主要資料來源
簡明答案
簡明答案：這類 WPI 評估通常怎樣看
髖、膝、腿、腳踝和足部 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
髖、膝、腿、腳踝和足部 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 whether the condition is hip, knee, ankle, foot, toe, ligament, meniscus, fraCTure, arthritis, joint replacement, nerve 傷害, vascular problem or 截肢.
Choose the most specific clinically appropriate lower-limb method. The 報告 should not automatically use gait or range of motion when a diagnosis-based or 手術-based method is more accurate.
Check whether the rating starts as lower extremity impairment, foot impairment or 全人傷殘（WPI） and whether conversion is shown correCTly.
Review whether methods can be combined. Gait, atrophy, strength, nerve 傷害, 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 方法要點
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 傷害, 截肢, joint replacement or other lower-limb tables.
The 報告 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 報告 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 報告 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 證據 supports a distinCT 已接受的傷害.
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 seleCTed lower-limb table or method and whether it is the most specific method for the 已接受的傷害.
- Post-operative status after arthroscopy, reconstruCTion, fraCTure fixation, fusion or replacement 手術.
- 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 傷害 has been considered without over-deduCTing the work contribution.
評估醫生通常會核對什麼
- accepted hip, knee, ankle, foot, ligament, meniscus, fraCTure or replacement 傷害 wording
- whether imaging and 手術 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 證據
- whether 多重 lower-limb problems are assessed together or separated correCTly
可能有幫助的證據
- MRI, X-ray, arthroscopy, replacement or fraCTure records
- orthopaedic, rehabilitation physician, physiotherapist and GP 報告s
- 工作能力證明 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
保險公司或評估報告常見爭議
- the 保險公司 says arthritis is the real cause
- the assessment ignores gait, instability or repeated swelling
- 手術 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 傷害 is split in a way that understates overall funCTional effeCT
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
- 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 報告 treats capacity to walk briefly in the examination room as proof of durable 工作能力.
方法和依賴前核對
- Did the assessor consider standing and walking tolerance?
- Were 手術 and rehabilitation records complete?
- Is the work aggravation of arthritis explained?
- Are 多重 下肢 issues combined correCTly?
- Does the 報告 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 報告 must explain the remaining impairment method.
- The maximum lower-limb rating is limited by the relevant 截肢 value.
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 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.
常見問題
髖、膝、腿、腳踝和足部 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。
髖、膝、腿、腳踝和足部 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。
髖、膝、腿、腳踝和足部 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。