Claims and rehabilitation forms
- Aids and Appliances (Excluding Hearing Aids) Claim form (PDF 75.4 KB)
- Alterations to a Place of Residence or Work or Modifications to a Vehicle or Article Claim form (PDF 114.5 KB)
- Authority (or Removal of Authority) to Act on Employee's Behalf form (PDF 67.8 KB)
- Authority and Consent for the Collection and Release of Medical Information Pertaining to my Claim form (PDF 101.6 KB)
- Authority and Consent for the Collection and Release of Medical Information Pertaining to my Claim sample form (PDF 106.9 KB)
- Authority and Consent for the Release of Superannuation Information form (PDF 66.3 KB)
- Case Conference (Multiple Claims) Request form (PDF 61.2 KB)
- Case Conference (Single Claim) Request form (PDF 119.7 KB)
- Certificate of Capacity - Use in Best Practice (Bp Premier) guide (PDF 542.2 KB)
- Certificate of Capacity - Use in Genie guide (PDF 89.4 KB)
- Certificate of Capacity - Use in Medical Director guide (PDF 383.9 KB)
- Certificate of Capacity for Work form (PDF 450.1 KB)
- Cessation of Employment form (PDF 76.5 KB)
- Claim for Time Off Work form (PDF 64.9 KB)
- Claim for Time Off Work Online form
- Claim for Time Off Work Online form information for employees (PDF 115.4 KB)
- Claim for Time Off Work Online form information for employers (PDF 117.1 KB)
- Claim for Time Off Work Online form reference guide for employees (PDF 140.8 KB)
- Contact Us Online Enquiry form
- Customer Information System (CIS) Access Request and Rehabilitation Case Manager update form (PDF 137.3 KB)
- Customer Information System (CIS) Agency Update Forms guide (PDF 150.3 KB)
- Customer Information System (CIS) Cost Centre Update form (PDF 118.9 KB)
- Customer Information System (CIS) Login
- Customer Information System (CIS) New Customer Creation form (PDF 96.2 KB)
- Debtor Creation form (PDF 103.1 KB)
- Direct Payments Update form (PDF 63.3 KB)
- Electronic Funds Transfer (EFT) Request form for departments and agencies (PDF 89.4 KB)
- Electronic Funds Transfer (EFT) Request form for injured workers (PDF 87.4 KB)
- Electronic Funds Transfer (EFT) Request form for providers (PDF 85.2 KB)
- Exercise as Medical Treatment Claim form (PDF 114.0 KB)
- Fraud Report Online form
- Hearing Aid Request form (PDF 114.0 KB)
- Household or Attendant Care Services application form (PDF 118.3 KB)
- Incapacity for Work and Record of Earnings (Paid Employment) Claim form (PDF 109.8 KB)
- Incapacity for Work and Record of Earnings (Self Employment) Claim form (PDF 107.8 KB)
- Information Publication Scheme Online Request form
- Journey Claim form (PDF 126.0 KB)
- Lump Sum Redemption section 137 application form (PDF 112.1 KB)
- Medical Services Claim form (PDF 95.9 KB)
- Medication Review form (PDF 67.8 KB)
- Normal Weekly Earnings Advice form (PDF 172.3 KB)
- Normal Weekly Earnings Advice online form reference guide for employers (PDF 113.1 KB)
- Online Claims Lodgement user guide for employers (PDF 124.5 KB)
- Online Forms Employer Login
- Online Forms Super User quick reference guide (PDF 99.9 KB)
- Online Forms Super User Registration form (PDF 110.4 KB)
- Online Forms Super User Registration reference guide (PDF 106.5 KB)
- Parliamentary Injury Compensation Scheme Claim form (PDF 232.2 KB)
- Pay Start Information form (PDF 73.2 KB)
- Periodic Review form (PDF 154.5 KB)
- Permanent Impairment and Non-economic Loss Compensation Claim form (PDF 141.9 KB)
- Permanent Impairment and Non-economic Loss Compensation Claim form notes to assist (PDF 139.9 KB)
- Physiotherapy Treatment notification plan (PDF 111.5 KB)
- Physiotherapy Treatment notification plan explanatory notes (PDF 64.7 KB)
- Psychology or Counselling Extended Consultation Request form (PDF 58.5 KB)
- Psychology or Counselling Treatment notification plan (PDF 128.2 KB)
- Psychology or Counselling Treatment notification plan explanatory notes (PDF 64.0 KB)
- Reasonable Adjustment Request form (PDF 115.7 KB)
- Reconsideration Request form (PDF 112.8 KB)
- Register or Update Email and Bank Details Online form for service providers
- Rehabilitation Assessment or Examination form (PDF 148.4 KB)
- Rehabilitation Assessment or Examination sample form (PDF 171.2 KB)
- Rehabilitation Program Alteration form (PDF 133.9 KB)
- Rehabilitation Program Alteration sample form (PDF 179.1 KB)
- Rehabilitation Program Closure Record form (PDF 158.6 KB)
- Rehabilitation Program Closure Record sample form (PDF 176.3 KB)
- Rehabilitation Program form (PDF 196.3 KB)
- Rehabilitation Program sample form (PDF 274.9 KB)
- Section 45 Election form (PDF 115.3 KB)
- Statement of Financial Circumstances form (PDF 106.4 KB)
- Suitable Duties form (PDF 92.3 KB)
- Suitable Duties sample form (PDF 120.9 KB)
- Supplier Direct Credit Information form (PDF 74.9 KB)
- Update Email and Bank Details Online form for employees
- Work Trial Agreement form (PDF 87.8 KB)
- Work Trial Agreement sample form (PDF 117.8 KB)
- Work-related Death Compensation Claim form (PDF 229.0 KB)
- Work-related Death Compensation Claim information for employers (PDF 150.7 KB)
- Workers' Compensation Claim form (PDF 190.5 KB)
- Workers' Compensation Online Claim form
- Workers' Compensation Online Claim form user guide for employees (PDF 121.8 KB)
- Workplace Rehabilitation Provider Consultant Approval application form (PDF 148.2 KB)
Page last reviewed: 03 March 2020