Forms

Form 132M Work capacity certificate - workers' compensation

To be completed by treating practitioner

Form 79.1 - Application for renewal single employer self insurance licence

Application for renewal - single employer self-insurance licence

Form 325B - Application for a lung disease examination

An application form for a lung disease confirmation examination under the Worker's Compensation and Rehabilitation Act 2003.

Application form – Rehabilitation and return to work coordinator (RRTWC) course approval

Version 1

Form 1990.182D Application for damages certificate

Includes information on eligibility

Form 132A: Application for assessment of permanent impairment

Form to be completed by a worker to request a permanent impairment assessment.

Application for a premium/policy review

Applying for a premium/policy review

Form 88 - Application for appointment/renewal - accredited provider for workplace health and safety auditor (self-insurance)

Form starts on page five. This application is for individuals wishing to become an accredited workplace health and safety (WHS) auditor (self - insurance) or to renew their accreditation. Includes guide to completing the form (8 pages total).

Form 133/133A: Employer reporting - Injury that may be compensable (reportable injuries)

Form for employers to report injuries that may be compensable (reportable injuries)

Form 79.2 Application for renewal - group employer self-insurance licence

Application for renewal - group employer self-insurance licence

Form 103 - Administrative release form

Employers use this one page form to request information to assist with the rehabilitation and return to work of an injured worker, or request information relating to the review of a decision.

Make a referral to the medical assessment tribunal

Form