About one in ten Australians who have lumbar X-rays has a lumbosacral transitional vertebra. In a minority of them the anatomy causes persistent low back, buttock or hip pain that is treated for years as non-specific strain. The condition is congenital, invisible and fluctuating, and it is usually diagnosed years after the symptoms begin. The file of a person who has it looks inconsistent to anyone who does not know why.

This guide sets out, for employers, human resources and return-to-work staff, claims assessors and case managers, and the lawyers and medical assessors who advise them, what the condition is in the terms a claim file uses, why the record looks the way it does, and how the condition sits within the Australian frameworks that govern work adjustments, leave, workers' compensation, motor accident claims, private health insurance waiting periods, income support and superannuation. It states what each framework provides and what follows from it, and what a medical report needs to contain to answer the question each framework asks. Two further chapters set out what patients report about work and claims, and what the treating clinicians will provide when asked; an appendix gives a template request for medical information.