What Is a Certificate of Capacity in a WorkCover Claim?

An on-the-job injury is an event every worker dreads. Fortunately, many workers are able to make a full recovery and return to their occupation after an injury or illness. But, if your injury or illness adversely impacts your ability to work, you may be entitled to WorkCover benefits that offset your loss of wages.

You will need a Certificate of Capacity to claim benefits for loss of income. An experienced lawyer can advise you how to get a Certificate of Capacity and what it means for your claim.

The WorkCover lawyers at Henry Carus + Associates have extensive experience helping workers get the benefits they deserve for on-the-job injuries. Contact us today for a free, no-obligation case review.

What Is a Certificate of Capacity?

A Certificate of Capacity is issued in WorkCover claims where the worker suffers a workplace injury or develops an occupational illness that prevents them from working or limits their ability to work. The certificate documents the following:

• Clinical diagnosis of the injury or condition
• Assessment of physical and mental function, including:
  • The worker’s ability to perform physical actions such as standing, walking, bending, squatting, kneeling, and lifting
  • Movement and range of motion of the shoulder, arm, hand, and neck
  • Mental health functions such as concentration, judgment, and short- and long-term memory
• Considerations in the work environment that may affect the worker’s physical and/or mental health
• Certification of capacity for pre-injury employment, suitable employment (i.e., modified or alternative work given the worker’s current capabilities), or incapacity for work
• Prospective timeframe for the worker to return to work
• Details of the treatment plan

Depending on the circumstances, you may need more than one Certificate of Capacity in the course of your WorkCover claim. The first certificate is valid for up to 14 days, while subsequent certificates can cover periods of up to 28 days.

The first Certificate of Capacity must be completed by a medical practitioner (such as a G.P., a surgeon, or a psychiatrist). Medical practitioners can also complete any subsequent certificates, or additional certifications can be performed by healthcare providers such as a physical therapist, an osteopath, or a chiropractor.

Each Certificate of Capacity is shared with the worker’s employer and the WorkSafe agent handling his or her claim. The certificate will be used to manage decisions concerning the employee’s ability to work, return to work, and WorkCover benefits.

How Do I Get a Certificate of Capacity?

For your initial Certificate of Capacity consultation, you will need to meet with a medical practitioner. During the appointment, the medical practitioner will do the following:

• Perform a physical examination or assess your mental status to determine your capacity to work
• Make a diagnosis based on the exam
• Develop a treatment plan to aid in your recovery and facilitate your return to work

During subsequent consultations, the certifier (either the medical practitioner or a healthcare provider) will evaluate the progress of your recovery. Your capacity to work and return to work timeline may be subject to change with every certificate. If your employer proposes a return to work arrangement, the certifier can determine whether or not you have the capacity for the suggested plan.

Why Do I Need a Certificate of Capacity?

The Certificate of Capacity plays two important roles in your WorkCover claim. First, you are required to have a Certificate of Capacity if you claim weekly payments benefits. Second, the Certificate of Capacity will affect your expectations for returning to work.

1. How Does Capacity Affect My Weekly Payments?

The weekly payments benefit is calculated based on your average weekly wage from before your injury or illness. Although the benefit will not replace the entirety of the income you would have otherwise earned, weekly payments can help offset the financial burdens of a condition that limits or prevents you from working.

The amount and schedule of weekly payments you may be entitled to in your WorkCover claim will depend heavily on the information in the Certificate of Capacity. The length and extent of incapacity affect your weekly payments as follows:

• If you have no capacity to work, you are entitled to:
  • 95 percent of your pre-injury wages for the first 13 weeks (just under 3 months)
  • 80 percent of your pre-injury wages from 14 weeks (approximately 3 months) to 130 weeks (just under two and a half years)
  • 80 percent of your pre-injury wages after 130 weeks (approximately two and a half years); depending on capacity, these payments can continue at this rate until you reach retirement age
• If you have some capacity to work and are able to return to work, you are entitled to:
  • 95 percent of your pre-injury wages for the first 13 weeks (less any income you earn from returning to work)
  • 80 percent of your pre-injury wages from 14 weeks to 130 weeks (less any income you earn from returning to work)
  • After 130 weeks, you can still receive weekly payments constituting 80 percent of your pre-injury wages (less 80 percent of any income you earn from returning to work) if you meet the following criteria:
    • You have returned to work for a minimum of 15 hours per week
    • You earn at least $205 in weekly wages
    • Your capacity is unlikely to improve

After the initial Certificate of Capacity, you are required to report any voluntary work or other employment you have undertaken. This information may affect your weekly payments benefits.

2. What Does Capacity Mean for Your Employment?

From the beginning of your WorkCover claim, WorkSafe has an expectation that you will return to work. The medical practitioner will discuss your return to work at the first Certificate of Capacity session. The focus on getting you back to work is also exemplified by the schedule for weekly payments: Your benefits decline over time due to the expectation that your capacity to work will improve.

Capacity is assessed according to certain criteria. The way you feel physically and mentally may not match what the healthcare provider includes in the Certificate of Capacity.

Despite the pressure you face in this scenario, it is important not to return to work prematurely. Resuming your duties before you are ready may aggravate your condition or result in a new injury. You also do not want to lose your weekly payments.

If you are worried about returning to work, share your concerns with your doctor. It may also be in your best interest to contact an experienced WorkCover lawyer to discuss your options for protecting your health and preserving your benefits.

Get the Benefits You Deserve for Your Work Injury

The team at Henry Carus + Associates has unparalleled experience with Victoria workers’ compensation law. We have helped many workers get the benefits and compensation they deserve after a workplace injury or illness.

Our philosophy is You Deserve More. In WorkCover claims, that means providing guidance at every step of the process – from filing your initial claim to getting a Certificate of Capacity and beyond.

Please call 03 9001 1318 today for a free, no-obligation consultation. Henry Carus + Associates serve workers in Melbourne and throughout Victoria.