主要資料來源
簡明答案
簡明答案：這類 WPI 評估通常怎樣看
截肢和嚴重傷害 的永久伤残評估不應只看诊断名称或影像结论。重點是 accepted injury、身體系統、maximum medical improvement (MMI)、NSW 指南方法、檢查所見、治療和手術紀錄、以及任何既往傷害或退變扣減是否有證據支持。
簡明答案
已接受的傷害
評估必須從保險公司已接受或正在爭議的傷害範圍開始。傷害描述過窄，可能影響評估方法和證據。
簡明答案
醫學評估方法
評估醫生需要按照 NSW Guidelines 和相關 AMA5 章節處理 MMI、檢查結果、既往扣減和身體系統。
簡明答案
索賠影響
WPI 百分比可能影響 Section 66、medical expenses、weekly payments 和 work injury damages 策略，不能只看數字。
評估路徑通常怎樣建立
截肢和嚴重傷害 的 WPI 報告應說明推理過程，而不只是給出百分比。以下是依賴該百分比前通常需要核對的路徑。
Identify the 截肢 level, affeCTed body part and whether there are additional accepted injuries from the same incident.
Check whether the 報告 uses the relevant upper-limb or lower-limb 截肢 value and conversion pathway.
Assess residual funCTion, prosthesis use, stump symptoms, 皮膚 problems, neuroma, phantom symptoms, balance, transfers, dexterity and safe work tasks.
For serious 傷害 files, coordinate WPI with 治療, prosthetics, OT, rehabilitation, care needs, transport, home modification, 心理 symptoms and 工作能力 證據.
If 多重 body systems are involved, consider whether a lead assessor or coordinated 報告 is needed to avoid missing or double-counting impairment.
NSW 指南和 AMA5 方法要點
截肢 assessment uses the relevant AMA5 tables with NSW modifications, and the rating cannot exceed the applicable 截肢 maximum for that part or region.
Upper-limb and lower-limb 截肢 values follow different regional conversion pathways, so the 報告 should show how the final WPI is reached.
A prosthesis may improve funCTion but does not automatically remove impairment. The 報告 should explain funCTion with and without assistive devices where the guideline requires it.
Residual symptoms such as neuroma, stump pain, 皮膚 breakdown, phantom symptoms or altered gait may affeCT 治療 and capacity 證據, but the WPI method still needs guideline support.
Serious 傷害 files may involve 多重 body systems, prosthetic needs, rehabilitation, OT assessment, 心理 sequelae and work-capacity 證據.
Where several impairments arise from the same 傷害 or incident, a coordinated approach or lead assessor may be needed.
The WPI percentage can affeCT serious-傷害 status, 治療 limits, 週薪賠償 and work 傷害 damages strategy, but it is not a promise of any particular outcome.
Secondary 心理 symptoms should be considered for 治療 and capacity 證據 without incorreCTly combining them as separate psychiatric WPI.
哪些因素可能改變 WPI 百分比
最終百分比可能受評估方法、客觀檢查、手術結果、既往扣減以及多重傷殘合併方式影響。
- 截肢 level and the relevant regional maximum value.
- Residual limb funCTion, prosthetic fit, endurance and complications.
- Additional accepted injuries such as fraCTure, nerve 傷害, 皮膚 breakdown, CRPS, 心理 symptoms or back/neck 傷害 from the same incident.
- Whether any upper-limb or lower-limb ratings exceed the relevant 截肢 maximum.
- The combined effeCT of several body-system 報告s where the same incident caused 多重 impairments.
