Assessment overview
How this assessment usually works
Endocrine WPI uses AMA5 Chapter 10 as modified by NSW Chapter 13. The assessor must apply stable clinical and laboratory evidence and assess any permanent end-organ consequence under the body-system chapter that actually governs it.
For endocrine system, 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.
- accepted pituitary or hypothalamic injury affecting one or more hormonal axes
- thyroid, parathyroid, adrenal-cortex or adrenal-medulla dysfunction caused or materially aggravated by the accepted work injury
- pancreatic endocrine dysfunction, including accepted diabetes-related impairment
- gonadal or mammary-gland endocrine impairment where the accepted condition fits the relevant AMA5 section
- permanent target-tissue or end-organ effects in the visual, neurological, renal, cardiovascular, skin or other body system
When a permanent impairment assessment can occur
For endocrine system, 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 endocrine system, 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.
For endocrine system, endocrine function should be assessed after the diagnosis, hormone replacement or suppression, metabolic control and any target-organ consequences have stabilised. Acute stress-related laboratory changes are not a final impairment baseline.
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 13 applies AMA5 Chapter 10 with Australian laboratory units, terminology and diabetes modifications. The applicable AMA5 table depends on the affected gland or hormonal system.
Endocrine classes integrate symptoms and clinical signs with objective hormone or metabolic testing, treatment dependence, adequacy of control and the residual effect on daily function. A diagnosis or one abnormal laboratory result is not the class.
Medication may replace a deficient hormone, suppress excess production or counter target-tissue effects. The report should explain whether treatment restores normal function and whether medication itself causes a stable adverse effect relevant to the table.
Related structural or end-organ change is assessed under the body-system chapter that governs that organ. It may be combined with an endocrine WPI only where permitted and without counting the same consequence twice.
NSW excludes AMA5 Chapter 18 pain. NSW paragraph 13.11 also says metabolic bone disease itself is unlikely to be work-related; a work-related fracture or collapse is assessed under the relevant musculoskeletal chapter.
What the assessor actually measures
For endocrine system, the percentage should be traceable to relevant, stable and reproducible findings.
- serial hormone, glucose and other pathology results in units recommended by the Royal College of Pathologists of Australasia
- clinical signs, symptoms and organ-specific functional testing required by the relevant pituitary, thyroid, parathyroid, adrenal, pancreatic or gonadal table
- type, dose, regularity and effect of hormone replacement, suppression, insulin or other continuing medication
- evidence of stable control, episodes of decompensation and response to physiological stress where the table makes those matters relevant
- separate visual, neurological, renal, cardiovascular, skin or other target-organ impairment assessed under its own chapter
How the measurements are converted to WPI
Identify the specific AMA5 Chapter 10 gland or hormonal table, place the stable condition in the supported class, and select the precise WPI from the severity, treatment and residual functional criteria.
An asymptomatic person whose diabetes is controlled by diet alone does not meet an impairment rating under AMA5 Table 10-8. A different treatment need or supported complication may change the method.
The diagnosis and treatment rating is kept separate from a target-organ WPI. Where combination is permitted, use the Combined Values Chart after both values are expressed as WPI.
Do not import superseded foreign laboratory units or a Chapter 18 pain value into the NSW calculation.
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 |
|---|---|---|
| Asymptomatic diabetes controlled by diet alone | No impairment rating under the AMA5 endocrine method | AMA5 Table 10-8, subject to NSW Chapter 13 |
| Laboratory reporting | Use units recommended by the Royal College of Pathologists of Australasia | NSW Guidelines paragraph 13.3 |
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: endocrine and target-organ impairment are separate calculations
Assumed findings: A worker has a stable accepted pituitary disorder requiring continuing hormone replacement and a separately established permanent visual-field loss caused by the same pathology.
Method and arithmetic: The assessor applies the relevant AMA5 Chapter 10 pituitary table to the hormonal condition using stable laboratory, treatment and functional evidence. An ophthalmologist separately assesses the visual loss under NSW Chapter 10 and AMA4 Chapter 8. Any permitted WPI values are then combined without duplication.
What the illustration shows: The hormonal diagnosis does not create one undifferentiated percentage that automatically includes the visual loss. This paraphrased illustration is not an estimate.
Method source: NSW Guidelines paragraphs 13.1-13.3 and Chapter 10; AMA5 Chapter 10
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.
- one abnormal hormone or glucose result without confirmation, stability and an accepted permanent disorder
- the diagnosis name without the treatment, control and functional criteria required by the applicable table
- a target-organ consequence assumed from symptoms rather than assessed under its own body-system method
- metabolic bone disease assumed to be work-related without causal evidence
- the same visual, neurological, renal or cardiovascular consequence counted under two systems
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
- endocrinology reports and serial laboratory results in Australian units
- medication, hormone-replacement, metabolic-control and treatment-dependence records
- records of episodes, treatment response and residual functional effect required by the relevant table
- specialist reports and calculations for any claimed target-organ impairment
Common insurer or report disputes
A disagreement about endocrine system 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.
- an abnormal result is treated as permanent impairment by itself
- the class criteria are not identified
- an end-organ consequence is omitted or counted twice
- causation is assumed from the diagnosis name
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 13, paragraphs 13.1-13.11: endocrine assessment, Australian units, diabetes, structural consequences and metabolic-bone modifications.
- AMA5 Chapter 10, Tables 10-1 to 10-10 as applicable: gland-specific endocrine class and treatment framework, subject to NSW modifications.
- NSW Guidelines paragraph 1.12: AMA5 Chapter 18 pain exclusion.
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 AMA5 endocrine class applies?
- Are Australian units and NSW modifications used?
- Does an end-organ consequence require a separate assessment?
- Are causation and any deduction explained?
How this connects to thresholds and strategy
In an endocrine system 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 endocrine system 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
Does an abnormal hormone or glucose result establish WPI?
Not by itself. The assessment requires a stable accepted condition and the clinical criteria in the applicable endocrine method.
How are end-organ complications assessed?
NSW paragraph 13.2 directs structural and end-organ consequences to the relevant body-system chapter, with combination only where permitted.
Is every metabolic bone disease work-related?
No. NSW paragraph 13.11 says the disease itself is unlikely to be work-related; causation and any permanent work-injury consequence require separate evidence.
Why do laboratory units matter?
NSW paragraph 13.3 requires findings to be reported in units recommended by the Royal College of Pathologists of Australasia.
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.