Making a claim

What is a certificate of capacity?

Usually completed by the worker’s nominated treating doctor, the certificate of capacity is used in the NSW workers compensation system to describe the nature of a worker’s injury/illness, their capacity for work, and the treatment required for a safe and durable recovery.

The certificate of capacity provides essential information to the insurer, including:

• the worker's name and details
• the type of injury/illness (diagnosis) and date it occurred
• information on the planned treatment
• how the injuries impact the worker's ability to do normal activities including work
• the details of the medical practitioner who completed the certificate including their provider number.

The certificate should not (in most instances) exceed 28 days. A certificate of capacity form is available on the SIRA website.

How is it used?

The certificate of capacity is the primary tool for the nominated treating doctor to communicate with the worker’s employer and the insurer.

The insurer uses the information in the certificate of capacity to make decisions about the worker’s capacity for work, and their entitlement to compensation.

The certificate allows the insurer to facilitate a tailored approach to the worker’s injury management, and plan for their recovery at work.

Workers must have a valid certificate of capacity in order to claim workers compensation and ongoing weekly benefits. They are responsible for maintaining a current, completed certificate of capacity and providing it to the employer or insurer.

Second and subsequent certificates of capacity

In response to the COVID-19 (Coronavirus) pandemic, temporary provisions are in place to allow SIRA approved treating physiotherapists and psychologists to issue certificates of capacity in some circumstances.

After the worker’s nominated treating doctor has assessed the full health needs of the worker and provided an initial (first) certificate of capacity, the second and subsequent certificates may be issued by the worker’s approved treating physiotherapist or treating psychologist.

The Certificate of capacity – treating physiotherapist or psychologist form is available on the SIRA website.

Worker declaration

While the majority of the certificate of capacity is completed by the nominated treating doctor (or approved treating physiotherapist or psychologist), there are two sections that the worker is required to complete:

Injured person's consent

The worker must sign the injured person’s consent (section 1) on each certificate issued. This allows stakeholders including the nominated treating doctor, other health-related practitioners, the insurer, the employer and SIRA to exchange information for the purposes of managing the worker’s injury and associated compensation claim.

Employment declaration

The worker must complete and sign the employment declaration with details of any employment (paid, voluntary or self-employment) they have been engaged in since the last certificate of capacity was submitted. This declaration must be signed on each certificate of capacity issued.

Certificates covering earlier periods of incapacity

Certificates must be dated on the day of the examination by the nominated treating doctor (or approved treating physiotherapist or psychologist). A doctor may however certify that a period of incapacity occurred prior to the date of examination.

In accordance with the Medical Council of New South Wales medical certificate guidelines, a certificate may be issued after a worker is away from work. The medical certificate should:

• state the date the certificate was issued
• cover the period during which the doctor believes the patient would have been unfit for work (for example, the patient was treated at emergency and is now visiting their treating doctor at their earliest convenience, or the symptoms were such that the worker could not visit the doctor at an earlier time)
• a certificate of capacity however, cannot relate to a period more than 90 days before the date of completion by the medical practitioner.