Primary sources used
Plain English answer
How this assessment usually works
Psychological impairment assessment in NSW is not simply an AMA5 Chapter 14 exercise. The NSW guidelines use a substitute psychiatric impairment approach, and the distinction between primary and secondary psychological injury can decide whether permanent impairment compensation is available at all.
The assessor does not decide legal liability. The assessment is a medical opinion about permanent impairment under the NSW workers compensation guidelines. The legal importance is what the percentage does to Section 66, weekly payments, medical expense time limits, settlement strategy or work injury damages preparation.
Step 1
Accepted injury
Check the accepted injury wording, body system and mechanism before looking at the percentage.
Step 2
Medical method
Check whether the correct NSW guideline method, clinical findings and records were used.
Step 3
Claim effect
Check what the WPI percentage changes before accepting a report or settlement position.
How the assessment pathway is usually built
A useful WPI report should show its working. For psychological injury, the pathway usually needs these steps before anyone relies on the percentage.
First decide whether the accepted injury is primary psychological injury or psychological symptoms secondary to a physical injury. That classification can change whether a psychiatric WPI assessment is available.
Check that the assessor is an appropriately trained psychiatrist using the NSW psychiatric impairment method, not a generic AMA5 Chapter 14 percentage.
Confirm the primary psychiatric diagnosis, diagnostic reasoning, treatment history, medication, hospital history and course of symptoms over time.
Review each Psychiatric Impairment Rating Scale (PIRS) area: self-care, social/recreational activity, travel, relationships, concentration/persistence/pace and employability.
Keep WPI separate from section 11A, reform strategy, weekly payments and treatment disputes. Those legal questions matter, but they are not the same as the medical rating method.
Assessment method points from the NSW guideline
These points are not a self-calculation tool. They are practical checks for whether the WPI report is using the right body-system method and reasoning.
NSW does not simply use AMA5 Chapter 14 for psychiatric impairment. The NSW guideline substitutes its own psychiatric impairment rating method.
The assessment should be performed by a psychiatrist trained in the NSW method, and the report should identify the primary psychiatric diagnosis with recognised diagnostic criteria.
The Psychiatric Impairment Rating Scale (PIRS) considers self-care and personal hygiene, social and recreational activities, travel, social functioning, concentration/persistence/pace and employability.
The report should use concrete functional examples for each PIRS category, not only labels such as mild, moderate or severe.
Primary psychological impairment is assessed separately from physical impairment. The results of primary psychiatric and physical assessments cannot be combined into one WPI number.
Secondary psychological injury is treated differently and receives no separate permanent impairment assessment for Section 66 purposes, although it can still matter for treatment, capacity and damages evidence.
The assessor should explain whether any pre-existing psychiatric condition has contributed to impairment and how any deduction is calculated.
A psychiatric WPI report is not a liability decision. It does not by itself answer whether section 11A or other legal defences apply.
What can change the WPI percentage
The final percentage can move because of method selection, objective findings, surgery, pre-existing deduction, or how multiple impairments are combined. These are the practical pressure points for this injury type.
- PIRS class allocation across the six functional domains and whether the examples given support the class chosen.
- Whether the diagnosis is current, work-related and stable enough for permanent assessment.
- Treatment response, ongoing therapy, medication, relapse pattern and functional consistency across records.
- Any deduction for pre-existing psychiatric impairment and whether it is reasoned under the same psychiatric method.
- Whether symptoms are primary psychological impairment or secondary symptoms flowing from physical injury, pain, disability or claim stress.
What the assessor usually checks
- whether the claim is accepted as primary psychological injury or secondary symptoms after a physical injury
- whether section 11A or management-action issues affect liability
- psychiatric diagnosis, treatment history and current functional impact
- whether symptoms have stabilised enough for impairment assessment
- whether physical injury impairment and primary psychological impairment are being kept separate
Evidence that may help
A useful WPI report depends on the material the assessor receives. These records often matter for psychological injury:
- GP notes, psychologist or psychiatrist reports and medication history
- workplace chronology, incident material and insurer liability notices
- certificates of capacity dealing with attendance, concentration, interaction and reliability
- rehabilitation provider notes and failed return-to-work attempts
- records explaining whether symptoms arise directly from workplace events or secondarily from physical injury consequences
Common insurer or report disputes
- the insurer says the condition is secondary and cannot support permanent impairment compensation
- the insurer says work was not a substantial contributing factor
- section 11A is raised in response to management action
- the diagnosis is accepted but capacity impact is understated
- the assessment mixes psychological impairment with physical impairment contrary to NSW rules
Report cautions before relying on the percentage
Report red flags
- The report uses AMA5 mental-and-behavioural language rather than the NSW PIRS method.
