主要資料來源
簡明答案
簡明答案：這類 WPI 評估通常怎樣看
慢性疼痛和 CRPS 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
慢性疼痛和 CRPS 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。
Separate 慢性疼痛 from CRPS. NSW excludes AMA5 Chapter 18 慢性疼痛 ratings, but CRPS has a specific NSW pathway.
For 慢性疼痛 without CRPS, identify the underlying diagnosed condition and body system that is aCTually assessed.
For CRPS Type 1, check whether the diagnostic criteria are met, whether the diagnosis has been present long enough, whether more than one physician has verified it, and whether mimicking conditions have been excluded.
For CRPS Type 2, identify the specific nerve 傷害 and then consider the relevant sensory and motor deficit methodology.
Keep pain-related 工作能力, 治療, medication, sleep and secondary 心理 issues in the 索賠 證據 even when they do not create a separate WPI rating.
NSW 指南和 AMA5 方法要點
NSW excludes AMA5 Chapter 18 for 慢性疼痛. Pain is usually assessed through the underlying diagnosed condition rather than as a separate pain rating.
CRPS has a specific NSW pathway. The 報告 should adDREss criteria, duration, signs, symptoms and exclusion of better diagnoses.
For CRPS Type 1, the guideline requires continuing disproportionate pain plus symptom and sign categories, diagnostic duration, verification by more than one examining physician and exclusion of other diagnoses.
The CRPS criteria look at sensory, vasomotor, sudomotor/oedema and motor/trophic symptoms and signs. A 報告 should not say CRPS merely because pain is severe.
CRPS Type 2 requires objeCTive 證據 of a specific nerve 傷害 and then uses the relevant sensory and motor deficit methodology.
The assessor should avoid double-counting pain already allowed for in another body-system rating.
Pain-related sleep disturbance, fatigue, medication effeCTs and distress can still be highly relevant to 週薪賠償 and 工作能力.
Secondary 心理 symptoms from 慢性疼痛 should be considered for 治療 and capacity 證據, but they are not a separate psychiatric WPI rating for SeCTion 66.
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。
- The underlying accepted physical 傷害 if 慢性疼痛 is assessed through another body-system chapter.
- For CRPS, documented symptoms and signs across sensory, vasomotor, sudomotor/oedema and motor/trophic categories.
- Duration, diagnostic confirmation and exclusion of other conditions that can mimic CRPS.
- 證據 of specific nerve 傷害 for CRPS Type 2.
- Whether the 報告 avoids double-counting pain already built into another impairment method.
評估醫生通常會核對什麼
- whether the diagnosis is 慢性疼痛 associated with another 傷害 or CRPS
- the underlying 已接受的傷害 and whether pain is already allowed for in that assessment
- pain 專科醫生, rehabilitation and therapy records
- funCTional impaCT on daily aCTivities, sleep, medication, tolerance and 工作能力
- whether 心理 symptoms are secondary and should not be confused with primary psychiatric impairment
可能有幫助的證據
- pain 專科醫生 and rehabilitation physician 報告s
- treating GP notes recording pain pattern, medication and funCTional effeCT
- physiotherapy, occupational therapy and graded aCTivity records
- 工作能力證明 dealing with endurance, flare-ups, concentration and safe duties
- records explaining CRPS signs, symptom consistency and 治療 response where relevant
保險公司或評估報告常見爭議
- the 保險公司 says pain is subjeCTive and not assessable
- the 報告 double-counts or ignores pain instead of applying the NSW pathway
- CRPS signs are not recorded consistently
- secondary 心理 symptoms are misused to rejeCT capacity 證據
- 治療 is described as excessive without engaging with 專科醫生 reasoning
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 gives a 慢性疼痛 percentage under AMA5 Chapter 18 despite the NSW exclusion.
- CRPS is accepted or rejeCTed without going through the required symptom/sign categories.
- CRPS Type 2 is discussed without identifying a specific nerve 傷害.
- Pain is used to increase WPI twice: once in the body-system rating and again as a separate pain rating.
方法和依賴前核對
- Is pain assessed through the correCT NSW pathway?
- Is CRPS diagnosed and documented clearly?
- Does the 報告 avoid double-counting pain?
- Are secondary 心理 symptoms treated carefully?
- Does 工作能力 證據 refleCT sustainable funCTion?
- Severe pain can be disabling, but NSW WPI 評估 still needs the correCT guideline pathway.
- CRPS should not be assumed from pain alone.
- Pain-related sleep, medication and fatigue may strongly affeCT 工作能力 even when they are not separately rated under AMA5 Chapter 18.
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
- The NSW guideline excludes AMA5 Chapter 18.
- CRPS is assessed under the NSW criteria and relevant extremity impairment method.
常見問題
慢性疼痛和 CRPS 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。
慢性疼痛和 CRPS 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。
慢性疼痛和 CRPS 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。