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NSW workers compensation help from Stephen Young Lawyers
NSW Work Injury Claim is the workers compensation service of Stephen Young Lawyers. Stephen Young Lawyers provides the legal service. Stephen Young Lawyers.
Stephen Young Lawyers was established in 2012. The firm is led by Stephen Young, Principal Solicitor and Accredited Specialist in Personal Injury Law.
Workers across New South Wales can arrange telephone or video appointments. In-person appointments can be arranged at the Sydney office when appropriate.
NSW Work Injury Claim enquiries: (02) 7233 3661
- Content publisher:
- NSW Work Injury Claim
- Published:
- Last legally reviewed:
Key legal sources
- Workers Compensation Act 1987 (NSW)
- SIRA workers compensation
- IRO legal assistance for injured workers
- Personal Injury Commission
This information is general in nature and is not legal advice. You should obtain advice about your own circumstances.
Assessment overview
How this assessment usually works
Respiratory and dust disease assessment usually turns on diagnosis, lung function, imaging, exposure history, medical stability and whether work materially contributed to the condition. The evidence needs to show both impairment and the occupational pathway.
For respiratory and dust disease, 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.
- occupational asthma, reactive airway disease and stable fixed airflow limitation
- hypersensitivity pneumonitis and other accepted restrictive, obstructive or gas-transfer disorders
- accepted asbestos-, silica- or other exposure-related lung disease, noting that pneumoconiosis is assessed under the separate NSW dust-diseases scheme rather than this Chapter 8 method
- accepted lung injury after chemical or fume exposure, infection or trauma
- post-treatment lung cancer and residual lung cancer where the condition falls within the workers compensation assessment pathway
When a permanent impairment assessment can occur
For respiratory and dust disease, assessment should occur only after maximum medical improvement (MMI). Under NSW Guidelines paragraph 1.15, that means the condition is well stabilised and unlikely to change substantially during the next year, with or without treatment.
For respiratory and dust disease, if treatment or rehabilitation is inadequate and could materially change the impairment, paragraph 1.16 says the assessment should be deferred. The report should explain the timing rather than merely state that MMI has been reached.
For respiratory and dust disease, lung cancer should be assessed at least six months after surgery under NSW paragraph 8.13. Asthma testing must reflect maximal treatment and adequate compliance before the impairment score is used.
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 8 applies AMA5 Chapter 5 with modifications. For respiratory disorders other than asthma, AMA5 Table 5-12 is the class framework.
Table 5-12 considers FVC, FEV1, the FEV1/FVC ratio, diffusing capacity for carbon monoxide (DCO or DLCO), and maximum exercise capacity expressed as VO2 max or metabolic equivalents (METs). These are physiological measures, not a breathlessness questionnaire.
FVC, FEV1 and DCO are compared with predicted normal values for the worker’s age, height and sex. “Percent predicted” means the observed value divided by the relevant predicted value. The lower limit of normal also matters: for example, FVC, FEV1 or DCO at least 60% of predicted but below the lower limit of normal can satisfy Class 2.
Class 1 has a special gateway. A VO2 max of at least 25 ml/kg/min or more than 7.1 METs can establish Class 1 by itself. Otherwise, FVC, FEV1, FEV1/FVC and DCO must all satisfy their Class 1 criteria. The FEV1/FVC ratio is used only to decide Class 1; it does not select Classes 2-4.
Except for the specific Class 1 logic, the highest impairment class reached by a valid Table 5-12 factor determines the respiratory class. Classes 2-4 are ranges, and NSW paragraph 8.4 requires a reasoned whole-number percentage within the supported range using the complete clinical circumstances.
Valid spirometry requires at least three acceptable tracings, with at least two of the three results within 5% of each other. The highest qualifying result is used. A low-quality effort cannot be converted into WPI simply because it produces a lower number.
Asthma follows the scoring method in AMA5 Tables 5-9 and 5-10 as modified by NSW paragraphs 8.5-8.7. It requires at least three consistent and repeatable lung-function tests over six months under maximal treatment with adequate compliance. The score adds the best post-bronchodilator FEV1, percentage change in FEV1 and minimum medication. NSW says to ignore Table 5-9 column 4 and PC20: bronchial challenge testing is not performed or scored for this assessment.
Sleep apnoea is not rated through Table 5-12. NSW paragraphs 8.8-8.10 direct the assessor to AMA5 section 13.3c and Table 13-4 after appropriate assessment and treatment by an ENT surgeon and a respiratory physician specialising in sleep disorders.
NSW paragraph 8.12 excludes pneumoconiosis from this Chapter 8 assessment because it is dealt with under dust-diseases legislation. The report must not mix that separate statutory pathway into a standard Table 5-12 calculation.
