Part 6 psychiatric impairment
How psychiatric WPI is assessed in NSW CTP claims
Psychiatric WPI is assessed by a psychiatrist using the Psychiatric Impairment Rating Scale, not by counting symptoms or converting a diagnosis into a percentage. Six functional tables are rated, the median class and aggregate score are applied to Table 6.17, and any permitted treatment adjustment is considered. Physical and psychiatric WPI remain separate.
Motor accident mechanism
What can happen in a motor accident?
Rear-end crash
Psychiatric impairment may follow direct involvement in a collision and continuing driving or work restrictions.
Side-impact crash
A side impact may lead to a recognised psychiatric illness affecting travel, concentration and relationships.
Motorcycle fall
Severe physical injury and rehabilitation after a motorcycle crash may contribute to a causally related psychiatric illness.
Pedestrian impact
A pedestrian may develop a recognised illness from the accident, injury consequences or witnessed trauma, subject to statutory eligibility and causation.
Injuries and diagnoses that may follow
- PTSD or another recognised trauma-related disorder
- major depressive disorder
- a recognised anxiety or other psychiatric illness
- pre-existing psychiatric impairment with an accident-related additional component
- organic brain-related behavioural disorder, which uses the neurological method rather than PIRS
Symptoms to record accurately
- self-care or personal hygiene difficulty
- reduced social or recreational participation
- travel restriction or inability to use transport independently
- relationship and social-function difficulty
- reduced concentration, persistence, pace or adaptation to work-like settings
Urgent health warning
Any current risk of self-harm, inability to remain safe or acute psychiatric crisis requires urgent clinical assistance rather than waiting for an impairment assessment.
Clinical evidence
What objective findings and records matter?
The psychiatrist’s report should identify the diagnosis and criteria, accident causation, treatment, prognosis, pre-existing impairment and examples supporting each PIRS class. The six tables are not a claimant self-assessment checklist.
| Record or test | What it can establish | What it cannot establish alone |
|---|---|---|
| Psychiatric interview and mental state examination | Establishes diagnosis, current symptoms, causation, consistency and clinical function. | The interview alone should be tested against longitudinal treatment and functional material. |
| PIRS functional history | Examines six defined areas using real examples and sustainable function. | A single activity should not determine an entire class or every table. |
| Treatment and medication record | Supports prognosis and any limited treatment-effect adjustment under clauses 6.222-6.224. | Treatment attendance or medication use does not automatically add WPI. |
| Pre-existing and collateral evidence | Allows a supported pre-existing deduction and tests the post-accident functional change. | A prior diagnosis does not justify an arbitrary deduction. |
Part 5 classification
Is the injury threshold or non-threshold?
WPI and threshold injury are different. A claimant may have a recognised non-threshold illness and still have 10% or less psychiatric WPI. Acute stress disorder and adjustment disorder remain threshold under the Regulation regardless of their diagnostic labels. A PIRS result does not rewrite the statutory classification.
Evidence consistent with a threshold classification
- symptoms not amounting to a recognised psychiatric illness
- acute stress disorder
- adjustment disorder
- a diagnosis or causation finding that is not supported
Evidence that may support a non-threshold injury
- another recognised psychiatric illness with supported criteria and causation
- PTSD or major depressive disorder where properly established
- consistent longitudinal diagnosis and functional evidence
- a reasoned psychiatrist opinion addressing differential diagnoses
Separate questions: threshold injury classification does not set WPI, and receiving statutory benefits does not automatically create a common law damages entitlement.
Part 6 permanent impairment
How is WPI assessed for this injury?
Clauses 6.201-6.228 govern psychiatric WPI. The six PIRS classes are combined through a defined calculation rather than simple addition or averaging. The worked example below explains the verified method but is not a tool for estimating an individual claim.
| Assessment question | Applicable method | Important limit |
|---|---|---|
| Six class ratings | Tables 6.11-6.16 rate self-care, social/recreational activity, travel, relationships, concentration and adaptation from class 1 to class 5. | The examples are indicative and must be applied in the claimant’s context. |
| Median class and aggregate | Clauses 6.225-6.228 arrange the six classes, identify the median and add the six class numbers before using Table 6.17. | The aggregate is not itself the WPI percentage. |
| Treatment adjustment | Clauses 6.222-6.224 permit 0%, 1%, 2% or 3% only where all specified treatment-effect conditions are met. | Medication or treatment alone does not justify an adjustment. |
- A psychiatrist must conduct the assessment.