評估醫生通常會核對什麼
- accepted 截肢 level, traumatic 傷害, 多重 傷害 or catastrophic 傷害 description
- prosthetic, orthotic, OT, rehabilitation and 專科醫生 證據
- whether 多重 physical impairments need coordination by a lead assessor
- impaCT on work durability, safety, daily aCTivities, care and transport
- whether the WPI result changes 週薪賠償, 治療 limits or damages threshold advice
可能有幫助的證據
- operation notes, prosthetic 報告s, rehabilitation plans and OT assessments
- 專科醫生 報告s adDREssing long-term funCTion, aids, care and 治療 needs
- certificates of capacity and vocational 證據
- domestic assistance, home modification and equipment records where relevant
- records of 心理 consequences, treated carefully as primary or secondary depending on the 證據
保險公司或評估報告常見爭議
- the 保險公司 separates issues that need coordinated assessment
- prosthetic or OT 證據 is missing from the impairment review
- capacity is overstated because a device allows limited aCTivity
- secondary 心理 symptoms are ignored for 治療 or capacity issues
- the WPI result is used without checking downstream damages consequences
收到評估報告後要核對什麼
覆核 WPI 報告時要問的問題
報告中的風險信號
- The 報告 rates anatomy only and ignores prosthesis tolerance, 皮膚 breakdown, endurance or safe duties.
- The assessment does not say whether assistive devices were considered correCTly.
- 心理 symptoms, care needs or OT 證據 are ignored because they do not fit neatly into the 截肢 table.
- 多重 serious injuries are handled by isolated 報告s that do not reconcile the final combined WPI.
方法和依賴前核對
- Was a lead assessor needed for 多重 impairments?
- Were prosthetic and OT records included?
- Does the 報告 adDREss praCTical daily funCTion?
- Are 治療 and capacity consequences checked?
- Does the percentage affeCT serious 傷害 or damages strategy?
- A prosthesis may improve funCTion without removing all impairment or work restriCTion.
- Care, transport, home modification and vocational 證據 may matter outside the WPI percentage.
- Serious 傷害 strategy should be reviewed before accepting an assessment that may affeCT 多重 索賠 pathways.
這如何影響 Section 66、週薪和 work injury damages
SIRA 資料说明，身體傷害的永久伤残賠償通常需要达到 11% 或以上 permanent impairment；primary psychological injury 通常需要达到 15% 或以上。secondary psychological injury 在 NSW 中有不同處理。
這些門檻不是賠償承诺。實際影響要看 accepted injury、醫學證據、MMI、評估方法和保險公司如何使用该百分比。WPI 可能影響 Section 66 lump sum compensation、medical expenses 時间限制、weekly payments 策略，以及是否需要 work injury damages 門檻建议。
Guideline notes
- NSW upper and 下肢 chapters use 截肢 maximum rules.
- 多重 body-system files may require coordinated assessment.
常見問題
截肢和嚴重傷害 的 WPI 可以自己計算嗎？
不應自行套用 AMA5 或网上表格。WPI 應由受训評估醫生按 NSW 指南、accepted injury、檢查结果和病历資料評估。你可以覆核報告是否使用了正确方法和資料。
截肢和嚴重傷害 評估為什麼要等 MMI？
MMI 代表伤情已经穩定到适合評估永久影響的程度。如果治療、手術或康复仍可能明显改变情況，过早評估可能不可靠。
如果保險公司報告偏低怎麼辦？
先索取報告和發给評估醫生的資料。核對 accepted injury、身體系統、影像、手術、治療、工作限制和任何扣減理由，再決定是否需要爭議或进一步證據。
截肢和嚴重傷害 會影響 work injury damages 嗎？
可能會。WPI 可能影響門檻和策略，但 work injury damages 还需要单独考虑 negligence、past economic loss、future economic loss 和證據一致性。不能只用百分比判断整個案件。
一般資料
本頁仅提供一般信息，不构成法律意見。你應就自己的情況取得法律建议，再依赖 WPI 百分比、接受一次性賠償或回應保險公司決定。
Reviewed by NSW Work Injury Claims - a branch of Stephen Young Lawyers.
相關傷害和評殘頁面
需要覆核 WPI 評估嗎？
如果百分比與 accepted injury、治療史、影像、手術、崗位要求或现有限制不一致，在接受保險公司立场前應先覆核報告。