primary psychological injury gateway does not apply in the same way to primary injuries notified before that date, secondary psychological injuries, exempt workers such as police officers, paramedics and firefighters, coal miners, volunteers or dust-disease claims. The notification date, worker category and transitional provisions must be checked before applying the new rules.
How a secondary condition is linked to a physical injury
The file should show the sequence from the physical injury to pain, treatment, restriction or loss of capacity and then to the psychological condition. A diagnosis alone does not establish that causal connection.
Useful treating evidence addresses alternative causes fairly and explains whether symptoms affect treatment, rehabilitation, attendance and sustainable work. Financial or personal stress does not automatically displace the work-related connection, but it should not be hidden from the medical history.
- Contemporaneous GP notes about pain, sleep, mood and function.
- Psychologist or psychiatrist material addressing diagnosis and causal history.
- Surgery, pain-management and rehabilitation records.
- Failed or difficult return-to-work attempts and updated certificates of capacity.
- A chronology separating physical-injury consequences from any later direct workplace events.
Section 11A and permanent impairment are separate issues
Section 11A concerns reasonable management action and causation. The applicable version depends on commencement and transitional rules. It should not be used as a shorthand for every primary or secondary psychological dispute.
Section 65A is different. It prevents permanent impairment compensation for secondary psychological injury and requires secondary symptoms to be left out of physical and primary psychological impairment assessments. Primary psychological and physical impairment are assessed separately.
Examples showing why classification matters
| Illustration | Issue to investigate |
|---|---|
| A worker develops PTSD after witnessing a fatal workplace incident. | This is potentially a primary injury caused by a relevant event. The witnessing definition, diagnosis and work connection need evidence. |
| A worker develops depression after chronic back pain, failed duties and reduced earnings. | This is potentially secondary. The medical evidence should connect the physical injury consequences to the condition and work capacity. |
| A worker has a shoulder injury, then alleges bullying during return to work. | The physical injury, possible secondary condition and possible direct relevant-conduct claim may need to be separated rather than collapsed into one label. |
Official sources
Sources are listed for transparency. This guide is general information only and is not legal advice.
- SIRA - psychological injury claims for workers and employers
- SIRA - current psychological injury guidance for insurers
- Workers Compensation Act 1987 (NSW), including section 65A and the earlier provisions
- Workers Compensation Legislation Amendment Act 2025 No 72 (NSW), as made
- SIRA - NSW permanent impairment assessment guidelines
Frequently asked questions
Is the diagnosis enough to decide whether an injury is primary or secondary?
No. Classification depends on the cause supported by the medical and factual evidence, not only whether the diagnosis is depression, anxiety, PTSD or adjustment disorder.
Do the 2026 relevant-event rules apply to secondary psychological injury?
No. SIRA states that the new primary psychological injury rules do not apply to secondary psychological injuries. Other provisions, including Section 11A, may still require separate review.
Can a physical injury and primary psychological injury both be assessed for WPI?
They are assessed separately. The statutory rules determine which impairment gives rise to permanent impairment compensation; secondary psychological impairment is excluded.
Can secondary symptoms still affect weekly payments?
They can if medical evidence explains their effect on sustainable work capacity and their connection with the work-related physical injury.
What if the cause is mixed?
The chronology and medical evidence should separate physical-injury consequences from direct workplace events and explain the contribution of each. Classification should not be guessed.
Unclear whether the condition is primary or secondary?
A careful review should compare the physical-injury history, direct workplace events, medical causation and insurer reasons before choosing a claim or dispute pathway.