When an employee sustains an injury at work and enters the Workers’ Compensation scheme, it is crucial to understand the significance and role of the medical certificate in their claim.
Upon visiting a doctor for the first time after the injury, the physician must complete a medical certificate, ideally using the form specified by the Regulator to ensure its acceptance. This doctor will serve as the Treating Doctor, although the injured worker retains the right to change their treating doctor at any time. In cases where a change of doctor may be necessary due to factors such as unavailability (common in medical clinics or regional locations), this should be noted on the medical certificate.
It is imperative that the injured worker has the right to select their own doctor and/or choose their own Treating Doctor.
The medical certificate plays a vital role for the insurer, as it aids in assessing the injured worker’s capacity for work and determining their entitlements. Additionally, it assists the insurer in developing an injury management plan in collaboration with the injured worker and their doctor, facilitating appropriate medical treatment and a return to work.
Employers, Return to Work Coordinators/Injury Managers, and Rehabilitation Providers also rely on the medical certificate to create suitable duties/return-to-work plans, in accordance with legal obligations.
As the most critical document in the Workers’ Compensation process, it is the doctor’s responsibility to ensure that the medical certificate accurately reflects the injured worker’s capacity. The injured worker is responsible for maintaining a current medical certificate throughout the duration of their claim. Failure to do so may result in non-compliance, potentially leading to the suspension of entitlements, including loss of pay.
The medical certificate should clearly state the medical diagnosis using appropriate medical terminology to avoid misunderstandings and must include:
- A clear outline of any restrictions on the injured worker
- Any additional tests/assessments required for a definitive diagnosis, if applicable
- A recovery-focused injury management plan
The information provided on the medical certificate is binding on all parties involved in the claim. All parties are required to adhere to the diagnosis and prognosis detailed in the certificate, whether at work or during non-work-related activities such as household chores, leisure activities, and other domestic tasks.
Ham and Co Consulting 
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