NSW Workers Compensation – WPI Assessment of the Lumbar Spine (Part 2)

During Part 1 of this topic, we explained how lumbar spine injuries are assessed in the NSW workers compensation scheme, and outlined the common clinical findings that the doctors will assess. We also discussed the impact of Activities of Daily Living (ADL) and how your level of WPI may increase if your ADL has been impacted by your lumbar spine injury.

Pursuant to section 4.27 of the NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, radiculopathy is defined as follows:

“Radiculopathy is the impairment caused by malfunction of a spinal nerve root or nerve roots. In general, in order to conclude that radiculopathy is present, two or more of the following criteria should be found, one of which must be major (major criteria in bold):

  • loss or asymmetry of reflexes
  • muscle weakness that is anatomically localised to an appropriate spinal nerve root distribution
  • reproducible impairment of sensation that is anatomically localised to an appropriate spinal nerve root distribution
  • positive nerve root tension (AMA5 Box 15-1, p 382)
  • muscle wasting – atrophy (AMA5 Box 15-1, p 382)
  • findings on an imaging study consistent with the clinical signs (AMA5, p 382).”

It is important to note that radicular complaints of pain or sensory features (such as “radiating pain” or “pins and needle” or “numbness”) but cannot be verified neurological findings (somatic pain, non-verifiable radicular pain) do not alone constitute radiculopathy.

Finally, we would like to provide some examples of the common lumbar spine injuries and examples of WPI permanent impairment assessment rating for each type of the injuries:

  • Soft tissue injury – 0% WPI (DRE I)
  • Single disc bulge with no radiating pain – 5-8% WPI (DRE II)
  • Discectomy surgery – 10-13% WPI (DRE III)
  • Fusion surgery – 20-23% WPI (DRE IV)
  • Fracture of greater than 50% compression of one vertebral body with unilateral neurologic compromise – 25-28% WPI (DRE V)

We had previously represented an injured worker who sustained an injury to his lower back (lumbar spine) when he was lifting a box at work, weighing approximately 20 kilograms. Our client presented persistent back pain, radiating pain and numbness down into his left leg and foot. Due to the injury, he was no longer able to participate in his social soccer games, and had to receive help from his son to do the lawn mowing at home. His MRI scan showed a herniated disk at L5/S1.

Our Independent Medical Examiner (IME) assessed him at DRE category III plus effects on ADL, equating to permanent impairment of 13% WPI. He was then entitled to make a lump sum compensation claim in the amount of $32,854.50 (inclusive of 5% uplift for back injuries) with a date of injury being 7 August 2021. This was in addition to his entitlement to weekly benefits and treatment expenses.

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 as to be used as a guide only.

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