Australian Government - Comcare

Return to Work Forms

INFORMATION ABOUT THE RETURN-TO-WORK FORMS:
  • With immediate effect Comcare requests that only these versions of the forms are used and any existing hard copies of the previous forms are destroyed. Comcare suggests that you download the forms and save a version. It is essential to check that all fields of the forms are filled in before the relevant parties sign-off and the forms are distributed.
  • The forms satisfy legal requirements for making a valid determination by including reasons for the making the determination on the forms. They now include an explanation of the role and responsibilities of the supervisor in the rehabilitation and return-to-work process. The forms also inform the rehabilitation authority, and approved provider, that by signing the forms they are entering into an agreement for the provision of particular services.
  • The case closure plan form clarifies that when a suspension of benefits occurs because of an employee's non-compliance, the program can continue to remain open and available. Its closure cannot be construed as the reason for non-compliance by the employee.
  • The forms meet all the requirements of the Privacy Act 1988 in relation to agency obligations when entering into contracts for the provision of services to, or on behalf of, the agency.
  • For further information and to provide feedback about using the forms,
    please ring Comcare on 1300 366 979.
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Work Trial Agreement form (SRC64) [pdf 41 kb]
 

Last Updated: 24 May 2005


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Referral for rehabilitation assessment (SRC116) [pdf 109 kb]

If you require an updated disk version of this form please contact Comcare on 1300 366 979

Last Updated: 11 August 2008

 
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Amendment to referral for Rehabilitation Assessment (SRC248) [PDF 245 kb]

 

Last Updated: 11 August 2008 

 

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Return to Work Plan (SRC40) [pdf 213 kb]

 

Last Updated: 23 July 2008


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Return to Work Plan Amendment Form (SRC86) [pdf 144 kb]

 

Last Updated: 23 July 2008


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Return to Work Plan Closure Form (SRC41) [pdf 79 kb]

 

Last Updated: 6 Jun 2005


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Pre-injury work description form (SRC117) [pdf 116 kb]

 

Last Updated: 16 Jan 2001


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Potential suitable duties form (SRC118) [pdf 206 kb]

 

Last Updated: 27 Oct 2000


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Medical diagnosis and prognosis form (SRC119) [pdf 190 kb]

 

Last Updated: 4 Sep 2002



Page last updated:August 11, 2008