What is a certificate of capacity?
A Certificate of Capacity is an official document required to be completed by a medical professional, which outlines a worker’s injury, illness, capacity to work and limitations or restrictions on regular work tasks. It is a “communication tool” between all parties involved.
Each work injury scheme has their own Certificate of Capacity form to be used.
When is a Certificate of Capacity required?
A Certificate of Capacity is required where a worker is making a claim for wage coverage following a workplace injury or illness, where they are not able to perform their previous employment. It is not required where an employee is only seeking coverage of medical costs associated with a workplace injury or illness.
An initial Certificate of Capacity is required to submit a claim to the work injury scheme. Subsequent Certificates may be required throughout the claims process at determined intervals.
What details do I have to provide?
You will need to provide:
- Worker details (name, address etc)
- Diagnosis
- Capacity Assessment (including whether a task can/ cannot be performed, or can be performed with modifications)
- Additional comments on physical and mental health function and other functional or workplace considerations
- Certificate duration (noting most schemes will only accept the initial Certificate of Capacity for 14 days and subsequent certificates for 28 days)
- An estimated timeframe to return to work
- Treatment plan
- Declaration
Accurate and detailed completion of the Certificate of Capacity can:
- Allow for timely processing of the claim
- Facilitate effective communication between relevant parties
- Help guide decisions about claim acceptance and associated benefits
- Set expectations for the patient around treatment, outcomes and return to work.
Tips:
- Ensure all parts of the form are completed
- Avoid acronyms and jargon
- Write clearly to ensure it is legible
The most jurisdictions the Certificate of Capacity requires a wet signature.
Comcare have developed a factsheet for GPs on assessing a patient’s capacity for work, with the principles being relevant across all schemes.
What are some examples of workplace restrictions or modifications that may be appropriate to support return to work?
These will be specific to the injury and body part affected, and should be detailed.
Restrictions may include:
- Weight limits for lifting [provide limit]
- Maximum time limit for standing [provide time]
- Regular breaks [provide interval]
- Rotation of activities
- No pulling or pushing/bending/squatting/twisting
- Limiting use of arm/s to below shoulder level
- Avoidance of repetitive tasks
- Limiting the hours of work for a day or days for the week [provide limits]
Can I back date a Certificate of Capacity?
No. But you can note on the certificate the date the patient states they were injured or became ill as a result of their work.
Where can I access the Certificate of Capacity form?
Certificate of Capacity forms are available from the website of the relevant work injury scheme.
Patients may also present you with a hardcopy form provided from their employer.
Some Clinical Information Systems (CIS) allow you to access, complete and print a Certificate of Capacity form from within your CIS or attached module i.e. Letter Writer.
Who submits the Certificate of Capacity/claim to the insurer?
The injured/ill employee must provide the certificate to the employer, who will submit it to the insurer. It is up to the employee to choose if they wish to proceed with a claim.
Am I responsible for determining fault or liability in relation to the injury/illness and whether a work injury claim is valid?
No. The insurer will investigate the incident and determine whether a claim will be accepted.
Your history taking and assessment will help make a diagnosis and determine if the medical condition is consistent with the circumstances described by the worker.