Certificate capacity work form 2026

1. Click ‘Get Form’ to open the certificate capacity work form in the editor.
2. Begin with Part A by entering your first name, last name, and date of birth. Fill in your current occupation and the date you were assessed.
3. Document any clinical symptoms or diagnosis in the designated field. Provide comments on physical and mental capacity, as well as any other issues impacting recovery or return to work.
4. Indicate your fitness for work by selecting the appropriate options and providing details for graduated return to work, modified duties, reduced hours, or workplace adjustments if applicable.
5. In Part B, enter the claim number and relevant dates regarding your condition. Specify whether it is an aggravation of a pre-existing condition, a new injury/disease, or a continuing injury/disease.
6. List any factors that may be relevant to your recovery and request a return to work case conference if needed.
7. Complete Part C by affixing your practice stamp or providing contact details. Ensure the medical practitioner’s signature and date are included.

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