General practitioners perform an integral function in progressing the medical forms for workers’ compensation claims.
General practitioners and medical practitioners are encouraged to use WorkCover WA’s gpsupport website to access a number of supporting resources.
First Certificate of Capacity
- First Certificate of Capacity (PDF – 175kb)
- Explanatory notes – First Certificate of Capacity (PDF – 241kb)
Progress Certificate of Capacity
- Progress Certificate of Capacity (PDF – 187kb)
- Explanatory notes – Progress Certificate of Capacity (PDF – 409kb)
Final Certificate of Capacity
The Clinical Framework for the Delivery of Health Services (Clinical Framework) is an evidence-based guide designed to support healthcare practitioners delivering services to people with compensable injuries. Developed by the Transport Accident Commission (TAC) and the Victorian WorkCover Authority, this framework reflects contemporary research and has been widely endorsed by Australian workers’ compensation jurisdictions, as well as peak health associations.
- Clinical Framework for the Delivery of Health Services (PDF – 1324kb)
WorkCover WA endorses the use of the Clinical Framework by medical and allied health practitioners delivering services to injured workers in Western Australia.
The Clinical Framework outlines five principles shown to deliver optimal recovery and return to work outcomes for injured workers. The principles are:
- measure and demonstrate the effectiveness of treatment
- adopt a biopsychosocial approach
- empower the injured person to manage their injury
- implement goals focused on optimising function, participation and return to work
- base treatment on best available research evidence
We encourage you to use and share the framework with your colleagues, patients (injured workers), employers and workplace rehabilitation providers in working towards optimal outcomes in recovery and return to work.
- Form AMS 1: Request for Assessment by AMS of Degree of Permanent Impairment (Word – 50kb)
This form is used when requesting an Approved Medical Specialist to assess the degree of your permanent impairment.
- Form AMS 2: Requirement for Worker to Attend before an Approved Medical Specialist (Word – 50kb)
This form indicates a requirement to attend an impairment assessment. There are penalties if a worker fails to attend as required.
- Form AMS 3: Requirement to Produce Relevant Documents or Information for an Impairment Assessment (Word – 50kb)
This form is used when an approved medical specialist requires a worker, employer or employer’s insurer to produce relevant documents and information to assist in the impairment assessment. The worker, employer or employer’s insurer must provide relevant documents or information to the approved medical specialist.
- Form AMS 4: Requirement to Consent to Another Party to Produce Relevant Documents or Information for an Impairment Assessment (Word – 50kb)
This form is used by an approved medical specialist when they require consent from the worker, employer or employer’s insurer, for another party to provide relevant documents or information required for the impairment assessment.
- Form AMS 4A: Requirement to Produce Information for an Impairment Assessment (Word – 50kb)
This form is used after an impairment assessment examination, when additional information is required from the worker.
- Form AMS 5: Report on Evaluation of Degree of Permanent Impairment (Word – 130kb)
The approved medical specialist is to produce a detailed Form AMS 5 and forward a copy to both the worker and employer alongside a Form AMS 6.
- Form AMS 6: Certificate of Degree of Permanent Impairment (Word – 50kb)
The approved medical specialist must forward this certificate alongside the Form AMS 5.
- Form AMS 6A: PIRs Rating (Word – 47kb)
Form AMS 5 and 6 may have the PIRs Rating Form attached when a psychological injury is being assessed.
- Form AMS 7: Report on Workers Condition Not Stabilised (Word – 50kb)
The approved medical specialist uses this form when the worker has been assessed, but their injury has not stabilised to the extent required by the Act and the WorkCover WA Guides for the Evaluation of Permanent Impairment. The approved medical specialist is to forward this report to both the worker and the employer alongside Form AMS 8.
- Form AMS 8: Certificate Where Workers Condition Not Stabilised (Word – 50kb)
The approved medical specialist is to forward this certificate to both the worker and the employer alongside Form AMS 7.
- Notice about special evaluations – on or after 12 October 2020 (PDF – 580kb)
- WorkCover WA Guidelines for the Evaluation of Permanent Impairment, fourth edition (PDF 652KB)
This guide is used by Approved Medical Specialists when evaluating the degree of an injured worker’s permanent impairment.
- WorkCover WA Guidance Notes for Approved Medical Specialists Procedures for the permanent impairment assessment process (PDF – 1MB)
Outlines the methodology, process and terminology of the impairment assessment process.
- Fact Sheet: Assessment of Permanent Injuries before and after 14 November 2005 (PDF – 2MB)
Provides guidance in determining the process to be followed when requesting or undertaking a disability or impairment assessment.
- AMS Application Pack – SPECIALIST – Medical Practitioners (PDF – 325kb)
Information on how to apply to become a specialist AMS medical practitioner.
- AMS Application Pack – NON-SPECIALIST – Medical Practitioners (PDF – 334kb)
Information on how to apply to become a non-specialist AMS medical practitioner.
Register of approved workplace rehabilitation providers (WorkCover WA Online)
A register of all WorkCover WA approved workplace rehabilitation providers (WRPs).
