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WCD Grant Application Form

Work Capacity Decision 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 Work Capacity Decisions

When to use this form

This form should only be used if the insurer has issued a Work Capacity Decision dated on or after 1 January 2019. For further guidance as to the use of this form please read the front page of the form.

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 as a PDF with accompanying documentation.



Work Capacity Decision Funding Guide and Information for Lawyers

Work Capacity Decision Funding Guide Extract 

PDF form: