Workers' Compensation Claim Forms

Two-part claim form:

• employee provides details of claim;
• employer provides details of employment & comment on claim. Must be accompanied by a Medical Certificate providing a diagnosis.

Last Updated: 23 July 2007

This form is to be completed if you wish to claim compensation for the work-related death of an Australian or ACT government employee.

Last Updated: 1 January 2008

This form is to be completed by the employer for the work-related death of an Australian or ACT government employee.

Last Updated: 1 January 2008 

Comcare's version of a Doctor's Certificate. Form should be completed by the employee's treating Doctor.

Last Updated: 4 Sep 2002

Form to be used by employee when claiming for the cost of medical treatment, such as a doctor's consultation.

Last Updated: 5 Nov 2004

Form to be completed by employee and employer when an employee wants to claim for any time off work.

Last Updated: 27 July 2004

This form is to be completed if you wish to claim for an aid or appliance

Last Updated: 27 July 2004

This form is to be completed if you wish to claim for household help or attendant care

Last Updated: 27 July 2004

For claims relating to EDITION 2 of the Guide to the Degree of Permanent Impairment. On this form, employee provides their own assessment of the degree of their impairment. A doctor must also provide comment.

Last Updated: 9 February 2006

Form to be used by employee when claiming for the cost of household services ('home help')

Last Updated: 27 July 2004

Employee signs this form to permit Comcare, or an Approved Rehabilitation Provider, to obtain medical information from doctors, hospitals etc.

Last Updated: Feb 2007

For use by claimants whose incapacity benefit is paid directly into their bank account & who wish to advise a change in bank account details

Last Updated: 27 July 2004