Claims and rehabilitation forms
Page last reviewed: 8 months ago
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Aids and Appliances (Excluding Hearing Aids) Claim form
(PDF, 75.41 KB)
Application for direct incapacity payments
(PDF, 155.85 KB)
Certificate of Capacity for Work form
(PDF, 229.94 KB)
Cessation of Employment form
(PDF, 152.9 KB)
Customer Information System (CIS) Cost Centre Update form
(PDF, 143.95 KB)
Customer Information System (CIS) New Customer Creation form
(PDF, 96.15 KB)
Hearing Aid Request form
(PDF, 167.46 KB)
CSC and Comcare joint authority form
(PDF, 341.53 KB)
Exercise as Medical Treatment Claim form
(PDF, 114 KB)
Household or Attendant Care Services application form
(PDF, 242.27 KB)
Journey Claim form
(PDF, 125.98 KB)
Lump Sum Redemption section 137 application form
(PDF, 112.14 KB)
Medical Services Claim form
(PDF, 185.04 KB)
Medication Review form
(PDF, 67.8 KB)
Normal Weekly Earnings Advice form
(PDF, 159.55 KB)
Online Claims Lodgement user guide for employers
(PDF, 124.51 KB)
Online Forms Super User Reference Guide
(PDF, 176.54 KB)
Online Forms Super User quick reference guide
(PDF, 99.86 KB)
Online Forms Super User Registration form
(PDF, 110.37 KB)
Pay Start Information form
(PDF, 180.21 KB)
Permanent Impairment and Non-economic Loss Compensation Claim form
(PDF, 240.54 KB)
Physiotherapy Treatment Plan
(PDF, 152.28 KB)
Parliamentary Injury Compensation Scheme Claim form
(PDF, 232.19 KB)
Psychology Extended Consultation Request form
(PDF, 127.06 KB)
Psychology Treatment Plan
(PDF, 105.64 KB)
Online forms - Quick reference guide
(PDF, 142.46 KB)
Customer Information System (CIS) - Quick reference guide
(PDF, 149.13 KB)
Reconsideration Request form
(PDF, 152.72 KB)
Rehabilitation assessment examination form SRC 116
(PDF, 249.26 KB)
Rehabilitation assessment form SRC 343
(PDF, 238.32 KB)
Rehabilitation assessments and examinations checklist
(PDF, 232.32 KB)
Rehabilitation program alteration form SRC 086
(PDF, 261.04 KB)
Rehabilitation program closure record form SRC 041
(PDF, 412.81 KB)
Rehabilitation program form SRC 040
(PDF, 281.17 KB)
Section 45 Election form
(PDF, 66.87 KB)
Statement of Financial Circumstances form
(PDF, 106.44 KB)
Claim for Time Off Work form
(PDF, 136.23 KB)
Work-related Death Compensation Claim information for employers
(PDF, 178.34 KB)
Work-related Death Compensation Claim form
(PDF, 258.83 KB)
Work Trial Agreement form
(PDF, 130.23 KB)
Workers' Compensation Claim form
(PDF, 265.85 KB)