The short version
One form, and the whole claim leans on it
If you have been hurt in a car accident in NSW and you are claiming weekly payments, there is one document your insurer reads more closely than anything else you will ever send it. Not the application form. Not the phone calls. The Certificate of Fitness. It is a short form with a large job: it names the injury, sets out what you can and cannot safely do, records the treatment plan, and covers a defined block of time. Weekly payments are paid against it.
Most people meet it once, in a rushed appointment, and never think about it again until the payments stop. This page explains what it actually decides, who is allowed to sign each one, how long each lasts, what happens when the chain breaks, and what separates a certificate an insurer can act on from one that quietly costs you months.
1. What the Certificate of Fitness is
The Certificate of Fitness is the NSW CTP scheme's medical evidence form. It sits in the same family as the Certificate of Capacity used in workers compensation, and people mix the two up constantly, but they are different documents governed by different rules. If you have a crash that happened while you were working, you may need both: how the two schemes fit together.
Section 3.15 of the Motor Accident Injuries Act 2017 puts the obligation squarely on you. If you are claiming weekly payments, you have to provide certificates of fitness for work covering the whole period you claim, plus a declaration about your employment and what you have been earning. There is a version of the form for a treating physiotherapist or psychologist, published by SIRA as form SIRA08719, alongside the version a doctor completes.
Sources: Motor Accident Injuries Act 2017 (NSW) s 3.15(1); SIRA, Certificates of fitness for motor crash injuries (checked September 2026).
2. What the certificate actually decides
Three things go into it, and each one reaches further than it looks.
The diagnosis. What is wrong with you, in clinical terms, supported by examination findings and imaging where there is any. This is the field that later determines how your injury is classified under the scheme, which in turn determines how long your benefits run.
Your capacity. Whether you have no capacity for work, or some capacity with restrictions, and for how long that is expected to last. This drives the payment. In the first 13 weeks, weekly payments are 95% of the difference between your pre-accident weekly earnings and what you can still earn. From weeks 14 to 78 that steps down to 80% where you have lost all earning capacity, or 85% where the loss is partial. The certificate is what tells the insurer which of those you are.
The treatment plan. What treatment you need, and why it relates to the crash. Treatment approvals are decided on whether the treatment is reasonable and necessary and related to the injury, so a certificate that records the injury vaguely makes every later treatment request harder to approve.
How long the payments can run at all depends on the classification the clinical record supports. Where the injury is a threshold injury, or where you were wholly or mostly at fault, weekly payments and treatment and care are available for up to 52 weeks. Where the injury is not a threshold injury and you were not mostly at fault, weekly payments can run to 104 weeks, and treatment continues for as long as it is reasonable and necessary. That is a very large difference, and it turns on medical evidence written in the first weeks.
Sources: Motor Accident Injuries Act 2017 (NSW) ss 3.6, 3.7, 3.11, 3.12 and 3.28 (checked September 2026).
3. Who can sign it, and why that matters
This is the part of the scheme that most people have never been told, and it is worth reading twice.
The first Certificate of Fitness must be given by your treating medical practitioner. A doctor, and no substitute. That rule is clause 4.68 of the Motor Accident Guidelines, and there is no way around it.
A second or subsequent certificate is different. Clause 4.69 allows it to be given by a medical practitioner, or by your treating physiotherapist or psychologist. So once a doctor has started the chain, the clinician you are actually seeing every week can keep it going.
Source: SIRA, Motor Accident Guidelines 4.68 and 4.69 (checked September 2026).
That is why we ask about all three disciplines when you book. Our doctors, physiotherapists and psychologists work from the same file and the same clinical notes, so the run of certificates does not stop because a doctor's appointment could not be found in the right week. If your physiotherapy is the treatment that is actually happening, your physiotherapist is in the best position to say what your capacity is, and the Guidelines agree.
4. The 28-day limit
Section 3.15(3) of the Act says each certificate must cover a period not exceeding 28 days, and must state the expected duration of your unfitness. There is no long certificate, no six-month certificate, no certificate that carries you through until you feel better.
So the shape of a CTP claim with weekly payments is a chain of 28-day blocks, each one issued before the last expires. Treat it as a standing appointment rather than an errand. The people whose payments never falter are the ones who book the next review while they are still in the room for this one, and that is how we run it: the review that produces the next certificate is booked at the end of the appointment, not chased by text message three days after the last one ran out.
Source: Motor Accident Injuries Act 2017 (NSW) s 3.15(3)(b) (checked September 2026).
5. What happens when a certificate lapses
Payments can be suspended. But the insurer is not allowed to do it silently, and knowing that changes how you should react to the letter.
Before suspending weekly payments for a missing certificate, a CTP insurer must write to you. The letter has to tell you what it needs and what will happen if you do not provide it, allow you not less than 7 calendar days to put it right, and give you the contact details for the Independent Review Office. Those requirements sit in clauses 4.61 to 4.63 of the Motor Accident Guidelines.
Sources: SIRA, Motor Accident Guidelines 4.61, 4.62 and 4.63; Motor Accident Injuries Act 2017 (NSW) s 3.15(7) (checked September 2026).
