主要資料來源
簡明答案
簡明答案：這類 WPI 評估通常怎樣看
肩部、手臂和手部 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
肩部、手臂和手部 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 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 全人傷殘（WPI）. The 報告 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 傷害, strength or another permitted pathway.
Where movement is measured, the 報告 should explain measurement consistency and whether pain, guarding or inconsistent effort affeCTed the findings.
If several impairments exist in the same limb, the 報告 should explain whether they are added, combined or limited by an 截肢 maximum.
NSW 指南和 AMA5 方法要點
上肢 assessment uses AMA5 Chapter 16 with NSW modifications. The 報告 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 報告 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 報告 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。
- Measured aCTive range of motion and whether repeated measurements are consistent.
- Sensory and motor nerve deficit findings, including nerve conduCTion studies where relevant.
- 手術 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.
評估醫生通常會核對什麼
- which body part is accepted: shoulder, elbow, wrist, hand, fingers, tendon or nerve
- whether 手術, 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
可能有幫助的證據
- ultrasound, MRI, X-ray, nerve conduCTion study or surgical records
- orthopaedic, hand surgeon, neurologist, physiotherapist or hand therapist 報告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
保險公司或評估報告常見爭議
- the 報告 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 手術 or post-operative stiffness
- capacity for suitable duties is assumed from a limited examination snapshot
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 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 報告 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.
方法和依賴前核對
- Was the correCT joint, tendon or nerve pathway assessed?
- Were movement and funCTional restriCTions measured consistently?
- Did the 報告 consider dominant-hand impaCT?
- Was 手術 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 索賠s often need work-duty 證據, not only a diagnosis label.
- Nerve conduCTion results, hand therapy notes and operative findings may change the impairment pathway.
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 extremity assessment modifies AMA5 Chapter 16.
- The maximum 上肢 rating cannot exceed the relevant 截肢 value.
常見問題
肩部、手臂和手部 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。
肩部、手臂和手部 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。
肩部、手臂和手部 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。