3.2.1 Provide certificates | 3.2.2 Further investigation | 3.2.3 Valid Certificate of Capacity | 3.2.4 Who can sign certificates | 3.2.5 Diagnosis | 3.2.6 Extended certificates | 3.2.7 Backdated certificates | 3.2.8 Post-dated certificates
Weekly payments can be paid for any period that is covered by a valid Certificate of capacity, if the certificate:
- relates to the compensable injury. If a Certificate of Capacity refers only to an injury or illness that has not been claimed on the worker’s claim form, weekly payments are not payable for that period. For situations where the diagnosis changes to that stated on the claim form see: Diagnosis.
- complies with the other requirements listed in 3.2.3 Valid certificate of capacity.
When weekly payments can be made without valid certificates
- When a decision to reject a claim for weekly payments or to terminate weekly payments is set aside, the worker is not required to provide Certificates of Capacity for any period between the date the rejection or termination decision takes effect and the date the decision is set aside. This can apply when:
- an Agent agrees to make weekly payments after a rejection or termination, even though there is no formal withdrawal of the notice
- an Agent withdraws (sets aside) a decision to reject or terminate after an internal review
- parties at conciliation agree to withdraw a decision to reject or terminate or the Conciliation Officer issues a direction to set aside a decision to reject or terminate or
- a Court sets aside a decision to reject or terminate.
- If a worker cannot supply an initial valid medical certificate The first medical certificate is for a maximum of 14 days and can only be issued by a registered medical practitioner., they can lodge a referral to the Accident Compensation Conciliation Service (ACCS Accident Compensation Conciliation Service. Workers can refer disputes about Agent decisions to the ACCS.). If ACCS is satisfied that the worker has made all reasonable attempts to obtain a Certificate of Capacity, the worker may apply to the County Court or the Magistrates' Court for a determination of the entitlement of the worker to compensation in the form of weekly payments.
Certificate not required if no entitlement
Certificates of Capacity are not required if the worker is not claiming or entitled to weekly payments. If the worker has a non-entitlement period for example, having received a superannuation lump sum and it is anticipated that the worker will start weekly payments after the non-entitlement period, they should continue to obtain certificates to verify ongoing incapacity.
Content of certificate
Workers are required to complete specific details themselves on the back of the form.
The information provided in the treatment/medication section:
- alerts Agents as to whether any surgical procedure is contemplated.
- allows Agents to reconcile ongoing treatment and medications with the worker's compensable injury and with any medical practitioner referrals, including type and frequency of service.
- allows Agents to consider early referral to allied health and rehabilitation services where appropriate.
To claim weekly payments, a worker must obtain:
- the initial Certificate of Capacity from a medical practitioner
- a continuing Certificate of Capacity from a medical practitioner or other specified THP Treating Health Practitioner
and provide the Certificate of Capacity to their employer (or the Agent if they are a direct payee). Certificates are not considered as having been provided:
- until they are actually received by the employer (or the Agent)
- if they have been given to the worker's legal representative.
Upon receipt of a claim, the employer sends the initial Certificate of Capacity (also known as a medical certificate) to the Agent together with the Worker’s Injury Claim form, the Employer Claim Report and any ongoing Certificates of Capacity.
The employer then forwards ongoing Certificates of Capacity to the Agent as they are received from the worker.
Agent reviews Certificates of Capacity
Agents must check each Certificate of Capacity to see if it is valid, complete and contains the required information.