The Workers' Compensation Claim Form 2B (REG 6AA) is the prescribed form for making a claim for workers’ compensation. In the event of a work related injury, an employer or injured worker may download the form, which should then be completed by both the injured worker and the employer as indicated, in duplicate.

INJURED WORKERS 

• When completing this form please print clearly and answer all questions.
• The more information you give to your employer/insurer the quicker the claim can be progressed
• Retain the information attached to the form for future reference
• When completed, attach your First Medical Certificate and any other relevant documents and give the form to your employer as early as possible after sustaining your injury.

EMPLOYERS

• Once you have received the completed claim form from the injured worker, fill in the employer section and forward to your insurer, together with the First Medical Certificate and any other attached documents within 3 days.
• If you are a self insured employer make sure you advise the injured worker within 17 days of your decision regarding liability for the claim.
• Make sure you give the injured worker the first two pages containing important information on the claims process and entitlements.
• Remember copies of the form must be forwarded to the insurer.
• If the first medical certificate indicates the injured workers will be off work, or unfit for normal duties for more than 3 days, complete the medical practitioner section attached to the claim form and forward to the treating medical practitioner concerned.
  

Click the link under 'Forms' to your right to download a claim form (2B).
Double click on the titles of individual boxes of the form if you need assistance when completing.
Note: Web links contained within the document will only work once you have saved the file on your computer.

To save the file -
1) Right Click on the link 
2) Select 'Save Target As...'
3) Browse to where you want to save the file, and click 'Save'
OR -
1) Left click on the link above
2) Click the 'Save' button on the Adobe Acrobat toolbar
3) Browse to where you want to save the file, and click 'Save'

You can also view some Handy Hints to explain sections of the form.

Other Forms for workers

Form 6 - Declaration in Respect of Worker Not Residing in WA, 1 page

Form 7- Interim Payment of Statutory Entitlements, 1 page 

Workers' Compensation Claim Form (2D) for Dependants of Deceased Workers (Fatality Claims)