- Clause 6.203 makes PIRS the controlling method; AMA4 Chapter 14 is background rather than an alternative calculation.
- Organic brain-related mental or behavioural impairment uses clauses 6.156-6.176, not PIRS.
- Pre-existing psychiatric impairment is assessed with the same PIRS method before any supported deduction.
- Physical and psychiatric WPI cannot be combined to determine whether impairment is greater than 10%.
The six PIRS tables
Psychiatric WPI is assessed across six areas of function. A psychiatrist assigns a class from the evidence in each area; the classes are not percentages and are not simply added or averaged.
| Guidelines table | Function assessed | Examples of useful evidence |
|---|---|---|
| Table 6.11 | Self-care and personal hygiene | washing, dressing, meals, medication and ordinary personal routines |
| Table 6.12 | Social and recreational activities | participation, initiation, frequency, support and withdrawal from usual activities |
| Table 6.13 | Travel | independent travel, public transport, driving, unfamiliar routes and support needed |
| Table 6.14 | Social functioning and relationships | family, friends, communication, conflict, isolation and capacity to maintain relationships |
| Table 6.15 | Concentration, persistence and pace | task completion, errors, supervision, breaks, reliability and sustained mental effort |
| Table 6.16 | Adaptation | response to work-like demands, stress, change, attendance and pre-injury roles where relevant |
Verified calculation example from the Guidelines
If the six supported class ratings are 2, 2, 3, 3, 4 and 4, the median class is 3 and the aggregate score is 18. Table 6.17 gives 22% WPI before any valid treatment adjustment. This demonstrates the calculation only. It is not a way to estimate WPI from symptoms without a psychiatrist’s assessment.
What does not establish the result by itself?
- diagnosis alone
- symptom severity scale alone
- adding six class numbers as the percentage
- medication use as an automatic adjustment
- combining physical and psychiatric WPI
Accident-specific examples
Verified PIRS calculation example
The Guidelines example uses class ratings 2, 2, 3, 3, 4 and 4. The median class is 3 and the aggregate score is 18. Table 6.17 gives 22% WPI before any valid adjustment. This only demonstrates the method; actual classes require a psychiatrist’s evidence.
High work restriction but independent self-care and travel
Adaptation and concentration may be affected, while other PIRS areas may fall in different classes. The psychiatrist must assess each area rather than repeat the work restriction six times.
Psychiatric and physical impairment both present
Each stream is assessed independently. They cannot be added to cross the greater-than-10% test for non-economic loss.
Claim file preparation
Evidence checklist
Assessment source
Psychiatric WPI and PIRS source
Assessment source: Motor Accident Guidelines v10.1 clauses 6.201-6.228 and PIRS Tables 6.11-6.17; sections 1.7 and 4.11 of the Motor Accident Injuries Act 2017 for the separate greater-than-10% impairment test.
Threshold injury: PIRS assesses permanent psychiatric impairment. It does not decide threshold classification, and physical and psychiatric impairment cannot be combined for the greater-than-10% test.
What the assessor checks
- six PIRS tables
- median and aggregate calculation
- limited treatment adjustment
- pre-existing deduction using the same method
What does not establish the result by itself
- diagnosis
- symptom score
- simple class addition
- combined physical WPI
Official sources
Related NSW CTP guides
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Frequently asked questions
- Who can assess psychiatric WPI?
- A psychiatrist trained in the PIRS method conducts the assessment under the Guidelines.
- Are the six PIRS class numbers averaged?
- No. The method uses the median class and aggregate score, then Table 6.17.
- Does medication automatically increase WPI?
- No. A limited treatment-effect adjustment is available only if all conditions in clauses 6.222-6.224 are met.
- Can psychiatric and physical WPI be combined?
- No. Each stream must independently be greater than 10% for the relevant non-economic loss test.
- Can I use the worked example to estimate my WPI?
- No. It explains the calculation only. A psychiatrist must assign each class from the full clinical and functional evidence.