Certificate of Capacity for your NSW workers compensation claim
One short form carries your diagnosis, your restrictions and your treatment plan — and your weekly payments are made against it.
- The Certificate of Capacity is the document your claim and your weekly payments run on; without a current one, payments stop.
- Our doctors write it in the room at your appointment and lodge it with the insurer the same visit.
- Your next review is booked before you leave, inside the certificate’s validity period, so there is no gap.
Three decisions live inside one form
Capacity, restrictions and treatment. Everything the insurer and your employer do next is read off these three.
Capacity
Whether you have no current work capacity, or capacity for some work. This is the line the insurer reads first, because weekly payments are calculated from it.
Restrictions
The practical limits — lifting, bending, standing, driving, keyboard work, hours per shift. Your employer builds suitable duties from this section, so vague wording here creates a problem on the floor.
Treatment plan
What is being done about the injury: physiotherapy, psychology, imaging, medication, referral onward. Treatment approvals turn on whether the plan reads as reasonable and necessary for the accepted injury.
The certificate is issued on the form approved by the State Insurance Regulatory Authority (SIRA), the regulator for the NSW workers compensation scheme. Each certificate covers a defined period rather than running open-endedly, and how long that period is depends on the SIRA-approved form and on your doctor’s clinical judgement about how quickly your capacity is likely to change. There is no single number that fits every injury, and a doctor who tells you otherwise is guessing.
Source: SIRA, the NSW workers compensation regulator, publishes the approved Certificate of Capacity form and the guidance around it — sira.nsw.gov.au.
The first certificate and the ones that follow
They do different jobs, and the first one carries the most weight.
The first certificate is where the claim gets its shape. It names the injury, records how it happened, connects it to your work, and sets the opening position on what you can safely do. Everything the insurer decides afterwards is measured against that starting point. See a doctor early: the sooner the injury is documented, the stronger your claim.
The certificates that follow are reviews. Each one asks the same questions again — has the diagnosis changed, has capacity moved, is the treatment working, what should the next block look like — and answers them from a fresh examination rather than by copying the previous form forward. A review is also where an over-cautious restriction gets relaxed, or a restriction that turned out to be unworkable in your actual job gets rewritten.
In our clinic that review is a real appointment, not a form handed over the counter. The certificate is written in the room with you, so you can ask what a restriction means before it is lodged, and it goes to the insurer from that visit. Our doctors work alongside our physiotherapists and psychologists on the same file, so the treatment plan on the certificate reflects the care actually being delivered.
What separates a certificate an insurer can act on
The difference between a claim that moves and one that stalls is usually detail, not disagreement.
A diagnosis, not a symptom
“Lumbar disc injury with radiculopathy” gives the insurer something to approve treatment against. “Sore back” does not, and that is a common reason a treatment request goes back and forth.
Duties described in real terms
Your job title tells the insurer nothing. What you actually do — how much you lift, how long you stand, whether you drive, the hours you are rostered — is what makes a restriction usable.
Restrictions that are specific
A weight limit, a time limit, a task exclusion. Specific restrictions protect you and give your employer something concrete to build suitable duties around, instead of a blanket line that suits nobody.
A treatment plan with a next step
What treatment is running, what is being requested, and what happens between now and the next review. An open plan reads as drift; a plan with a next step reads as recovery in progress.
The dates lined up
The period covered, the date of the next review, and the date of injury all consistent with the rest of the file. Mismatched dates are a quiet cause of stalled payments.
Your own account recorded
How the injury happened, in your words, and what has changed since the last review. Your account is evidence; a certificate that omits it leaves the insurer reading half the picture.
What happens when a certificate runs out
Payments are made against a current certificate. When the covered period ends, there is nothing for the payment to attach to.
This is the failure mode we see most often, and it almost never happens because somebody made a decision. An appointment could not be found in time, or the review date passed while everyone assumed somebody else was watching it. The result is the same: weekly payments stop, treatment approvals stall, and the worker chases a form instead of recovering.
It is recoverable. A new certificate re-establishes the position, and the claim carries on. But the interruption lands at the worst possible time, on people who are already down on income, and it is entirely avoidable with one piece of scheduling discipline: your next review is booked before you leave the appointment, inside the period the certificate covers, so the run of certification never breaks.
If your certificate has already lapsed, that is not a reason to wait. Ring us and we will find the appointment that produces the new one, and tell the insurer what is happening in the meantime.
What it costs
On accepted claims, your appointments are billed to the WorkCover insurer, not to you. If your claim has not been accepted yet, we will tell you what applies before you are seen.
Certificates, reviews and the referrals that come out of them are billed to the insurer on accepted claims under the fees order set by SIRA, so the paperwork side of your claim is not something you pay for.
Booking the appointment that produces the certificate
Whether it is your first certificate or your next review, the process is the same.
Ring (02) 7238 7379 or book with our doctor online. Our reception team will ask for your claim number, your insurer, the date of injury and — if you already have a certificate — the date it runs to, so the appointment lands inside the covered period. We hold appointments across Sydney, with telehealth reviews for workers elsewhere in NSW, and the certificate carries the same weight either way.
At the appointment you are examined, the certificate is completed and lodged with the insurer, and the next review is booked before you leave. Where physiotherapy, psychology or imaging is needed, the referral is made from the same visit and onto the same file. You are seeing doctors who complete the certificate every day, which is the practical reason the wording lands correctly the first time and the insurer can act on it without a round of queries.
To read more about the role first, our workers compensation doctor page walks through a first appointment. If you already have a treating doctor and want to move your care across, you can change your nominated treating doctor at any time.
Certificate of Capacity — common questions
What workers ask us most often about the form their claim runs on.
Talk to us first
Not sure what your certificate should say?
Send us where your claim is up to and our team will come back to you with what the next certificate needs to cover. If you would rather talk it through, the call costs nothing.
Call (02) 7238 7379Ask about your certificate
Related reading
Workers compensation doctor
What our doctors do inside the NSW scheme and how a first appointment runs.
Read moreContinueChange your WorkCover doctor
You choose your nominated treating doctor. One call moves your care across.
Read moreContinueBook a WorkCover doctor
Appointments across Sydney and telehealth reviews for the rest of NSW.
Read moreBook the appointment that writes your certificate
Assessment, the Certificate of Capacity, and your next review — handled in the one visit, with the insurer notified the same visit.
Call (02) 7238 7379