The scheme

What a permanent impairment assessment actually decides

A permanent impairment assessment is a measurement made under published guidelines. The percentage it produces is narrow, and it controls more of a workers compensation claim than its narrowness suggests.

General information, not legal advice. This page sets out how the law generally applies. It does not take account of your circumstances, and you should get advice about your own situation before acting on it. The official sources this page is written from are listed on it; where they differ from anything here, they are the authority.

Last updated: 23 September 2026

If you have been asked to attend a permanent impairment assessment, or a medical assessment certificate has arrived and you are not sure what it means, this page sets out what is being measured, who measures it, and what turns on the result.

The short version is that the assessment is a clinical measurement of the injury, expressed as a percentage, made under a set of guidelines that the assessor is required to apply. It is not a view about how much pain you are in, how your work has changed, or what the injury has cost you. It is still the figure that decides which parts of the scheme remain open to you. If you want the shape of the whole claim first, start with how the scheme works.

What is being measured, and what is not

The New South Wales scheme treats permanent impairment as its own question, separate from the two entitlements most people meet first. Weekly payments are about your capacity to work and are reassessed as that capacity changes. Medical and treatment expenses are about what treatment is reasonably necessary. Permanent impairment is a measurement of what the injury has permanently done to the body.

That distinction catches people out. A worker whose life has been changed completely can be assessed at a low figure, and a worker with a modest assessment can still be off work. The assessment is not measuring your job, your income or your household. Those matter elsewhere in the scheme and in a work injury damages claim, not in the percentage itself.

Because the measurement is of what is permanent, when it is made matters. Whether an injury has settled enough to be assessed can itself be in issue, and it is dealt with in the guidelines the assessment is made under rather than left to preference.

Who assesses it, and under which guidelines

Where the degree of permanent impairment is in dispute, it is dealt with through the Personal Injury Commission’s medical pathway. The Commission publishes that most disputes in that pathway are about the degree of permanent impairment caused by a work-related injury, and that its medical assessors are independent medical specialists appointed by the Commission who have worked across a range of specialties.

An examination arranged by the insurer earlier in a claim is a different thing, whatever the letter calls it, and so is a report obtained by your own side. Both can be part of the material, but the Commission’s published statement about a binding assessment is about a medical assessor’s certificate, not about every medical report on the file.

The measurement is not made at large. It is made under the NSW Workers Compensation Guidelines for Evaluation of Permanent Impairment, which the Commission publishes in its resources library alongside the regulator’s copy. The Commission’s page records the fourth edition as reissued on 1 March 2021. Check which version governs your claim, because the 2025 and 2026 amendments included changes to injury assessment.

The Commission’s damages pathway describes the impairment threshold for work injury damages as assessed by a trained permanent impairment assessor. Not every doctor who treats you is one.

The medical assessment certificate, and what final and binding means

The Commission publishes that a medical assessor provides it with a Medical Assessment Certificate setting out the assessor’s independent and unbiased assessment of permanent impairment, and that the assessor’s assessment of the degree of permanent impairment, as set out in that certificate, is final and binding on the parties.

That phrase is doing real work. It does not mean a decision by the insurer is final. It means that once a Commission medical assessor has certified the degree of impairment, the parties and the Commission proceed on that figure, and the ordinary way to change it is not to argue about it but to appeal it.

The Commission publishes that a party may appeal against a medical assessment to a medical appeal panel, made up of a Commission member and two medical assessors, with the assessor who made the original assessment excluded from the panel. The grounds on which an appeal can be brought, and the procedure for it, are set out in the Commission’s procedural directions, including Procedural Direction PIC6 on medical assessments and Procedural Direction PIC7 on appeals, reviews, reconsiderations and correction of obvious errors in medical disputes.

An appeal against a medical assessment has its own period and it is short. It runs from the date the certificate was issued, not from the date you understood it or the date someone explained it to you. No day count is published on this site; take it from the certificate and the Commission.

Why the percentage decides what else is open to you

This is the part that is usually missed until it is too late. The assessment is not a side issue in the claim: several other parts of the scheme are gated on the figure it produces.

