Your final certificate of capacity

There’s nothing in the WorkCover legislation (laws) that refers to a “final certificate of capacity”.

So it’s not a legal term, but it is a term you will see used to describe a couple of different concepts.

You might get a “final certificate of capacity” when the person issuing the certificate (usually your GP) is of the opinion that you have a capacity to return to full unrestricted duties.

Once you have a certificate for full duties, you would no longer need to get further certificates unless your capacity changed at a later date.

Once you are certified as having a capacity for full unrestricted duties, you would no longer be entitled to claim weekly payments from the WorkCover insurer, unless either your capacity changes again at a later time, or if you qualify for top-up payments.

If there has been a long-term impact on your work capacity but you do have some capacity for work, it’s very likely that your payments will be terminated at the 130-week mark.

If this happens, your final certificate of capacity may be obtained to reach up to the 130-week mark, as you wouldn’t need them further after that.

In some instances, people have an entitlement to weekly payments beyond 130 weeks.

In such instances their final certificate of capacity may be when they reach retirement age or when their payments are otherwise terminated by the insurer.

Certificates only required when claiming weekly payments

In order to claim weekly payments from the WorkCover insurer if your ability to work is impacted because of your work related injury, illness, or condition, you need to obtain certificates of capacity.

The WorkCover insurer will not pay a person weekly payments unless they have provided a valid certificate of capacity (in some instances, a statutory declaration may suffice).

There is sometimes, however, some uncertainty, as to how long a person needs to continue to get certificates of capacity for, and when a final certificate of capacity is to be obtained.

Read more about when you need certificates of capacity.

If certified as having a capacity for modified duties or no work capacity

If you are getting certified as having a capacity for modified duties only or no work capacity, then, generally speaking, you should continue to obtain certificates of capacity as long as the modified duties certification or the no work capacity certification continues – or until your payments are terminated.

Capacity for suitable/modified duties

No capacity for employment

You should continue to obtain certificates of capacity as long as the modified duties certification or the no work capacity certification continues.

If certified as having a capacity for full duties

If you are getting certified as having a capacity for full unrestricted duties, then this may be the point where you obtain a final certificate of capacity and you will no longer need to obtain certificates on an ongoing basis.

Capacity for pre injury/full duties

The reason for this is that if you are certified as having a capacity for full unrestricted duties, you will not be entitled to claim weekly payments from the WorkCover insurer.

It can be a good idea, if you have been certified as having a capacity for full unrestricted duties, to continue to obtain certificates of capacity for another month or two (sometimes longer – depending upon the nature of your injury and the type of work you do) after you obtain the certificate certifying you as having a capacity for full unrestricted duties.

The reason for this is that even though you may no longer have an entitlement to weekly payments at that point, sometimes a person can be certified as having a capacity for full unrestricted duties and they return to work but find that they are not able to continue working in that role because of their injury.

So they might return to their doctor who changes their certificate from fit for full duties to fit for modified duties (or in some instances, no capacity for work at all).

So, you should make sure that you can actually perform your full duties before you stop getting certificates of capacity.

It’s a good idea anyway to continue to work with your doctor when returning to work to help ensure that you don’t aggravate your injury.

130 weeks of payments and your final certificate of capacity

In order to continue receiving weekly payments after 130 weeks, a person will need to be considered as having no work capacity which is likely to continue indefinitely.

This can be a difficult test for people to meet and remain on weekly payments.

This is because the test requires that they not only are unable to perform their old job, but any job that they are reasonable suited to doing taking into account their skills, training and experience.

And so, if a person does have some capacity for work. (perhaps the person is working on light duties or restricted hours), then the WorkCover insurer is likely to terminate their entitlement to weekly payments moving forward at the 130 week mark.

At this point, if it is clear that a person has no entitlement to claim weekly payments beyond the 130 week mark (if they have a capacity for employment) then they can obtain their final certificate at the 130 week mark and cease obtaining certificates from that point onwards.

However, sometimes the insurer may terminate a persons entitlement to weekly payments at 130 weeks but there is merit in contesting their decision to do so.

In this instance, if a person wishes to contest the insurers decision to terminate weekly payments at 130 weeks they should continue to obtain certificates of capacity until that issue has resolved.

If the matter resolves on the basis of the insurer paying weekly payments for a limited period of time, then a person should have certificates of capacity covering that period.

Their final certificate of capacity would be at the end of the agreed period.

If the matter resolves on the basis that a person is entitled to weekly payments ongoing, then they should continue to obtain certificates on an ongoing basis.

Their final certificate may therefore be obtained down the track if they get certified as having a capacity for modified duties or full duties.

Or if the certification of no work capacity continues and the insurer continues to pay weekly payments, their final certificate of capacity may be obtained once they hit retirement age when they no longer have an entitlement to weekly payments.

Top up weekly payments post 130 weeks

Even when a person is certified as having some capacity for work at or after the 130 week mark, they may still have an entitlement to weekly payments if they’re returned to work.

And therefore they may have a need to continue to obtain certificates.

If a person has returned to work, but working only on a limited basis – whether that be in the job during which they suffered injury, or a new job – but because of their work related injury they are working at least 15 hours per week but they’re not able to increase the hours that they are working and their earnings, they may be entitled to top up payments.

If this applies, a person should continue to get certificates of capacity.

The final certificate of capacity in this situation might be obtained when they no longer have an entitlement to top up payments from the insurer (eg; if they get certified as having a capacity for full unrestricted work).

The same certificate of capacity

The final certificate of capacity that you obtain will be the same blank certificate of capacity as you’ve been using throughout the course of your WorkCover claim.

There is no specific or different final certificate of capacity that you must use.

Conclusion

An injured person’s final certificate of capacity will usually be obtained when a person gets certified as having a capacity for full unrestricted work.

If they are certified as having a capacity for full unrestricted work they will no longer have an entitlement to weekly payments.

It’s really important to note that getting a “final certificate” does not change your ability to claim medical expenses, impairment benefits or common law damages. Your claim isn’t ‘closed’ because you got a final certificate.

If they are certified as having a capacity for full unrestricted work they will no longer have an entitlement to weekly payments.

If an injured person reaches the 130 week mark and they have a capacity for work, their final certificate of capacity may be at this point.

If they have returned to work but on a limited basis at or after the 130 week mark, they may have an entitlement to top up payments from the WorkCover insurer and therefore they should continue to obtain certificates of capacity.

Their final certificate may come if they are later certified as having a capacity for full unrestricted work, or if they reach retirement age.

If a person has no capacity for work at the 130 week mark and they obtain weekly payments ongoing, their final certificate of capacity may be obtained if they are certified as having a full unrestricted capacity for work, or if they reach retirement age.