Non-work conditions and lifestyle factors, including smoking, must be considered. A deduction is not automatic merely because there is a smoking history: the assessor must use clinical judgment about contribution to the degree of impairment and record the method and reasons for any deduction.
What the assessor actually measures
For respiratory and dust disease, the percentage should be traceable to relevant, stable and reproducible findings.
- forced vital capacity (FVC): the total volume exhaled forcefully after a full breath
- forced expiratory volume in one second (FEV1): the amount exhaled in the first second, together with the FEV1/FVC ratio
- diffusing capacity for carbon monoxide (DCO/DLCO): how effectively gas transfers from the lungs into the blood, measured by the single-breath method; anaemia can lower the result and must be considered
- VO2 max or METs from clinically available exercise testing where indicated; NSW does not require exercise testing routinely for every assessment
- repeatability, effort, testing conditions, bronchodilator response and whether anaemia, obesity or another condition may distort a result
- imaging, specialist examination, medication, exacerbation and treatment history, and the accepted occupational exposure or event
How the measurements are converted to WPI
For Table 5-12, classify each valid factor. Class 1 is 0% WPI, Class 2 is 10-25% WPI, Class 3 is 26-50% WPI and Class 4 is 51-100% WPI.
Use the highest supported class from the valid physiological factors, then select the precise whole-number WPI within that range from the complete test pattern, symptoms, treatment and functional evidence. One borderline number should not be used in isolation from test quality and the rest of the record.
An isolated abnormal DCO with otherwise normal lung-function results requires caution and clarification of its cause under NSW paragraph 8.16.
Residual lung cancer after treatment is Class 4 under paragraph 8.14. This fixes the class, not an automatic point within the 51-100% range.
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 |
|---|---|---|
| Respiratory Table 5-12 classes | Class 1: 0%; Class 2: 10-25%; Class 3: 26-50%; Class 4: 51-100% WPI | 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 METs | AMA5 Table 5-12, subject to NSW Chapter 8 |
| Class 2 lower-limit example | FVC, FEV1 or DCO at least 60% predicted but below the lower limit of normal | AMA5 Table 5-12 and NSW paragraph 8.3 |
| DCO below 40% of predicted | Class 4, 51-100% WPI | AMA5 Table 5-12 |
| Residual lung cancer after treatment | Respiratory Class 4 | NSW Guidelines paragraph 8.14 |
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: the most severe valid lung-function factor selects the class
Assumed findings: A process worker with stable accepted occupational lung disease has repeatable testing after treatment: FVC is 64% predicted, FEV1 is 46% predicted, DCO is 51% predicted, and clinically available exercise testing falls within Class 2.
Method and arithmetic: The assumed FVC reaches Class 2. FEV1 and DCO each reach Class 3, while the exercise result reaches Class 2. The highest supported factor therefore places the impairment in Class 3, a range of 26-50% WPI. The exact point must be explained from the complete clinical circumstances and where the results lie within the class bands.
What the illustration shows: The worker’s description of breathlessness remains relevant, but it does not replace valid physiological testing or choose the percentage by itself. This paraphrased illustration is not an estimate for the reader.
Method source: NSW Guidelines paragraphs 8.3-8.4 and 8.15-8.16; AMA5 Table 5-12
Illustration: the NSW asthma score excludes bronchial challenge testing
Assumed findings: A warehouse picker with accepted stable occupational asthma has three consistent and repeatable tests over six months while following maximal treatment. The best post-bronchodilator FEV1 is 53% predicted, the FEV1 improvement is 25%, and the minimum treatment is a daily bronchodilator.
Method and arithmetic: Using the retained parts of AMA5 Table 5-9, the post-bronchodilator FEV1 scores 3, the FEV1 change scores 2 and daily bronchodilator treatment scores 2. The total is 7. NSW excludes column 4 and PC20, so no bronchial-challenge score is added. Table 5-10 places a total of 7 in Class 3, a range of 26-50% WPI.
What the illustration shows: The exact whole-number percentage within Class 3 still requires the assessor to explain the complete clinical circumstances. This paraphrased illustration shows the method; it is not an estimate for a reader.
Method source: NSW Guidelines paragraphs 8.5-8.7; AMA5 Tables 5-9 and 5-10 as modified by NSW
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.
- breathlessness, cough, wheeze or fatigue without a stable accepted diagnosis and valid objective respiratory assessment
- one poor-quality spirometry effort, fewer than three acceptable tracings, or results that do not include two of three values within 5% of each other
- an exposure history, scan abnormality or diagnosis label without the functional and physiological evidence required by the method
- one isolated low DCO where the remaining lung-function results are normal and the cause has not been clarified
- an asthma score based on challenge testing, inadequate treatment, or fewer than the required serial tests
Evidence checklist
The assessor should receive enough material to test the accepted injury, stability, measurable impairment and any deduction.