Completed applications should be emailed to email@example.com.Applications to become an approved workplace rehabilitation provider
- Guidelines to be approved as a Workplace Rehabilitation Provider (PDF – 294KB)
- Application for Approval as a Workplace Rehabilitation Provider Form (PDF – 318KB)
- Staff Details (PDF – 183KB)
- Renewal application for approval as a workplace rehabilitation provider (PDF – 273KB)
- Staff Details (PDF – 183KB)
- Workplace Rehabilitation Providers Principles and Standards of Practice (Principles and Standards) (PDF – 2.21MB)
The Principles and Standards were developed to outline WorkCover WA’s baseline expectations of WRPs operating in the scheme.
- Principles of Practice for Workplace Rehabilitation Providers (Principles) (External link)
WorkCover WA is a signatory to the Principles developed by the Heads of Workers’ Compensation Authorities, and any organisation seeking to become an approved WRP will need to demonstrate that they conform to the Principles.
Note: “Workplace Rehabilitation” means “Vocational Rehabilitation” as stated in the Workers’ Compensation and Injury Management Act 1981.
- WorkCover WA Online User Guide – Workplace Rehabilitation Providers (PDF – 437kb)
A user guide for WRPs learning to use WorkCover WA Online.
- Information Sheet – WRP Transition from Rehab Online to WorkCover WA Online (PDF – 427kb)
Information on the transition from Rehab Online to WorkCover WA Online.
- Information Sheet – Workplace Rehabilitation – Worker’s Status at Referral and Closure (PDF – 353kb)
Information on declaring a worker’s status at referral and closure of their workplace rehabilitation.
- Information Sheet – Workplace Rehabilitation – Closure Reasons (PDF – 340kb)
Information on valid reasons for closing a workers’ workplace rehabilitation program.
- Form 310: Workplace Rehabilitation Referral (Word – 35kb)
Form used when referring an injured worker to a WRP.
- Form 311: Service Delivery Plan (Word – 40kb)
Form used when developing a service delivery plan.
- Form 312: Workplace Rehabilitation Referral Closure (Word – 40kb)
Form used when closing a worker’s workplace rehabilitation program.
- Consent Form (Word – 38kb)
A form that assists WRPs in advising workers of their rights, responsibilities and conflicts of interest.
- Referral Checklist (Word – 39kb)
A checklist of items that need to be completed upon a worker’s referral to your organisation.
- Initial Assessment Report (Word – 37kb)
The report completed at commencement of a worker’s rehabilitation to assess their current health.
- Progress Report (Word – 33kb)
The report that’s completed throughout a worker’s rehabilitation to track their progress.
- Closure Report (Word – 33kb)
The report that’s completed upon closure of a worker’s workplace rehabilitation.
- NIHL Directory of Service Providers (Word – 196kb)
A directory of approved hearing testers in Western Australia.
- Form 19A: Report of Baseline Audiometric Test (Word – 48kb)
Form used to report a baseline hearing test for workers commencing employment in prescribed workplaces.
- Form 19B: Report of Subsequent Audiometric Test (Word – 128kb)
Form used to report subsequent hearing tests for workers in prescribed workplaces.
- Form 407: Noise Induced Hearing Loss Audiometer Calibration (Word – 94kb)
Form used to verify audiometer calibration is WorkCover WA approved.
- Form 408: Noise Induced Hearing Loss Audiometric Booth Assessment (Word – 131kb)
Form used to assess an audiometric booth.
- Form 409: Worker Requires a Baseline Full audiological Assessment (Word – 43kb)
Form used to notify an employer that their worker requires a baseline full audiological assessment.
- Form 411: NIHL Audiogram Results (Word – 44kb)
Form used to provide results of an audiogram.
- Form 18: Notice of Arrangement of Audiometric Test (Word – 308kb)
This form is used to notify a worker that an audiometric test has been arranged including the appointment details and pre-appointment requirements of the worker.
- Form 410: Request for Baseline Full Audiological Assessment (Word – 50kb)
Form used by employers to request a full audiological assessment of a worker.
- Form 21: Notice of Dispute (noise induced hearing loss) (Word – 120kb)
This form can be used by workers or employers when disputing the results of an audiometric (hearing) test.
- Form 406: Authorisation to Release WorkCover WA Audiometric Test Results (Word – 98kb)
Form used by workers to authorise the release of their audiometric test results to whoever they specify.
- Form 412: Worker’s Consent to Release Hearing Test Results (PDF – 195kb)
This form can be used by a worker to authorise WorkCover WA to release their hearing test(s) results to a nominee.
- Approved hearing testers – Fact Sheet (PDF – 115kb)
A fact sheet developed to educate approved hearing testers of their responsibilities in the scheme.
- Noise Induced Hearing Loss – Audiometric Officer Testing Manual (PDF – 436kb)
A testing manual designed for audiometric officers that demonstrates the steps taken during an audiometric test.
- Hearing Tester Registration and Testing Requirements – Fact Sheet (PDF – 131kb)
A fact sheet outlining the registration and testing requirements of approved hearing testers.
- NIHL Learning Module (PDF – 479kb)
A learning module developed to assist with the assessment of hearing testers seeking approval from WorkCover WA.
- Fact sheet – Case Conferences (Fillable PDF – 535kb)
This fact sheet outlines how a case conference can assist all parties involved in a claim to help an injured worker return to work.