主要资料来源
简明答案
简明答案：这类 WPI 评估通常怎样看
肩部、手臂和手部 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
肩部、手臂和手部 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 the exaCT upper-limb part first: shoulder, elbow, wrist, hand, thumb, finger, tendon, peripheral nerve or vascular disorder. The AMA5 upper-extremity chapter uses different conversion pathways for different regions.
Confirm whether impairment is first expressed as digit, hand, upper extremity or 全人伤残（WPI）. The 报告 should show the conversion pathway rather than jump straight to WPI.
Check whether the method is based on range of motion, nerve deficit, 截肢 value, diagnosis-based disorder, arthritis, tendon 伤害, strength or another permitted pathway.
Where movement is measured, the 报告 should explain measurement consistency and whether pain, guarding or inconsistent effort affeCTed the findings.
If several impairments exist in the same limb, the 报告 should explain whether they are added, combined or limited by an 截肢 maximum.
NSW 指南和 AMA5 方法要点
上肢 assessment uses AMA5 Chapter 16 with NSW modifications. The 报告 should identify whether it is rating thumb, fingers, hand, wrist, elbow, shoulder, tendon, nerve or vascular disorder.
Upper-limb impairment is often calculated regionally first and converted to WPI. A sound 报告 should show each conversion step.
多重 impairments for the same joint or limb are not always handled the same way. Some values are added, some are combined, and the final value cannot exceed the relevant 截肢 value.
Range of motion should be measured carefully and consistently. Inconsistent movement findings should not be used without explanation.
Peripheral nerve impairment should identify the nerve, sensory deficit, motor deficit and whether the same loss has already been captured by another method.
Carpal tunnel, digital nerve lesions, tendon rupture, epicondylitis, impingement and overuse conditions need the correCT specific pathway; a diagnosis label alone is not enough.
Strength loss should be used cautiously and only where the Guides permit it; it should not be a back-door rating for pain, effort or a restriCTion already captured elsewhere.
The 报告 should distinguish WPI from praCTical hand use at work. Grip, overhead work, fine motor use and tool handling may be highly important for capacity even where the WPI number is modest.
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。
- Measured aCTive range of motion and whether repeated measurements are consistent.
- Sensory and motor nerve deficit findings, including nerve conduCTion studies where relevant.
- 手术 outcome, residual stiffness, recurrent instability, tendon rupture, hardware and post-operative therapy records.
- Whether the impairment is in the dominant hand may matter funCTionally, although dominance is not a general automatic WPI uplift under Chapter 16.
- Whether strength loss is legitimately rated; AMA5 treats strength as a limited pathway and it should not double-count movement, pain or deformity already captured elsewhere.
评估医生通常会核对什么
- which body part is accepted: shoulder, elbow, wrist, hand, fingers, tendon or nerve
- whether 手术, imaging and therapy notes were available
- range of motion, strength, sensation and funCTional use of the arm or hand
- dominant-hand impaCT and whether the worker's aCTual job duties were recorded
- whether overuse or repetitive work has been treated as work-related aggravation or dismissed as ordinary degeneration
可能有帮助的证据
- ultrasound, MRI, X-ray, nerve conduCTion study or surgical records
- orthopaedic, hand surgeon, neurologist, physiotherapist or hand therapist 报告s
- photos or duty records showing tools, gripping, lifting, keyboarding or repetitive tasks
- certificates of capacity recording lifting, reaching, gripping, overhead work and fine-motor restriCTions
- failed return-to-work records where duties exceeded medical restriCTions
保险公司或评估报告常见争议
- the 报告 treats a tear as degenerative without dealing with work contribution
- dominant-hand restriCTion is understated
- nerve symptoms are recorded but not analysed
- the assessor did not consider 手术 or post-operative stiffness
- capacity for suitable duties is assumed from a limited examination snapshot
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
- The 报告 gives a WPI figure without showing digit, hand, upper extremity or whole person conversions.
- Dominant-hand disability is ignored in the funCTional history even though the worker uses tools, typing, gripping or fine motor tasks.
- A nerve complaint is recorded but the 报告 does not identify sensory/motor findings or the nerve pathway.
- Overuse is dismissed as ordinary degeneration without analysing aCTual repetition, force, posture or work exposure.
方法和依赖前核对
- Was the correCT joint, tendon or nerve pathway assessed?
- Were movement and funCTional restriCTions measured consistently?
- Did the 报告 consider dominant-hand impaCT?
- Was 手术 or therapy outcome included?
- Does the assessment match the aCTual work duties?
- Surgical improvement does not always mean normal funCTion, but post-operative stiffness still needs objeCTive support.
- Overuse 索赔s often need work-duty 证据, not only a diagnosis label.
- Nerve conduCTion results, hand therapy notes and operative findings may change the impairment pathway.
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 upper extremity assessment modifies AMA5 Chapter 16.
- The maximum 上肢 rating cannot exceed the relevant 截肢 value.
常见问题
肩部、手臂和手部 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。
肩部、手臂和手部 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。
肩部、手臂和手部 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。