- the accepted injury description, claim history and any insurer liability decisions
- contemporaneous GP and treating-specialist records
- relevant imaging, pathology, operation reports and rehabilitation records
- earlier impairment assessments and records about any pre-existing impairment
- a current treatment history and an explanation of whether further material improvement is expected
- complete serial pulmonary-function reports showing FVC, FEV1, FEV1/FVC, DCO, predicted values, lower limits and quality or repeatability data
- respiratory-specialist reports, imaging, bronchodilator response, medication and exacerbation history
- available exercise-test results where clinically obtained, without commissioning a test solely to create a WPI value
- workplace exposure, PPE, safety-data, air-monitoring and industrial-hygiene records, together with smoking and non-work exposure history where relevant
- for asthma, at least three compliant tests over six months and the medication evidence required by the NSW method
- for sleep apnoea, the ENT and specialist sleep-respiratory assessment, treatment history and evidence needed to apply AMA5 Table 13-4
- clinical reasoning for any contribution from smoking or another non-work condition, including the calculation and reasons for any deduction
Common insurer or report disputes
A disagreement about respiratory and dust disease 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.
- the insurer attributes symptoms to smoking or non-work disease
- exposure history is incomplete or undocumented
- testing is done before the condition stabilises
- work restrictions are treated as temporary despite persistent lung impairment
- the assessment does not explain causation or apportionment
Report cautions before relying on the percentage
Report red flags
- The report treats every respiratory symptom as smoking-related without analysing workplace exposure.
- The report ignores safety data sheets, exposure monitoring, PPE records or co-worker evidence.
- A dust disease condition is handled as an ordinary generic lung complaint without considering the correct NSW pathway.
- Pulmonary function is abnormal but the report does not explain causation, reliability or whether the condition is stable.
Method and reliance checks
- Does the respiratory specialist connect test results to functional impairment and work exposure?
- Were safety data sheets, exposure records, dust monitoring or PPE records considered where available?
- Is the condition stable enough for permanent assessment?
- Does any apportionment explain the medical basis?
- Does the report identify whether dust diseases legislation or a different compensation pathway may be relevant?
- If asthma is assessed, does the report address repeated testing, maximal treatment and compliance rather than relying on one test?
- Respiratory disease claims can involve long exposure periods and multiple employers, so chronology matters.
- A diagnosis and a WPI percentage are separate questions from liability and contribution.
- Work restrictions from breathlessness, irritant avoidance or medication effects may affect capacity even before WPI is final.
Guideline notes
- NSW respiratory assessment draws on AMA5 Chapter 5 subject to NSW guideline control.
- The NSW guideline excludes some pneumoconiosis assessment from the ordinary respiratory chapter because dust diseases legislation may apply.
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 8, paragraphs 8.1-8.16: non-work deductions, lower limits, asthma serial testing and exclusions, sleep-apnoea method, pneumoconiosis exclusion, lung-cancer timing, Table 5-12 use and isolated DCO caution.
- AMA5 Chapter 5, especially sections 5.4-5.10 and Tables 5-9, 5-10 and 5-12, as adopted and modified by NSW: test validity, FVC, FEV1, FEV1/FVC, DCO, asthma scoring, exercise factors and respiratory class ranges.
- AMA5 Chapter 13, section 13.3c and Table 13-4, as directed by NSW paragraphs 8.8-8.10: sleep-apnoea assessment after appropriate specialist assessment and treatment.
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.
- Is the diagnosis accepted and supported?
- Were lung function and imaging records available?
- Was the exposure history complete?
- Are non-work factors addressed carefully?
- Does the report explain whether MMI has been reached?
How this connects to thresholds and strategy
In a respiratory and dust disease 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 respiratory and dust disease 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 breathlessness establish respiratory WPI?
No. The assessment requires valid pulmonary-function testing and clinical evidence that place the accepted condition in the applicable respiratory class.
What tests commonly matter?
Depending on the condition, spirometry, gas-transfer testing, imaging, specialist findings and treatment response may be relevant.
How is residual lung cancer treated?
NSW paragraph 8.14 directs residual lung cancer after treatment to respiratory impairment Class 4.
Can exposure history replace medical impairment evidence?
No. Exposure is important to causation, but a WPI assessment still requires stable, objectively assessed permanent respiratory impairment.
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.
Published by NSW Work Injury Claim, the workers compensation service 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.