主要资料来源
简明答案
简明答案：这类 WPI 评估通常怎样看
髋、膝、腿、脚踝和足部 的永久伤残评估不应只看诊断名称或影像结论。重点是 accepted injury、身体系统、maximum medical improvement (MMI)、NSW 指南方法、检查所见、治疗和手术记录、以及任何既往伤害或退变扣减是否有证据支持。
简明答案
已接受的伤害
评估必须从保险公司已接受或正在争议的伤害范围开始。伤害描述过窄，可能影响评估方法和证据。
简明答案
医学评估方法
评估医生需要按照 NSW Guidelines 和相关 AMA5 章节处理 MMI、检查结果、既往扣减和身体系统。
简明答案
索赔影响
WPI 百分比可能影响 Section 66、medical expenses、weekly payments 和 work injury damages 策略，不能只看数字。
评估路径通常怎样建立
髋、膝、腿、脚踝和足部 的 WPI 报告应说明推理过程，而不只是给出百分比。以下是依赖该百分比前通常需要核对的路径。
Identify whether the condition is hip, knee, ankle, foot, toe, ligament, meniscus, fraCTure, arthritis, joint replacement, nerve 伤害, vascular problem or 截肢.
Choose the most specific clinically appropriate lower-limb method. The 报告 should not automatically use gait or range of motion when a diagnosis-based or 手术-based method is more accurate.
Check whether the rating starts as lower extremity impairment, foot impairment or 全人伤残（WPI） and whether conversion is shown correCTly.
Review whether methods can be combined. Gait, atrophy, strength, nerve 伤害, arthritis and range-of-motion methods have combination limits.
Compare examination findings to praCTical duties: standing, walking, stairs, uneven ground, kneeling, squatting, driving and safe manual handling.
NSW 指南和 AMA5 方法要点
下肢 assessment uses AMA5 Chapter 17 with NSW modifications. The assessor should choose the most specific valid method, not simply the easiest one.
The method may involve diagnosis-based estimates, range of motion, arthritis, gait, nerve 伤害, 截肢, joint replacement or other lower-limb tables.
The 报告 should not use gait derangement loosely. It needs pathological support and should not be combined where the guideline or AMA5 cross-usage table does not permit it.
For hip and knee replacements, specific replacement tables and outcome faCTors may apply; the 报告 should not rate the worker as if the joint had never been replaced.
Foot and ankle impairments may need regional conversion before WPI is stated. A bare WPI number can hide an error in the conversion path.
Arthritis, muscle atrophy, strength, peripheral nerve deficit and range-of-motion methods have combination restriCTions. The 报告 should explain the chosen pathway.
The maximum lower-limb rating is limited by the relevant 截肢 value unless a specific method allows a different result.
下肢 symptoms caused by 脊柱 pathology should not be rated as a separate lower-limb impairment unless the 证据 supports a distinCT 已接受的伤害.
哪些因素可能改变 WPI 百分比
最终百分比可能受评估方法、客观检查、手术结果、既往扣减以及多重伤残合并方式影响。
- The seleCTed lower-limb table or method and whether it is the most specific method for the 已接受的伤害.
- Post-operative status after arthroscopy, reconstruCTion, fraCTure fixation, fusion or replacement 手术.
- Measured movement, joint stability, deformity, arthritis grade, gait derangement and use of aids, where the method permits those faCTors.
- Whether lower-limb impairment or foot impairment was converted to WPI correCTly.
- Whether a spinal cause, non-work arthritis or previous 伤害 has been considered without over-deduCTing the work contribution.