- Primary and secondary psychological injury are blurred together without explaining the consequence for permanent impairment.
- PIRS categories are selected without functional examples.
- The insurer uses a low or unavailable psychiatric WPI to ignore psychological symptoms in weekly payments or treatment disputes.
Method and reliance checks
- Is the injury pleaded and accepted as primary psychological injury, or are symptoms secondary to a physical injury?
- Does the report explain diagnosis, treatment, functional history and PIRS classes?
- Does each PIRS category contain examples from records or clinical interview rather than conclusory labels?
- Has any pre-existing psychiatric impairment deduction been reasoned under the same method?
- Are section 11A and NSW reform issues being kept separate from the medical impairment rating?
- Does the report explain whether psychological symptoms affect work capacity, treatment or damages even if they do not produce a separate WPI rating?
- A diagnosis alone does not decide psychiatric WPI; functioning over time matters.
- Secondary symptoms may still affect weekly payments, treatment, work capacity and damages evidence even if they are not separately rated for permanent impairment compensation.
- Psychological injury pages should be legally reviewed because NSW reform and section 11A issues may change strategy.
Guideline notes
- NSW Chapter 11 replaces AMA5 Chapter 14 for psychiatric impairment.
- The guideline states secondary psychological impairment receives no separate permanent impairment assessment.
Questions to ask when the report comes back
How this connects to thresholds and strategy
SIRA says permanent impairment compensation generally requires 11% or more permanent impairment for physical injury, and 15% or more for primary psychological injury. Secondary psychological injury is treated differently. Those thresholds are not a payout promise; they are eligibility and strategy checkpoints that need to be applied to the accepted injury and current evidence.
A low WPI opinion may also affect weekly-payment planning, treatment time-limit issues, dispute posture, and whether work injury damages threshold advice is required. The safest approach is to review the method, evidence and consequences before signing or letting the insurer rely on a weak assessment.
Questions workers often ask
Is psychological injury assessed the same way as every other injury?
No. NSW permanent impairment assessment depends on the accepted injury, body system, medical evidence, maximum medical improvement and any NSW-specific guideline modification. The assessment method for psychological injury should be checked against the injury actually accepted in the claim.
Can I calculate the WPI percentage myself?
No. A trained permanent impairment assessor must perform the assessment. A worker can still check whether the report used the correct injury description, records, body system, causation assumptions and deduction reasoning.
What if the insurer report seems too low?
Ask for the report and the material sent to the assessor. For psychological injury, compare the report against treating records, imaging, specialist material, work duties and certificates of capacity before accepting the percentage or relying on it for settlement strategy.
Does maximum medical improvement matter?
Yes. SIRA guidance says permanent impairment assessment should occur when the condition has stabilised and is unlikely to change substantially in the next year with or without treatment. If treatment is incomplete, the timing may need review.
General information only
This information is general in nature and is not legal advice. You should obtain advice about your own circumstances before relying on a WPI percentage, accepting a lump sum offer, or responding to an insurer decision.
Reviewed by NSW Work Injury Claims - a branch of Stephen Young Lawyers.
Related injury and impairment pages
- Psychological injury
- Primary vs secondary psychological injury
- Secondary psychological injury
- Section 11A psychological injury
- Psychological symptoms and work capacity
- WPI assessment guide
- AMA5 and NSW permanent impairment guide
- Section 66 lump sum guide
- Lump sum WPI service
- Work injury damages
- Free claim check
Need a WPI assessment checked?
If the percentage does not match the accepted injury, treatment history, imaging, surgery, work duties or current restrictions, get the report checked before accepting the insurer position.