Shoulder Injury at Work Claim: What NSW Workers Do

A shoulder injury at work claim in NSW follows the same process as any other workers compensation claim, but the shoulder tends to cause more confusion than most body parts. Pain often builds over weeks rather than arriving with one obvious incident, imaging frequently shows changes that were already there, and overhead work is hard to modify. Knowing how the claim runs, and what rehab usually looks like, makes the first few weeks far less messy.

How shoulders get injured at work

The mechanisms cluster into a few groups. Sudden overload from catching a falling object, a slip where you grab a rail, or lifting a load away from your body. Falls onto an outstretched arm or directly onto the point of the shoulder, which is how AC joint injuries and some fractures happen. And gradual onset from repeated overhead or end-range work: electricians, painters, warehouse pickers, hairdressers, carpenters, nurses doing patient transfers.

The diagnoses you are most likely to see on a certificate include rotator cuff tendinopathy or tear, subacromial pain, AC joint sprain, labral injury, and shoulder bursitis. Neck-related referred pain also shows up as shoulder pain and is worth ruling in or out early, because the rehab is different.

Report it before you do anything else

Tell your employer as soon as you can and make sure it goes in the register of injuries. For gradual onset shoulder pain, the injury date is usually recorded as the day you first noticed it affected your work, or the day you first sought treatment. Write down the tasks involved. "Stacking pallets above shoulder height, roughly 200 lifts a shift, four weeks" is far more useful to an insurer than "sore shoulder from work".

Then see a doctor and ask for a certificate of capacity. Your nominated treating doctor coordinates the medical side of the claim and signs off on what you can and cannot do at work.

In NSW the insurer generally has to start provisional payments within seven days of being notified unless they have a reasonable excuse, and provisional liability can cover medical expenses up to $10,000 while liability is being determined. That means physiotherapy can usually start before the claim is formally accepted.

What the physiotherapy assessment looks at

A first shoulder appointment under workers compensation runs about 45 minutes and is as much about your job as your joint.

The physiotherapist takes a history of the mechanism, your symptom pattern, night pain, and any neck or arm symptoms. Then active and passive range in flexion, abduction, external and internal rotation, compared side to side. Strength testing of the rotator cuff and scapular muscles, often with a handheld dynamometer so there is a number to track. Scapular control through elevation and lowering. Cervical screening. Specific tests for the cuff, AC joint and instability, used in clusters rather than one at a time.

The work-specific part matters for the claim. How much weight do you lift, at what height, how often, and for how long? Can you reach the top shelf? Can you hold a tool at head height for two minutes? These answers shape what gets written on the certificate of capacity and what suitable duties your employer can realistically offer.

Imaging, surgery and loaded rehab

Ultrasound and MRI pick up rotator cuff changes in plenty of shoulders that have never hurt, and the rate rises with age. A finding on a scan does not automatically explain your pain or mean you need surgery. Imaging is more useful when there is trauma, significant weakness, or symptoms that are not responding as expected.

Most non-traumatic shoulder presentations are managed with progressive loading. Early work often starts with isometric holds and range within comfortable limits, then moves to rotator cuff and scapular strengthening, then to loaded positions that look like your actual job: overhead press patterns, carries, repeated reaching under fatigue. Progress is guided by how the shoulder responds over the following 24 hours, not by how it feels during the exercise.

If a surgeon is involved, rehab usually follows their protocol, with sling periods, range restrictions and strengthening timelines set by the procedure.

Returning to duties with a shoulder restriction

Shoulder restrictions are among the easier ones to accommodate if the conversation happens early. Common modifications include capping lift height below shoulder level, limiting single-arm loads, rotating off overhead tasks every 20 to 30 minutes, moving stock to waist-height racking, and reallocating ladder work. Driving, keyboard work and supervisory duties are often available while the arm is loaded conservatively.

Your physiotherapist can write to the insurer and the return-to-work coordinator with the specific capacities measured in the clinic, which is more useful than a blanket "light duties only". Reassessment every few weeks lets restrictions change as capacity changes.

When to get it checked

See a doctor promptly if you cannot lift your arm after an injury, if there is obvious deformity, if you have numbness or weakness down the arm, or if night pain is waking you regularly. For gradual onset pain, the sensible point is when it starts changing how you do your job, rather than waiting until you cannot do it at all.

SportsFit Health & Rehab works with injured workers in Five Dock and across the Inner West, including SIRA-registered physiotherapy and exercise physiology under NSW workers compensation. Call the clinic to book an assessment for a work-related shoulder injury.