Whole Person Impairment - WPI

When a worker is injured, the immediate focus is on treatment and recovery. But once the injury has stabilised—meaning it’s unlikely to get much better or worse with further treatment—another important step may take place: a Whole Person Impairment (WPI) assessment.

WPI assessments are a key part of the Workcover process in New South Wales and across Australia. They play a significant role in determining a worker’s long-term entitlements after an injury.

What Is a WPI Assessment?

A Whole Person Impairment assessment is an independent medical evaluation that measures the permanent impact of a workplace injury on a person’s overall functioning.

The assessment is carried out by a doctor accredited by the State Insurance Regulatory Authority (SIRA) using strict medical guidelines (the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment).

The result is expressed as a percentage (%)—for example, a worker may be assessed as having a 10% WPI due to their injury.

Why Are WPI Assessments Done?

WPI assessments are usually arranged when an injury has stabilised and ongoing recovery has plateaued. The purpose is to:

• Determine permanent impairment entitlements: Workers with a WPI above a certain threshold may be eligible for a lump sum compensation payment.

• Assist with settlement of claims: The assessment provides clarity for insurers, employers, and workers about the long-term impact of the injury.

• Guide future planning: It helps establish realistic expectations about return to work, retraining, or other supports needed.

How the Assessment Works

1. Referral: Usually made by the insurer, sometimes at the request of the worker or their legal representative, once the injury has stabilised.

2. Examination: The accredited doctor reviews medical records, imaging, and history, then conducts a physical examination.

3. Impairment Rating: Using the approved guidelines, the doctor applies specific criteria (such as range of motion, functional loss, or neurological signs) to calculate a WPI percentage.

4. Report: A detailed report is issued to the insurer and worker, outlining the assessment, reasoning, and final WPI rating.

   
   

What Does the Percentage Mean?

• 0–9% WPI: No lump sum compensation, but the worker may still receive weekly payments and medical expenses if required.

• 10–14% WPI: Eligible for a lump sum payment for permanent impairment.

• 15% WPI and above: May be entitled to additional benefits, such as access to common law damages (in some cases) and extended weekly compensation.

  
  

Thresholds and Entitlements Can Vary

It’s important to note that thresholds and entitlements can vary depending on the jurisdiction and the type of claim.

• Jurisdictional Differences: While this article focuses on the NSW Workcover system, each Australian state and territory has its own workers’ compensation scheme with slightly different rules. For example, the minimum WPI percentage required to qualify for a lump sum payment or common law damages may differ between states. This means that a worker with the same injury could receive different entitlements depending on where their claim is lodged.

• Physical vs Psychological Injuries: The thresholds are also not the same across injury types. In NSW, for instance:

  • Physical injuries (like back injuries, fractures, or neurological conditions) usually require a WPI of 11% or more to qualify for a lump sum payment.

  • Psychological injuries (such as PTSD, anxiety, or depression caused by workplace trauma) require a WPI of 15% or more to access lump sum compensation. This higher threshold reflects the way psychological impairments are measured under the guidelines and can significantly impact eligibility.

    
    

• Single vs Combined Injuries: Another complexity is that workers who suffer multiple injuries (e.g., a shoulder and a back injury from the same incident) may have their impairments combined to reach a higher WPI percentage. However, injuries from different accidents cannot usually be combined, and psychological injuries are assessed separately from physical ones.

  
  

Because of these variations, it’s critical that workers, employers, and insurers understand the specific thresholds that apply to each case. Independent legal or medical advice is often recommended to ensure entitlements are correctly assessed.

Key Points for Workers and Employers

• WPI assessments are independent—your treating doctor cannot perform them.

• The assessment is final once determined, except in rare cases where there is a significant change in the injury.

• Both workers and insurers can dispute the assessment through the Personal Injury Commission if they disagree with the outcome.

• A WPI rating does not necessarily reflect a worker’s ability to return to employment—it’s a measure of permanent medical impairment, not work capacity.

  
  

Conclusion

WPI assessments are a crucial step in the Workcover journey. They provide a clear, medically guided measure of how a workplace injury has permanently affected a person. For injured workers, understanding the process can help prepare for what to expect. For employers, it highlights the importance of supporting injured staff not only in their immediate recovery but also in their long-term wellbeing.