WPI dispute (NSW CTP)
WPI (whole person impairment) disputes are technical and evidence-driven. They usually arise where the insurer relies on a medico-legal assessment you disagree with, or where the assessed impairment affects an entitlement pathway.
General information only. The correct pathway depends on the decision type.
1) What WPI is (high level)
WPI is a permanent impairment percentage assessed under prescribed guidelines. It is not simply a diagnosis.
Read: WPI and the 10% threshold.
2) Evidence planning (what often matters)
- specialist reports that address diagnosis and function clearly
- treating records showing stability/permanence where relevant
- imaging and objective findings (where relevant)
- correct assessment methodology for the body system
3) Internal review and PIC medical pathway
Many disputes begin with internal review and may then proceed to PIC medical pathways.
Read: internal review and merit vs medical assessment.
Frequently asked questions
- What is a WPI dispute?
- A WPI dispute is a dispute about a whole person impairment (permanent impairment) assessment. WPI is assessed under prescribed guidelines and can be relevant to certain entitlement thresholds.
- Is WPI the same as non-threshold injury?
- No. Non-threshold injury classification and WPI are separate concepts used for different entitlement questions.
- What evidence helps in WPI disputes?
- Treating specialist evidence, consistent records, relevant imaging, and clear function/permanence evidence are commonly important. The right evidence depends on injury type.
- How is a WPI dispute decided?
- WPI disputes are commonly determined through PIC medical pathways, depending on the decision type and dispute category.
- Does WPI > 10% automatically mean I get damages?
- Not automatically. Thresholds are only one part of eligibility. Liability, causation, and other requirements still matter.