WorkCover certificate of capacity

What is a WorkCover certificate of capacity?

A certificate of capacity is a document that describes your injury or illness.

It provides an opinion on your capacity to work and any limitations that you have on performing your work tasks.

You need a certificate of capacity if you are making a WorkCover claim and that claim includes a claim for weekly payments.

You also need a certificate of capacity if you have an accepted WorkCover claim and you wish to obtain WorkCover payments because you are not able to perform your pre-injury employment.

If you have a WorkCover claim for medical expenses only, you do not need a certificate of capacity in Victoria.

Here’s an example of a completed certificate of capacity.

When is a certificate of capacity required and not required?

Certificates of capacity are required when;

You have suffered an injury or illness at work and you’re not able to perform your pre-injury duties and you want to claim weekly payments.

Certificates of capacity are not required;

• To claim medical and like expenses
• To claim an impairment lump sum
• To claim a common law lump sum
• If you have not entitlement to claim weekly payments (eg: if you have returned to full time work and there is no restriction on your work capacity).

WorkCover certificate of capacity download If you’re looking for a blank certificate of capacity to download and use, here’s a pdf version you can use.

Certificate of capacity vs medical certificate

A certificate of capacity and a regular medical certificate are two different things.

To be clear, a regular medical certificate will usually look something like this (below):

Whereas a certificate of capacity looks like this (below):

When it comes to WorkCover claims, if you want to claim weekly payments you must have certificates of capacity.

You will not be paid weekly payments unless you have provided certificates of capacity (in some instances, insurers will accept statutory declarations).

A WorkCover insurer will not accept regular medical certificates.

A certificate of capacity is a specific medical certificate that is used in WorkCover matters.

The certificate of capacity not only includes the diagnosis of injury, but also includes a comment by the treating medical practitioner about your work capacity.

Each certificate of capacity will indicate whether a worker has a capacity for full unrestricted duties, modified duties, or no work capacity at all.

Here’s the section on the certificate where the person certifying you needs to indicate what your work capacity is:

A normal medical certificate on the other hand is the type of certificate that you might get from your doctor if you need time off work for a flu or for any other (usually) non-related work condition.

Are certificates of capacity the same for physical injuries and mental injuries?

Yes, the same certificate is used regardless as to the nature of your injury.

There is not separate certificate for physical injuries and mental health related conditions.

Are the certificates of capacity the same for all WorkCover insurers?

Yes, all WorkCover insurers, including self insurers, use the same certificate of capacity.

This means that if the insurer is Gallagher Bassett, the same certificate will be used as the person who has Allianz as their WorkCover insurer, for example.

Who can provide a certificate of capacity?

The initial certificate needs to be completed by a medical practitioner.

This means your GP, a surgeon or a psychiatrist.

Initial certificates must cover no more than a 14 day period.

Subsequent certificates are able to be completed by a medical practitioner or a physiotherapist, chiropractor or osteopath.

These certificates can run for no more than 28 days.

In limited instances (usually if you have a long term injury that’s not likely to change, or you’re heading overseas and can’t see a doctor for a while) you can get certificates that cover up to three months.

However, you can’t just obtain certificates that run for more than 28 days and up to three months. You will need to obtain the permission of the WorkCover insurer first.

What if you think the person certifying you has not certified you correctly?

Sometimes people receive certificates of capacity that certifying people incorrectly.

For example, a practitioner may certify a person as having either a capacity for full duties when they should be certified as having a capacity for suitable employment.

Recently, one of my clients showed me a certificate where she was certified as having a lifting restriction of no more than 10kgs given her injury.

However, her physiotherapist had certified her as having a capacity for full, unrestricted duties.

My advice to her was to go back to her physiotherapist and speak to them about appropriately certifying her on her certificates of capacity.

So if you feel that the person certifying you has perhaps made an error, perhaps not certified you as having the appropriate work capacity, then you should go back and speak to them about it.

