WorkCover Certificate of Capacity Example: Every Section Explained
Here’s an example of a certificate of capacity that is used in Victorian WorkCover matters.
Below, we detail each section that you’ll find on a certificate of capacity. And here’s a blank copy of the certificate if you need it.
1. Worker details
In this section, your basic details will need to be filled in.
Your name, address, WorkCover claim number. If your claim number isn’t known, the date of injury can be listed.
2. Diagnosis
In this section, the person certifying you needs to indicate the date they assessed you.
They will also need to indicate what their clinical diagnosis is.
For example, it might be ‘right shoulder injury’ or ‘shoulder bursitis’.
3. Capacity assessment
This is an important section on the certificate.
In this section, the person certifying you needs to indicate what restrictions there might be given your injury.
If you have a physical injury, then the person certifying you will need to fill in this section:
For each of those physical functions – eg; sit, stand/walk, squat, kneel etc – the person certifying you will need to indicate whether you can perform those physical functions, whether you can perform those physical functions with modifications, or whether you’re not able to perform the relevant physical function.
If there is addition comments required – such as ‘no lifting above 10kg’ or ‘no repetitive bending’ these can be written here.
If you have a psychological injury, then the person certifying you will need to fill in this section:
For each of the mental health functions listed there, the person certifying you will need to indicate whether a particular function is not affected or affected.
Again, to the right of this is a box for the person certifying you to provide additional comments in relation to your capacity.
Any further functional considerations or additional comments – for example: “taking opiod medication so needs to avoid using heavy machinery” can be noted in this section.
If there are any comments the certifier wants to make in relation to your work environment, they can do so here.
An example might be, if someone has contact dermatitis because of an allergic reaction to cleaning chemicals, the person certifying may note “need to avoid aggravating chemicals and avoid working in hot conditions.”
4. Certification section
This is another important section of the certificate of capacity.
Here, the person certifying you (eg; your General Practitioner) needs to indicate whether you have a capacity for full, unrestricted duties, suitable or modified duties, or no capacity for work at all.
They will need to indicate a date that this capacity starts from. And in the event they certify you as having a capacity for suitable or modified duties, or no capacity for work at all – they will need to indicate a date that the certification goes to.
In this section, the person certifying you is asked to indicate when they estimate you might be able to return to work (this only needs to be filled out if you’re certified as having a capacity for no work – and if the certifier can’t answer it because it is unknown, it can be left blank).
5. Treatment plan
The person certifying you can provide some information regarding your treatment plan.
That is, injury management, what strategies will they implement to increase capacity for work, address return to work barriers, and/or prevent recurrence/aggravation of injury.
An example might be ‘referral to a specialist doctor’ or ‘review in a month with a view to reducing reliance on pain killing medication’.
6. Certifier declaration
In this section, the person that is certifying you will need to note their details and will need to sign the certificate.
They’ll also need to indicate the date the certificate is being completed.
7. Worker declaration
In this section, you as the worker will need to indicate whether, at any time since the last certificate of capacity was provided, you have engaged in any voluntary work or in any form of employment or self employment for which you have received or been entitled to receive payment in money or otherwise.
You’ll need to indicate either yes or no.
Keep in mind however that this is a broad definition.
Say that you’ve been doing dog walking on weekends and you’ve been getting paid in cash.
This should mean that you’d tick yes on the form. And then you’d need to provide details in this section as to the work you’ve been performing.
Underneath that, you’ll need to sign and date the certificate.
| Section | Purpose | Completed By |
|---|---|---|
| Worker details | Identifies the worker | Doctor and worker |
| Diagnosis | Records injury | Treating practitioner |
| Capacity assessment | Records restrictions | Treating practitioner |
| Certification | States work capacity | Treating practitioner |
| Treatment plan | Outlines management | Treating practitioner |
| Worker declaration | Declares work activity | Worker |
Certificate of Capacity FAQs
What is a certificate of capacity?
A certificate of capacity is an official document used in Victorian WorkCover claims. It describes your work-related injury or illness, your capacity for work and any limitations affecting your ability to perform your usual work tasks.
What information is included in a certificate of capacity?
A certificate of capacity generally includes the worker's details, diagnosis, capacity assessment, work restrictions, certification period, treatment plan, certifier declaration and worker declaration. You can see examples of these sections in the certificate screenshots above.