评估医生通常会核对什么
- accepted hip, knee, ankle, foot, ligament, meniscus, fraCTure or replacement 伤害 wording
- whether imaging and 手术 records match ongoing symptoms
- movement, stability, gait, use of aids and work funCTion
- whether arthritis or degeneration is being treated as unrelated despite work aggravation 证据
- whether 多重 lower-limb problems are assessed together or separated correCTly
可能有帮助的证据
- MRI, X-ray, arthroscopy, replacement or fraCTure records
- orthopaedic, rehabilitation physician, physiotherapist and GP 报告s
- 工作能力证明 covering walking, standing, kneeling, stairs, driving and lifting
- worksite material showing standing tasks, uneven ground, ladders, deliveries or manual handling
- records of failed suitable duties or recurrent flare-ups after return to work
保险公司或评估报告常见争议
- the 保险公司 says arthritis is the real cause
- the assessment ignores gait, instability or repeated swelling
- 手术 outcome is described as successful even though funCTion remains restriCTed
- 工作能力 is assumed because the worker can walk short distances
- a combined 伤害 is split in a way that understates overall funCTional effeCT
收到评估报告后要核对什么
复核 WPI 报告时要问的问题
报告中的风险信号
- A lower-limb WPI is stated without showing the regional impairment and conversion calculation.
- A worker with a knee replacement, ACL reconstruCTion or fraCTure fixation is assessed without operation notes or updated orthopaedic review.
- Gait is used as a rating method simply because the worker limps, without explaining pathology and combination limits.
- The 报告 treats capacity to walk briefly in the examination room as proof of durable 工作能力.
方法和依赖前核对
- Did the assessor consider standing and walking tolerance?
- Were 手术 and rehabilitation records complete?
- Is the work aggravation of arthritis explained?
- Are 多重 下肢 issues combined correCTly?
- Does the 报告 separate impairment from 工作能力 properly?
- Being able to walk a short distance does not necessarily answer durable 工作能力, but WPI and 工作能力 remain different questions.
- A successful operation can still leave permanent impairment, but the 报告 must explain the remaining impairment method.
- The maximum lower-limb rating is limited by the relevant 截肢 value.
这如何影响 Section 66、周薪和 work injury damages
SIRA 资料说明，身体伤害的永久伤残赔偿通常需要达到 11% 或以上 permanent impairment；primary psychological injury 通常需要达到 15% 或以上。secondary psychological injury 在 NSW 中有不同处理。
这些门槛不是赔偿承诺。实际影响要看 accepted injury、医学证据、MMI、评估方法和保险公司如何使用该百分比。WPI 可能影响 Section 66 lump sum compensation、medical expenses 时间限制、weekly payments 策略，以及是否需要 work injury damages 门槛建议。
Guideline notes
- NSW lower extremity assessment modifies AMA5 Chapter 17.
- Where several methods are available, the assessor should use the most clinically accurate permitted method and explain combination rules.
常见问题
髋、膝、腿、脚踝和足部 的 WPI 可以自己计算吗？
不应自行套用 AMA5 或网上表格。WPI 应由受训评估医生按 NSW 指南、accepted injury、检查结果和病历资料评估。你可以复核报告是否使用了正确方法和资料。
髋、膝、腿、脚踝和足部 评估为什么要等 MMI？
MMI 代表伤情已经稳定到适合评估永久影响的程度。如果治疗、手术或康复仍可能明显改变情况，过早评估可能不可靠。
如果保险公司报告偏低怎么办？
先索取报告和发给评估医生的资料。核对 accepted injury、身体系统、影像、手术、治疗、工作限制和任何扣减理由，再决定是否需要争议或进一步证据。
髋、膝、腿、脚踝和足部 会影响 work injury damages 吗？
可能会。WPI 可能影响门槛和策略，但 work injury damages 还需要单独考虑 negligence、past economic loss、future economic loss 和证据一致性。不能只用百分比判断整个案件。
一般资料
本页仅提供一般信息，不构成法律意见。你应就自己的情况取得法律建议，再依赖 WPI 百分比、接受一次性赔偿或回应保险公司决定。
Reviewed by NSW Work Injury Claims - a branch of Stephen Young Lawyers.
相关伤害和评残页面
需要复核 WPI 评估吗？
如果百分比与 accepted injury、治疗史、影像、手术、岗位要求或现有限制不一致，在接受保险公司立场前应先复核报告。