Seven days is workable, and it is also unforgiving if you leave the letter on the kitchen bench. If one arrives, ring us that day. The fix is an appointment and a certificate, not an argument. It is also worth noticing what this rule tells you about the scheme: the insurer's power here is procedural, and it is answered with paperwork produced on time rather than with a dispute.
6. How it fits with the Application for personal injury benefits
The certificate does not open the claim on its own. The claim is opened by the Application for personal injury benefits, the current form for making a statutory benefits claim in the NSW CTP scheme. The certificate is the medical evidence that goes with it and keeps it alive afterwards.
Two dates decide how much that application is worth to you. Lodge within 28 days of the crash and weekly payments can be back-dated rather than starting from the day you got around to it. Lodge within 3 months and you are inside the ordinary claim period. After the application is in, the insurer must notify you whether it accepts liability for statutory benefits during the first 52 weeks within 4 weeks.
There is also a window before any of that. In the first 28 days after a crash, and at the insurer's discretion, the scheme allows one GP consultation and two allied health treatment sessions before a claim has been lodged. It is a small allowance and it is easy to miss, but it means you can be examined and start treatment while the paperwork is still being sorted out.
Sources: Motor Accident Injuries Act 2017 (NSW) ss 6.13(1), 6.13(2) and 6.19(1); SIRA, Motor Accident Guidelines 4.78 and 4.79 (checked September 2026).
7. What a good certificate contains, and what a vague one costs
A weak certificate is rarely wrong. It is thin. “Neck pain, unfit for four weeks” is not false, and it is also almost useless to the person at the insurer who has to decide something with it.
A certificate that works names the injury with the findings behind it, rather than a symptom. It describes capacity in terms an employer could act on: what weight, what hours, what movements, what driving. It sets out treatment that plainly relates to the crash, so the treatment request that follows has something to stand on. It gives an expected duration instead of leaving the end date blank. And it is consistent with the last one, because a run of certificates that contradict each other invites scrutiny that a straightforward recovery never needed.
Two consequences make this worth caring about. The first is the independent medical examination. Under clause 4.157 of the Motor Accident Guidelines, an insurer's request that you attend a medical examination is ordinarily reasonable where your treating practitioner has not responded to a request for information, or where the information provided was inadequate. Put plainly: a treating clinician who is slow or vague is the reason people get sent to the insurer's examiner. That is within our control, and we treat reporting as part of the job rather than as admin that happens later.
The second is timing on the other side. Once a treatment request is with the insurer, it must be answered as soon as possible and no later than 10 days from receipt. That deadline only helps you if the request went in promptly and was properly supported in the first place.
Sources: SIRA, Motor Accident Guidelines 4.157 and 4.106 (checked September 2026).
There is one more decision the record has to survive. The insurer must notify you whether it accepts liability for benefits beyond the first 52 weeks within 9 months, and that is the point at which the classification of your injury is settled. It is decided on the clinical documentation that already exists by then. Evidence has to be created in the first weeks, not argued for in the ninth month.
Source: Motor Accident Injuries Act 2017 (NSW) s 6.19(2) (checked September 2026).
8. Appointments, cost and how to book
Certificate appointments are booked in person. That is our practice rather than a rule we are quoting at you. A certificate states what you are physically fit to do, and that assessment is better made with you in the room, where range of movement, gait, grip and the neurological examination can actually be tested. Ongoing treatment and reviews can run in person or by telehealth. We see car accident patients in person across Sydney and NSW, with telehealth available for the appointments where it genuinely fits.
On cost: where liability has been accepted, the CTP insurer pays for the consultation and the certificate directly. Doctors in the CTP scheme are paid at the applicable Australian Medical Association rates, and allied health rates are agreed with the insurer before treatment starts, because SIRA does not set a maximum for them. An approved account must be paid within 20 calendar days. Where liability has not yet been accepted, or a particular request has been declined, we tell you where you stand before you are treated rather than afterwards.
Sources: SIRA, Motor Accident Guidelines 4.101; Motor Accident Injuries Act 2017 (NSW) s 3.31(4); SIRA, Fees paid for motor crash health services (checked September 2026).
To book, call (02) 7238 7379 and say it was a car accident, so the right appointment type is set aside and the certificate is not squeezed into a standard consultation. Or use the car accident booking page. Bring the police event number if you have it, the claim number and insurer if you have already lodged, any imaging, and a short note about what your job normally involves. If none of that exists yet, come anyway. The first certificate is what starts it.
Questions we get asked
Six questions about this one form, answered the way we answer them at the front desk.
Before you go
The Certificate of Fitness is a small form that carries a lot. It sets the diagnosis your claim is classified on, the capacity your weekly payment is calculated from, and the treatment plan every later approval refers back to. Each one lasts a maximum of 28 days, the first must come from a doctor, and the ones after that can come from the physiotherapist or psychologist who is already treating you.
Written well and issued on time, it is invisible and everything simply works. Written thinly or allowed to lapse, it is the reason payments stop, treatment requests stall and someone books you in to see the insurer's examiner. It is one of the few parts of a CTP claim that is genuinely within a treating clinician's control, which is why we take it as seriously as we do. If you want to see how the treatment side of the scheme works around it, start with our car accident treatment page.