Lump sum compensation for permanent impairment. The Commission lists entitlement to lump sum compensation for permanent impairment among the disputes decided in its legal pathway, alongside weekly compensation, medical and related expenses compensation, and payments in respect of the death of a worker.
Work injury damages. The Commission publishes that a worker must have sustained injuries resulting in permanent impairment at or above a level fixed in the legislation, as assessed by a trained permanent impairment assessor, before a damages claim against the employer is open. The figure is not printed here, because the one that matters is the one in force for your claim, read against your own assessment.
Having taken the statutory lump sum first. The Commission also publishes that a worker must have received all statutory lump sum entitlements for permanent impairment to which they are entitled before the damages route is available. The order of these steps is not optional.
Fault, which the statutory scheme does not require. Damages are different in kind. The Commission publishes that the worker needs to establish that the injury resulted from the employer's negligence, for example by not providing a safe working environment. A prefiling statement must be served, and all parties must participate in mediation at the Commission, before court proceedings.
Which body parts were assessed. The Commission lists which body parts were injured, and the amount of compensation payable, among the things decided in a legal dispute. An assessment deals with what was referred to it, so what was left out of the referral is as important as what was in it.

If liability itself is still in dispute — whether the scheme covers the injury at all — that argument usually has to be resolved first. See liability disputes.

Before the assessment

An assessment is an examination by a specialist you have not met, who will see you once, and whose certificate may be the most consequential document in your claim.

Take the claim number, the certificates of capacity, the imaging and specialist reports you have, and a written list of every part of the body you say was injured and every symptom you still have. Describe an ordinary day, not your worst one and not your best one. If something was missed at the start — a second injury, a condition that developed later — say so, and say when it began.

What was recorded at the beginning tends to matter more than anything argued afterwards. The guides on notifying an injury at work and certificates of capacity deal with those early documents in detail, and when a decision goes against you covers the procedure around an insurer decision. If you are back at work on restricted duties while this is going on, return to work deals with that separately.

The 2025 and 2026 amendments changed injury assessment

The Personal Injury Commission publishes that the Workers Compensation Legislation Amendment Act 2025 and the Workers Compensation Legislation Amendment (Reform and Modernisation) Act 2026 were assented to in late 2025 and early 2026, and that the amendments included changes to injury assessment, claims management, available entitlements and how disputes are decided.

The reform has been commencing in stages. The Commission records that some of the changes commenced on 27 March 2026, and that the Workers Compensation Legislation Amendment Regulation 2026 was published on 26 June 2026 and outlined further amendments which commenced on 1 July 2026. Its workers compensation pages carry a standing notice that their content may change as the reforms are implemented.

The Commission also publishes that there are significant changes to the eligibility for entitlements for primary psychological injuries notified after 1 July 2026. It does not set out on that page what those changes are.

The practical consequence is that when an injury was notified can decide which version of the rules, and which edition of the guidelines, governs its assessment. If your claim involves a psychological injury, do not assume that anything written before your claim, including this page, describes the law that applies to it.

The time limits are real, and no number appears here

There is more than one clock running around a permanent impairment assessment, and they are not the same length. Making the claim has its own period. Disputing an insurer’s decision has another. Appealing a medical assessment certificate has a much shorter one that runs from the date the certificate was issued. Commencing court proceedings for work injury damages is a separate limitation period again.

Which period binds you depends on the kind of claim, the injury, when it was notified and what your own document decided. Some can be extended and some cannot. Confirm the period that applies to you before you rely on it. Take it from the document in your hand and from the official sources listed below, and get advice while the period is still running rather than after it has closed.

This is why no day count and no percentage threshold is published anywhere on this site. These periods and figures sit in legislation amended through 2025 and 2026 with parts of it still commencing, and a figure that is right for one claim can be wrong for the next.

Help that does not depend on this site

A permanent impairment dispute can be run without a lawyer, and some are. The Commission accepts self-represented applicants and publishes that while it cannot provide legal advice, it will assist with the procedural aspects of an application. There is also funded and free help that has nothing to do with this page.

Funded legal assistance. The Commission publishes that funding for legal assistance in workers compensation matters is available through the Independent Legal Assistance and Review Service, administered by the Independent Review Office.
Complaints about an insurer. Legal Aid NSW describes the Independent Review Office as an independent body that deals with complaints by injured workers against insurers, including complaints about medical treatment, denials of liability and delays in determining claims.
Free legal information and referral. LawAccess NSW is a free government service providing legal information, referrals and, in some cases, advice. Legal Aid NSW publishes its own information on workers compensation, and describes the Personal Injury Commission as an independent tribunal that helps resolve disputes between workers, employers and insurers.
Before lodging anything. The Commission publishes that a claim must first have been submitted with the insurer, that you may ask the insurer to review its decision, and that in some cases an internal review is required before a dispute can be lodged. Disputes are lodged through the Commission's online Pathway Portal.

If you would rather not work it out alone, tell us what has happened and when the certificate or the letter reached you. A short summary is enough to begin. Please do not send medical records before a conflict check.