3.2.6 Extended certificates

Agents may authorise a period beyond 14 days for initial medical certificate The first medical certificate is for a maximum of 14 days and can only be issued by a registered medical practitioner. (first certificate) or 28 days for ongoing Certificates of Capacity (subsequent certificate), if they believe special reasons exist.

Authorise extended certificates

Initial medical certificates that exceed 14 days or ongoing Certificates of Capacity that exceed 28 days are only authorised for the extended period if:

• there are special reasons written on the certificate, explaining why the certificate covers the longer period or
• the Agent has enough information (from the worker's file for example) to infer from the details on the certificate that there is a special reason for an extended certificate and
• the Agent is satisfied that there are special reasons to warrant an extension.

Note: A certificate is valid even if the extended period is not authorised, i.e. the certificate is still valid for 14 days (first certificate) or 28 days (subsequent certificate).

Examples

• spinal cord resulting in paraplegia or quadriplegia
• amputation of major limbs
• major psychiatric disease that requires hospitalisation
• myocardial infarction
• paralysing disease or injury
• severe brain affliction, for example: stroke or brain injury
• surgery
• internal cancer including leukaemia
• hospitalisation.

• the worker depends heavily on others, for example: severe continuing brain damage or quadriplegia
• long haul recovery, for example: paralysing diseases, surgery to vertebrae, paraplegia, serious infection, osteomyelitis, brain abscess or tuberculosis
• permanent incapacity, for example:
• any worker living overseas who has satisfied the Agent before leaving Australia, that they have no current work capacity Under the legislation, unless inconsistent with the context or subject-matter — current work capacity, in relation to a worker, means a present inability arising from an injury such that the worker is not able to return to his or her pre-injury employment but is able to return to work in suitable employment, declared training program and this is likely to continue indefinitely
• an examination by an independent medical examiner confirms that the worker will be continuously incapacitated at the same level
• the worker has been classified as having no current work capacity indefinitely.

Maximum time limit for extended certificates

There is no limit on the maximum length of time for which a Certificate of Capacity Ongoing certificate is issued for up to 28 days and can be issued by a: medical practitioner, osteopath, physiotherapist, chiropractor. can be extended. Each claim must be assessed on its merits. However, the Agent must be satisfied that the worker does not require a review by a health practitioner during the period of the extended certificate.

If the reason for extended certificates is not one of the examples listed above:

• the Agent must be satisfied that the information contained in the certificate is enough to authorise the extended period such as an anticipated return to work date noted on certificate or practitioner is going on leave
• a file note should be made as to the reasons why the extended period has been authorised
• Agents should only approve an extension of the certificate for a period of up to 14 calendar days after the expiry of the 28 day period and
• if the certifier continues to issue certificates for greater than 28 days, Agents should advise the worker and the certifier that further certificates will only be valid for 28 days (or less).

If the Agent is satisfied that a Certificate of Capacity meets the criteria to extend the certificate they must:

• decide the extended period that will be authorised
• advise the worker of the length of time for which Certificates of Capacity will be accepted and of changes to this authorisation
• determine if the authorisation for an extended certificate is a 'one off' or can apply to ongoing certificates.

Community integration program

Workers who participate in the Community Integration Program can obtain certificates that cover periods of up to 12 months.

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3.2.7 Backdated certificates

Commencement date prior to examination date

Where the commencement date of a certificate is prior to the date of examination, Agents and Self-insurers can exercise their discretion to accept the certificate.

Acceptable reasons may include:

• original certificate issued on date of examination is lost and another one reissued

• certificate was due during a weekend or a public holiday, and was issued directly after the holiday period

Agents are to review the circumstances of each claim and ask for necessary information to accept or reject the certificate.

Commencement date more than 90 days before the certificate is provided

Section 167(4) limits the ability of Agents and Self-Insurers to accept certificates of capacity relating to periods more than 90 days before the certificate was provided to the Agent/Self-insurer.

Section 167(4A) which came into effect 1 September 2022, states that if a certificate is for a period more than 90 days before the date that the certificate is provided, and

• the person giving the certificate (the certifier) states in the certificate the special reasons*/information as to why the certificate relates to that period of time, and

• WorkSafe, the Agent or Self-Insurer is satisfied with the reasons provided,

the certificate can be accepted and paid on.

*Assessing 'special reasons'

Special reasons must be stated on the certificate by the certifier. If a certificate is provided without special reasons, the Agent/Self-Insurer must return the certificate, and invite the certifier to provide the reasons for the lateness on the certificate.

The following factors may be considered in assessing the ‘special reasons’ stated on the certificate in determining whether to accept a certificate under this subsection. Note that this is indicative only and not exhaustive:

• evidence of work related injury, and evidence of incapacity from the work related injury (consider how the certificate certifier is able to ascertain the worker’s capacity retrospectively if a certificate is backdated)

• presence of a statutory declaration confirming the worker has not worked during the period

• how far back the certificate extends e.g. marginally beyond 90 days or significantly beyond 90 days

• whether there is any evidence contrary to the special reasons provided by the worker

• whether it would be prejudicial to WorkSafe to accept the backdated certificate in the circumstances

• whether the worker was aware, or reasonably ought to have been aware, of the requirement to provide certificates of capacity

Generally, WorkSafe will consider it appropriate to exercise the discretion to accept certificates under s167(4A) where it is not in dispute that the worker was injured at work and that the worker was incapacitated during the period that the certificate relates to, because of that injury.

1. A GP who consistently treats a worker over a period of time initially provided only attendance certificates. The clinical notes indicate that the GP considered that the worker did not have capacity for employment and it was caused by a work related injury. Subsequently, backdated certificates of capacity are provided.

2. The worker and their treater were unaware of the requirement to provide ongoing certificates of capacity. Once they became aware backdated certificates were issued. Clinical notes demonstrate clear evidence of a work related injury and incapacity.

3. An administrative error had resulted in the certificates of capacity not being issued/provided to the Agent, or the certificates are stated to have been provided at the time but the Agent does not have a record of them on file. The certifier then issued backdated certificates to rectify this issue.

4. The worker had taken reasonable steps to seek a certificate of capacity, however was not able to obtain one (e.g. one treater directing worker to another treater for certificates).

5. An invalid certificate was initially provided within the 90 days, however there was delay in rectifying the invalidity, extending the timeframe beyond 90 days. All other evidence points towards a work related incapacity.

Note that the examples are indicative only and not exhaustive.

Agents and Self-insurers must:

• ensure that the decision to accept, or otherwise, a certificate based on s167(4A) is appropriately file noted

• have appropriate controls in place in relation to making decisions under s167(4A)

• ensure requests are reviewed by an appropriately qualified person preferably via a centralised contact

3.2.8 Post-dated certificates

Post-dated certificates are where a period of incapacity is from a future date. They can be accepted if special reasons are stated on the certificate and the reasons are reasonable.

For example The worker is booked into hospital for an operation to be performed at a date in the future.

Post-dated certificates - greater than 28 days

Any period in excess of 28 days of the date of issue has no effect unless the doctor writes the special reasons on the certificate or there is enough information on the certificate for the Agent to approve the extended period.

See: Extended certificates

Post-dated certificates start two days after examination

If the worker already has a Certificate of Capacity that covers the date of the examination, WorkSafe allows the 28 day period to start two working days after the examination.

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