Who can issue the first certificate of capacity?
The first certificate of capacity must be issued by a medical practitioner. This may include a general practitioner, surgeon or psychiatrist. A psychologist cannot issue the first certificate of capacity.
Who can issue an ongoing certificate of capacity?
After the first certificate has been issued, an ongoing certificate of capacity may be issued by a medical practitioner, physiotherapist, chiropractor or osteopath.
How long does a certificate of capacity last?
The first certificate of capacity is generally valid for a maximum of 14 days. An ongoing certificate is generally valid for a maximum of 28 days. A certificate may cover a longer period where special reasons exist.
Do I need a certificate of capacity to receive WorkCover weekly payments?
A certificate of capacity is generally required if you are claiming WorkCover weekly payments because you cannot perform your pre-injury work. It provides medical evidence of your capacity for work during the period covered by the certificate.
Do I need a certificate if I am only claiming medical expenses?
You do not generally need a certificate of capacity if you are claiming treatment expenses only. However, the WorkCover insurer may require other medical information about the treatment and its relationship to your work-related injury.
What do suitable duties mean on a certificate of capacity?
Suitable duties are work duties that take account of your injury, functional capacity, medical restrictions and circumstances. For example, a certificate may permit reduced hours or modified work while restricting lifting, bending, standing or other activities.
Can a certificate say that I have no capacity for work?
Yes. A certifying practitioner may state that you have no capacity for work if your injury currently prevents you from performing any work. The certificate should identify the period for which this certification applies.
Can I work while I have a certificate of capacity?
Yes. Having a certificate does not necessarily mean that you are unable to perform all work. You may be certified as having capacity for unrestricted work or for suitable or modified duties, subject to the hours and restrictions recorded on the certificate.
What should I do if my certificate of capacity is incorrect?
If you believe that your certificate does not accurately reflect your injury, restrictions or work capacity, discuss the issue with the practitioner who issued it. The practitioner can reassess your capacity and issue a revised certificate if appropriate.
Can a physiotherapist issue a certificate of capacity?
Yes. While the first certificate of capacity must be issued by a medical practitioner, ongoing certificates can also be issued by a physiotherapist, chiropractor or osteopath. This is why some workers obtain their ongoing certificates from the practitioner who is regularly treating them.
How long is a certificate of capacity valid for?
The first certificate of capacity is generally valid for a maximum of 14 days. Ongoing certificates are generally valid for up to 28 days, although there can be exceptions in some circumstances.
What happens if my certificate of capacity expires?
If your certificate of capacity expires, it may affect your entitlement to ongoing weekly payments. It is generally a good idea to arrange a review appointment before your certificate expires to avoid any gap in your certification period.
What if I cannot get an appointment before my certificate expires?
Sometimes it can be difficult to obtain an appointment before a certificate expires. If this happens, try to arrange an appointment as soon as possible. Depending on the circumstances, the WorkCover insurer may require additional medical information before determining whether weekly payments are payable for any period not covered by a certificate.
What is the worker declaration section for?
The worker declaration is where you disclose whether you have performed any paid work, self-employment or voluntary work since your previous certificate of capacity. It is not simply a declaration that you have not worked. If you have undertaken any work activities, you should provide details of them in this section.
What does suitable duties mean?
Suitable duties are duties that take account of your injury, current work capacity and medical restrictions. Depending on your circumstances, suitable duties may involve reduced hours, modified work or different duties from those you performed before your injury.
Can a psychologist issue a certificate of capacity?
A psychologist cannot issue the first certificate of capacity. The first certificate must be issued by a medical practitioner. However, psychologists often play an important role in diagnosing and treating workers with psychological injuries.
What needs to be included on a certificate of capacity for a mental injury?
For mental injury claims arising on or after 31 March 2024, the certificate should include a diagnosis consistent with the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). It should also indicate whether the injury has caused significant behavioural, cognitive or psychological dysfunction.
Can my certificate of capacity change over time?
Yes. As your condition changes, so can your certificate. For example, a worker who is initially certified as having no capacity for work may later be certified as having a capacity for suitable duties. Likewise, additional restrictions may be added if symptoms worsen.
This article was last reviewed and updated on September 7, 2026. This article was first published on July 27, 2023.
