Approval criteria and conditions of approval Forms

Form APIA1: Permanent Impairment Assessment – report and certificate
This form is used by the APIA to produce a report certifying a worker’s degree of permanent impairment. The approved permanent impairment assessor is to forward this report to the worker, the employer and the employers insurer.


Form APIA2: Permanent Impairment Assessment – request
This form is used by worker, insurer, or self-insurer to request assessment of workers degree of permanent impairment.


Form APIA3: Permanent Impairment Assessment – requirement to attend
This form indicates a requirement to attend an impairment assessment.


Form APIA4: Permanent Impairment Assessment – provision of information
This form is used when an approved permanent impairment assessor 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 permanent impairment assessor.


Form APIA5: Permanent Impairment Assessment – consent to provision of information
This form is used by an approved permanent impairment assessor 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 APIA6: Permanent Impairment Assessment – condition not stabilised notice
The approved permanent impairment assessor 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 permanent impairment assessor is to forward this report to the worker, the employer and the employers insurer.


Form APIA7: Permanent Impairment Assessment – Psychiatric impairment rating form
The approved permeant impairment assessor uses this form when the impairment assessment involves a psychiatric injury.


Form Permanent Impairment Notice
This form is used by the worker and employer to indicate whether or not the employer agrees with the assessed degree of permanent impairment.


Form Permanent Impairment – further assessment 
This form is used by the employer to request a further assessment if the employer does not agree with the assessed degree of permanent impairment. the cost of further assessment to be paid by the employer.

Publications

WorkCover WA Guidelines for the Evaluation of Permanent Impairment – 1 July 2024
This guide is used by Approved Permanent Impairment Assessors when evaluating the degree of an injured worker’s permanent impairment.


WorkCover WA Guidance Notes for Approved Permanent Impairment Assessors – procedures for the permanent impairment assessment process – Coming soon
Outlines the methodology, process and terminology of the impairment assessment process.