The people that certify you – doctors, physiotherapists, psychiatrists, surgeons etc – will all have varying degrees of experience with the WorkCover system and providing certificates of capacity. They won’t always get it right.

What happens if WorkCover certificates are not submitted?

WorkCover payments will not be made by the WorkCover Insurer unless you have provided them with valid certificates of capacity.

In some cases, as mentioned above, the WorkCover Insurer will accept a signed statutory declaration in lieu of a WorkCover certificate or certificates.

However, this is the exception rather than the rule.

What about certificates of capacity and returning to work?

You should not be returning to work unless you have a certificate certifying you either fit for full duties or fit for modified duties.

Sometimes people refer to certificates certifying them with some level of work capacity as fit for work certificates. However, this is not really a term you’ll hear the WorkCover insurer or lawyers (or other people who have experience with the WorkCover system using).

Return to work plans are developed based on the restrictions listed in the certificate of capacity.

Because of this, it is important that the person that is certifying you identifies each restriction on the certificate.

You need to make sure that the person that is certifying you understands the type of work you do and the specific tasks.

Who do I send my certificate of capacity to?

You should provide a copy of the certificate of capacity to your employer or the insurer directly. If you’re comfortable doing so, you should provide a copy of the certificate to both your employer and the insurer.

You should ensure to keep copies of your certificates of capacity.

When is a WorkCover certificate considered invalid?

If it covers more than 28 days it will be rejected by the insurance company.

The exception to this is if the insurer has agreed to allow it to run for more than 28 days as mentioned above.

Some certificates can be three months but you first need the approval from the insurer.

Your first certificate of capacity needs to be for a 14 day period. You can read more about first certificates of capacity here.

A certificate can also be considered invalid if your doctor has not completed it correctly (eg; they haven’t signed it or adequately completed it).

It can also be considered invalid if you haven’t completed the certification section. More on that below.

The declaration section on certificates of capacity

The worker declaration section on a certificate of capacity is a very important section.

This section asks you to indicate whether, during the period the certificate covers (eg; 28 days) you’ve performed any work.

This includes work done with a different employer to the employer you suffered injury with.

It also includes any volunteer work or cash in hand work.

If you have been performing work and do tick yes, in most instances you should be providing the WorkCover insurer with details of your weekly earnings relating to that other work.

If you’re not sure whether you need to tick yes or no here, you should ask your lawyer.

If you don’t have one that you can ask, you can reach out to us via our contact page.

Are certificates able to be backdated?

Certificates of capacity can be backdated for a period of no more than 90 days.

Backdated certificates must still be for periods of not more than 28 days.

So if you are getting certificates backdated for 90 days, in most instances you would four separate certificates covering that 90 day period (not just one certificate covering the period).

You can read more about backdating certificates here.

Does the person certifying me need to speak to my employer about my certificate?

On some occasions the medical practitioner may contact your employer to find out more about your employment and the specific roles that you perform. However, this more often than not does not occur.

When can you stop obtaining certificates of capacity?

You can read about that here.

Can you obtain a doctors letter of capacity instead of a certificate of capacity?

No, a letter from a doctor that provides an opinion on your work capacity is not sufficient for the purposes of claiming weekly payments under the WorkCover system.

You must have certificates of capacity.

Conclusion

A certificate of capacity is a type of certificate that is used in WorkCover matters. It is different to a regular medical certificate.

You will need to have certificates of capacity completed if your ability to work has been impacted and you wish to claim weekly payments from the WorkCover insurer.

In most instances, if you don’t supply the employer and/or insurer with certificates of capacity, you will not receive weekly payments.

Initial certificates can cover no longer than 14 days. Certificates beyond that should cover no more than 28 days (although in limited instances, with the approval of the WorkCover insurer, they can cover up to three months).

Care should be taken to ensure certificates of capacity are fully completed. If a certificate is not fully completed, the WorkCover insurer may not accept it which can impact on weekly payments being made to you.