Pursuant to the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, evaluation of impairment of the spine is only to be done using diagnosis-related estimates (DREs). You may have heard the terms “you were assessed at DRE II”. So what does that actually mean and how many WPI percentage does that represent? 

There are a total of five (5) DRE categories for the assessment of the lumbar spine. To qualify for a particular category of DRE, you must satisfy certain criteria. Each category includes a range to account for the resolution, or continuation of symptoms and their impact of the ability to perform Activities of Daily Living (ADL).  

In assessing the injured worker to the correct DRE category, there are two approaches that the medical assessor may use. The first is based on reported symptoms, signs and appropriate diagnostic test results. The second is based on the presence of a fracture and/or dislocations.  

Some of the common symptoms reported by injured workers are pain, tenderness, restricted range of motion, unable to bend, difficulties with twisting, standing or sitting for prolonged periods of time. More severe lumbar spine injuries may include symptoms such as radiating pain and numbness into the lower limbs. From our experience of representing hundreds of injured workers, these are the most commonly reported symptoms of a lumbar spine injury.  

After determining the diagnosis, the medical assessor will use clinical findings to place the injured worker’s condition in a DRE category that is most appropriate. The common clinical findings the doctor will assess are the following: 

  • Muscle spam – this is a sudden, involuntary contraction of a muscle or group of muscles.  
  • Muscle guarding – this is a contraction of muscle to minimize motion or agitation of the injured tissue or area. 
  • Asymmetry of spinal motion – this is sometimes caused by muscle spasm or guarding. 
  • Reflexes – any abnormalities recorded. 
  • Weakness and loss of sensation – to be valid, the sensory finding must be in a strict anatomic distribution. 
  • Atrophy – for reasons of reproducibility, the difference in circumference should be 2cm or greater in the thigh, and 1cm or greater in the arm, forearm or leg.  
  • Radiculopathy – this must be verified. 

Impact of Activities of Daily Living (ADL)

If your lumbar spine injury has affected your ADL, then there may be an increase in the base rating of the DRE category WPI percentage of 0 – 3% WPI. This is only added if there is a difference in activity level as recorded and compared to the injured worker’s ability prior to the injury.  

The Guidelines states the following: 

“Increase base impairment by: 

  • 3% WPI if the worker’s capacity to undertake personal care activities such as dressing, washing, toileting and shaving has been affected 
  • 2% WPI if the worker can manage personal care, but is restricted with usual household tasks, such as cooking, vacuuming and making beds, or tasks of equal magnitude, such as shopping, climbing stairs or walking reasonable distances 
  • 1% WPI for those able to cope with the above, but unable to get back to previous sporting or recreational activities, such as gardening, running and active hobbies etc.” 

Next, we will look at what are the criteria for “verified radiculopathy” and some examples of WPI permanent impairment assessment rating for lumbar spine injury. 

If you have sustained a work-related lumbar spine injury, or any work-related injury, we highly recommend you seek legal advice. The Head of our NSW team, Jessica Cheung is an Accredited Specialist in Personal Injury Law specializing in workplace injuries. If you believe you have sustained a work-related injury and would like professional legal, reach out to Jessica and her team for a confidential discussion at no costs to you.   

*The intention and purpose of this article is to be used as a guide only. 

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