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Get And Sign Queensland Workers Compensation Medical Certificate Form

(given names)  (surname)   Date of birth  DD / MM / Y Y Y Y Worker’s daytime contact phone number:  Worker’s employer name:  The worker is/was suffering from (list all medical diagnoses relevant to the claim): Diagnosis:  This is a provisional diagnosis (if provisional complete Part B) Worker was first seen at this practice/hospital for this injury/disease on:  DD / MM / Y Y Y Y Worker stated date of injury:  DD / MM / Y Y Y Y Worker’s stated cause of injury (if not previously...

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Instructions and help about Queensland Workers Compensation Medical Certificate

new Queensland work certificate workers allows doctors dentists and nurse practitioners to focus on what recovering workers can do rather than what they can't which supports the earliest possible return to work there are a number of changes from the old worker's compensation medical certificate this film provides an overview are the major changes for more detailed information please refer to the explanatory notes attached to the certificate here are the major changes for certifiers part a contains a new tick box claim is report only to be used when a patient is unsure whether they want to make a claim Part B includes an opportunity for certifiers to give details about the cause of the injury enter this into the mechanism of injury field this new field in Part C allows you to indicate that medication has been prescribed that may impact our workers safe travel work or cognitive function certified the workers capacity for work in Part D whether they can return to their pre-injury role imm

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