How Much Compensation for a Shoulder Injury at Work

Ask how much compensation for a shoulder injury at work and you will get a different answer depending on who you ask, because NSW workers compensation is not a single payout. It is several separate entitlements, each calculated a different way. A labourer with a full-thickness rotator cuff tear and a payroll officer with a shoulder impingement can both have accepted claims and end up with entirely different numbers.

Here is how the parts fit together, and where a physiotherapist does and does not come into it.

The four things a NSW claim can pay

An accepted workers compensation claim in NSW can cover weekly payments while your capacity for work is reduced, reasonably necessary medical and related treatment, a lump sum for permanent impairment if you pass a threshold, and in a smaller number of cases, work injury damages where employer negligence is established.

Most shoulder claims involve the first two. The lump sum only comes into play once the shoulder has settled as far as it is going to, and work injury damages is a legal matter handled by a solicitor, not a treating clinician.

Weekly payments follow capacity, not diagnosis

Weekly payments are based on your pre-injury average weekly earnings (PIAWE) and on how much work you can currently do. The entitlement steps down over time. For the first 13 weeks the rate is higher, then it reduces from week 14, with a better rate available to workers who return to at least 15 hours a week. After 130 weeks the rules tighten considerably.

This matters for shoulders specifically because overhead work, ladder work and sustained reaching are usually the first duties to go and the last to come back. A roof plumber may have no capacity for their normal role while still managing eight hours a day of ground-level tasks. The gap between those two things is what weekly payments are covering, and it is the part your certificate of capacity has to describe accurately.

Medical costs and how long they continue

Treatment that is reasonably necessary as a result of the injury is paid by the insurer at SIRA gazetted rates, which is why there is no gap payment for physiotherapy on an accepted claim. Approval is usually granted in blocks against a submitted management plan rather than open-ended.

How long treatment continues after weekly payments stop depends on your assessed degree of permanent impairment. Workers with a low assessed impairment have a defined window, those in the middle band have a longer one, and workers above the higher threshold can access treatment on an ongoing basis. The current time limits and thresholds are published by SIRA, and your insurer should confirm in writing which applies to your claim.

Permanent impairment and the shoulder

A lump sum under section 66 depends on whole person impairment (WPI), assessed by a trained independent assessor using the NSW guidelines based on the AMA Guides 5th edition. For physical injury, the threshold for any lump sum is more than 10 per cent WPI.

Shoulder impairment is largely measured through range of motion. The assessor measures flexion, abduction, internal and external rotation, converts those into an upper extremity impairment figure, then converts that figure to whole person impairment. The conversion is unkind to shoulders. A surgically repaired cuff that regains most of its range can produce a WPI figure below the threshold even though the shoulder still aches at the end of a shift.

Assessment happens once the injury has reached maximum medical improvement, which for a repaired rotator cuff is often six to twelve months post-surgery. Going too early produces a number that reflects a shoulder still in rehab.

What physiotherapy contributes to the paperwork

A treating physiotherapist does not assess permanent impairment or decide what you are paid. What we do contribute is the record. Measured range of motion at each review, strength testing figures, which duties you have resumed and at what hours, and what has changed since the last block of treatment.

That record is what the insurer reads when deciding on further treatment approval, and it is what the nominated treating doctor relies on when writing your certificate of capacity. Vague notes make every later step harder.

Where to get advice about the money

For questions about your specific entitlements, contact your insurer's case manager and ask for the calculation in writing. SIRA runs a claims enquiry line on 13 10 50, and icare can be reached on 13 44 22. The Independent Review Office (13 94 76) handles complaints about insurer conduct and administers funding for legal advice for injured workers, which means you can usually speak to a workers compensation solicitor about a lump sum without paying for it yourself.

What rehab for a work shoulder usually looks like

At our Five Dock clinic, a first appointment for a work-related shoulder injury runs about 45 minutes. We take the mechanism in detail, whether it was a single lift, a fall onto an outstretched arm or a gradual onset from repeated overhead work. Then we test range, rotator cuff and scapular control, and screen the neck, because referred pain from the cervical spine turns up regularly in shoulder claims.

From there we build a loading plan and match it against your actual job demands, including weights, heights and shift length, and report those details back to your doctor and insurer.

If you have a shoulder injury from work and want it assessed properly, you are welcome to book an appointment with us.