Assessment overview
How this assessment usually works
ENT impairment is not one generic rating. The assessor must identify whether the accepted condition concerns equilibrium, facial disorder, airway, speech, voice, swallowing, smell or taste, then use the retained AMA5 section or the NSW replacement table for that function.
For ear, nose and throat, the assessor gives a medical opinion about permanent impairment under the NSW workers compensation guidelines; the assessor does not decide legal liability. Once the body-system method and percentage are understood, separate advice may be needed about Section 66 compensation, weekly payments, medical-expense time limits or work injury damages.
Injuries and diagnoses assessed in this body system
The referral and report should identify the accepted diagnosis precisely. Similar symptoms can use different assessment methods depending on the injured structure.
- vestibular or equilibrium disorder after head trauma, blast, infection or accepted otological injury
- facial nerve disorder, outer-ear loss, nasal loss or other facial disorder or disfigurement
- nasal or upper-airway obstruction, sleep apnoea and permanent tracheostomy or stoma where causally accepted
- speech, voice, swallowing, smell or taste impairment after an accepted injury
When a permanent impairment assessment can occur
For ear, nose and throat, assessment should occur only after maximum medical improvement (MMI). NSW Guidelines paragraph 1.15 describes a condition that is well stabilised and unlikely to change substantially during the next year, with or without treatment.
For ear, nose and throat, if adequate treatment or rehabilitation could materially change the impairment, paragraph 1.16 says the assessment should be deferred. The report should explain why the timing is appropriate.
The NSW and AMA5 assessment method
The NSW Workers Compensation Guidelines prevail over AMA5 wherever the two differ. The method is a medical assessment framework, not a self-scoring exercise.
NSW Guidelines Chapter 6 applies AMA5 Chapter 11 with NSW replacement tables and exclusions. Hearing loss is assessed separately under NSW Chapter 9.
Equilibrium uses AMA5 section 11.2b and Table 11-4 with the NSW clarification in paragraph 6.3. Facial disorder or disfigurement uses NSW Table 6.1, which replaces AMA5 Table 11-5.
Air-passage defects use NSW Table 6.2. Sleep apnoea requires a sleep study and ENT specialist examination and is read with the respiratory provisions identified in paragraphs 6.6-6.7.
The dedicated vestibular and facial-disfigurement pages explain those methods in greater detail. This page remains the broader ENT guide for airway, speech, voice, swallowing, smell and taste.
What the assessor actually measures
For ear, nose and throat, the percentage should be traceable to relevant, stable and reproducible findings.
- the precise ENT structure and function affected by the accepted injury
- objective vestibular, facial-nerve, airway, speech, voice, swallowing, smell or taste findings
- functional effect required by the applicable retained AMA5 section or NSW replacement table
- sleep study, airway testing and specialist examination where sleep apnoea or obstruction is alleged
- any separate hearing loss kept within the NSW Chapter 9 hearing calculation
How the measurements are converted to WPI
The assessor selects the retained AMA5 section or NSW replacement table for the affected function and states a specific WPI supported by its criteria.
NSW paragraph 6.15 requires AMA5 Table 11-10 to be disregarded except for smell or taste and hearing impairment determined under the NSW Guidelines.
Separate functional impairments may be combined only where the applicable method permits and only after avoiding duplication.
Verified category and table examples
These short examples show how the published method works. They do not predict an individual assessment.
| Finding or category | Published value or method | Source |
|---|---|---|
| Facial disorder or disfigurement, NSW Table 6.1 Class 1 | 0-5% WPI | NSW Guidelines Table 6.1 |
| Air-passage defect, NSW Table 6.2 Class 2 | 11-29% WPI | NSW Guidelines Table 6.2 |
| Successful permanent tracheostomy or stoma | 25% WPI | NSW Guidelines note before paragraph 6.9 |
Worked illustrations
How the assessment method can operate
These paraphrased illustrations explain the published method. They are not estimates of another worker's WPI.
Illustration: an airway condition needs the specific NSW table
Assumed findings: A worker has stable accepted nasal and upper-airway structural loss after facial trauma. An ENT report identifies the anatomic defect, objective obstruction and functional effect.
Method and arithmetic: The assessor applies NSW Table 6.2 rather than the displaced AMA5 Table 11-6 and selects the exact value within the matching class from the supported findings. A sleep-apnoea component would require the additional NSW sleep-study evidence.
