Enquiry form - injured workers

Register your details below if think you may have received incorrect weekly payments for a workers compensation claim between 2012-2018. Once registered, you will be on our database to receive further communications from SIRA on this matter.

There is a separate enquiry form for employers

Required fields are marked with an asterisk (*).

Have you received weekly workers compensation payments? *
Please include claim number if known
Are you still receiving weekly payments *
If you're not, how long were you on weekly payments after 2012:
Insurer name: * Please indicate from the list below your insurer name.
Have you raised a complaint about the calculation of your weekly workers compensation payments previously? Please indicate who you made your compliant with;
Do you consent for SIRA to contact your regarding the information you have provided? *
Do you consent for SIRA share information with icare or your workers compensation insurer? *
Personal details

Privacy statement

Personal information in this form is collected in accordance with the Privacy and Personal Information Protection Act 1998 (PPIP Act). We respect your privacy and are committed to protecting your personal information.

Further information on our privacy policy is available on our privacy page.