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 firstname.lastname@example.org as a PDF with accompanying documentation.