What the illustration shows: Symptoms alone do not select the class, and a hearing component must remain under the separate NSW hearing method. This is an illustration only.
Method source: NSW Guidelines paragraphs 6.6-6.8 and Table 6.2; AMA5 Chapter 11 as retained
What does not establish WPI by itself
These matters can remain medically and practically important, but they do not replace the measurements or category requirements in the applicable method.
- dizziness, nasal blockage, voice change or swallowing difficulty without a stable diagnosis and the objective findings required by the selected method
- snoring or fatigue without the required sleep study and ENT assessment
- appearance alone without applying NSW Table 6.1
- hearing loss folded into a generic ENT percentage
- a displaced or excluded AMA5 table used instead of the NSW replacement
Evidence checklist
The assessor should receive enough material to test the accepted injury, stability, measurable impairment and any deduction.
- the accepted injury or disease description and any insurer liability decisions
- contemporaneous GP, hospital and treating-specialist records
- relevant investigations, pathology, procedure reports and treatment history
- earlier impairment assessments and evidence about any pre-existing impairment
- a current clinical opinion explaining stability and whether material improvement remains likely
- ENT, vestibular, speech-pathology or other relevant specialist reports
- sleep-study, airway, speech, voice, swallowing, smell or taste test material where applicable
- operation and treatment records and appropriate clinical photographs for visible structural loss
Common insurer or report disputes
A disagreement about ear, nose and throat WPI may concern the accepted diagnosis, the body-system findings, the selected method, a deduction or the way another impairment was handled. The report should identify the disputed step rather than leave the percentage unexplained.
- a displaced AMA5 table is used instead of the NSW replacement
- dizziness or airway symptoms are rated without objective evidence
- hearing loss is incorrectly folded into a generic ENT percentage
- the value within a broad class is not explained
Sources for this assessment guide
The public NSW Guidelines control where they modify AMA5. AMA5 table references below identify the method without reproducing the proprietary table in full.
- NSW Guidelines Chapter 6, paragraphs 6.1-6.15 and Tables 6.1-6.2: equilibrium, face, airway, speech, voice and summary-table modifications.
- AMA5 Chapter 11, sections 11.2-11.4: ENT assessment framework only where retained or modified by NSW.
Questions to ask when the report comes back
These questions help identify whether the report explains its method and evidence. They do not replace medical or legal advice about the particular assessment.
- Which ENT function is being assessed?
- Does a NSW replacement table apply?
- Are the required specialist tests present?
- Has hearing been assessed separately where necessary?
How this connects to thresholds and strategy
In an ear, nose and throat claim, SIRA's permanent impairment thresholds must be applied to the accepted injury and the supported body-system percentage. The general thresholds are 11% or more permanent impairment for physical injury and 15% or more for primary psychological injury; secondary psychological injury is treated differently. A threshold is an eligibility checkpoint, not a promised payment.
A low ear, nose and throat WPI opinion may affect weekly-payment planning, treatment time-limit issues, dispute posture and whether work injury damages threshold advice is required. Before the opinion is relied on, check the relevant measurements, body-system method, deduction and practical consequences.
Questions workers often ask
Are hearing loss and other ENT impairment assessed together?
Not automatically. Hearing uses the separate NSW Chapter 9 methodology, while other ENT functions use Chapter 6.
What evidence is required for sleep apnoea?
NSW paragraph 6.6 requires a sleep study and an examination by an ENT specialist before permanent impairment assessment.
Does dizziness automatically produce WPI?
No. The equilibrium method requires a supported diagnosis, objective findings and the functional evidence required by the applicable category.
Can a permanent tracheostomy be rated?
The NSW Guidelines state that a successful permanent tracheostomy or stoma is rated at 25% WPI.
General information only
This information is general in nature and is not legal advice. You should obtain advice about your own circumstances before relying on a WPI percentage, accepting a lump sum offer, or responding to an insurer decision.
Reviewed by NSW Work Injury Claims - a branch of Stephen Young Lawyers.
Related injury and impairment pages
Need a WPI assessment checked?
If the percentage does not match the accepted injury, treatment history, imaging, surgery, work duties or current restrictions, get the report checked before accepting the insurer position.