Certificate of capacity: the complete guide for claims teams
Regulators publish the form. Law firms explain it to the injured worker. This guide is for the person who has to action it — the Injury Management Advisor or Claims Advisor deciding what happens next on the claim.
A certificate of capacity is the medical certificate that drives an Australian workers compensation or CTP claim: the treating practitioner's assessment of what the worker can and cannot do, for how long, and under what treatment. The insurer's claims team must action it — this guide explains how to read one, state by state.
Key Takeaways
- What it is: the treating practitioner’s certification of diagnosis, capacity for work, restrictions, and treatment — the document the claim runs on
- Who issues it: the treating doctor (first certificate); some states allow subsequent certificates from other treating practitioners — check the regulator’s current rules
- Naming differs: NSW, VIC, SA, WA and Comcare say "certificate of capacity"; Queensland uses "work capacity certificate"
- Who explains it: regulators publish the form and law firms explain it to the worker — this guide is for the claims professional who has to action it
- The part most often misread: the treatment/medication section, which frequently contradicts the certified capacity
What does a certificate of capacity actually contain?
Across jurisdictions the structure is consistent:
- Diagnosis — the injury or condition being certified, which should match the compensable injury
- Capacity — fit for pre-injury duties, unfit for all work, or fit for suitable duties with stated restrictions (hours, lifting, driving, tasks)
- Period — the dates the certificate covers
- Treatment — current and planned treatment, including medications
- Practitioner details and declaration
Each element is a decision input: capacity drives suitable-duties planning and weekly payments, the period drives review cadence, the diagnosis guards scope, and treatment — the most underused section — tells you whether the certified capacity is even plausible.
How do the states differ?
| Jurisdiction | Document | Regulator |
|---|---|---|
| NSW | Certificate of capacity | SIRA |
| Victoria | Certificate of capacity | WorkSafe Victoria |
| Queensland | Work capacity certificate | WorkSafe Queensland |
| South Australia | Certificate of capacity | ReturnToWorkSA |
| Western Australia | Certificate of capacity (First / Progress / Final) | WorkCover WA |
| Tasmania | Workers compensation medical certificate | WorkSafe Tasmania |
| Commonwealth | Certificate of capacity | Comcare |
State-specific guides: NSW, Queensland (work capacity certificate), Victoria. Current forms are linked from the forms page — always the regulator's live version, never a saved copy.
How should a claims team read one?
- Capacity vs duties: does the certified capacity match duties actually available? "Fit for suitable duties" with no suitable duties identified is a stalled claim.
- Period and pattern: is this certificate a fresh assessment or the fourth identical 28-day rollover? Unchanged certificates are the earliest drift signal on the file.
- Diagnosis scope: has the certified condition expanded beyond the compensable injury?
- Treatment vs capacity: do the listed medications make sense against the certified capacity? Sedating combinations and driving/machinery clearances need reconciling.
- Certificate vs file: does the medication section match the dispense history? It usually understates it — the certifier lists what they prescribed, not what three prescribers supply.
Step 4 and 5 are where claims teams have the least support, and where the certificate most often quietly contradicts itself — which is why we wrote a dedicated guide to reading a certificate when the worker is on multiple medications.
See what a complete medication picture looks like on a claim
The certificate is where the claim starts. Allmeds reads the medication section against the full dispense history and flags what the certificate can't show.
In this guide
Important: This page is general health information, not personal medical advice. If you have questions about your medication — including starting it, stopping it, changing the dose, or combining it with something else — speak with your doctor or pharmacist. For an emergency or suspected overdose, call your local emergency number or poison information service immediately. Information is drawn from regulator and clinical guideline sources (TGA, FDA, MHRA, NICE, PBS, CDC); see our methodology for details.