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S39 Fast Track ILARS Grant Application Form

This form is to be used for applications for grants of funding for the provision of advice to injured workers in relation to section 39 of the Workers Compensation Act 1987.

When to use this form

This form should only be used if the insurer has notified an injured worker that weekly benefits may cease because of the operation of section 39 of the Workers Compensation Act 1987.

Submitting this form

Step 1 - Complete the form

Step 2 - Print the form

Step 3 - Sign and return the consent and declaration section

Step 4 - Return to WIRO by email to ilarscontact@wiro.nsw.gov.au as a PDF with accompanying documentation.

Documents

PDF form: S39 Fast Track ILARS Grant Application Form

Guide:  The S39 Guide - Information for lawyers for injured workers