---
title: "Line up a Victorian Worker's injury claim or Transport Accident Commission claim"
url: "https://ailawframework.com/practice/personal-injury-and-compensation/draft-the-pre-action-notice-or-statutory-claim-form-from-the-instruction/victoria"
type: "task_jurisdiction_version"
site: "AI Law Framework"
id: "A21-T1-R5-VIC"
practice_area: "Personal Injury & Compensation (workers compensation, CTP/TAC, medical negligence)"
tier: "red"
lawyer_review: "required"
jurisdictions: ["VIC"]
last_reviewed: "2026-10-25"
---

# Line up a Victorian Worker's injury claim or Transport Accident Commission claim

> From the instructions, list the facts still needed for questions 1 to 6 of Part A, or for a Transport Accident Commission claim. Do not write on the form the worker completes.

Canonical page: https://ailawframework.com/practice/personal-injury-and-compensation/draft-the-pre-action-notice-or-statutory-claim-form-from-the-instruction/victoria  
Last reviewed: 2026-10-25

Site index for agents: https://ailawframework.com/llms.txt

## Key facts

| Fact | Value |
| --- | --- |
| Practice area | [Personal Injury & Compensation (workers compensation, CTP/TAC, medical negligence)](https://ailawframework.com/practice/personal-injury-and-compensation.md) |
| Human involvement | Red: Lawyer writes; AI may check, clarify or collect data |
| How AI is used | From the instructions, list the facts still needed for questions 1 to 6 of Part A, or for a Transport Accident Commission claim. Do not write on the form the worker completes. |
| What the lawyer must review | The worker completes questions 1 to 6 and signs or submits the form You check the certificate of capacity and the mental-injury rules The tool writes nothing on the form |
| Written for | Victoria |
| Applies to | [Draft the pre-action notice or statutory claim form from the instructions](https://ailawframework.com/practice/personal-injury-and-compensation/draft-the-pre-action-notice-or-statutory-claim-form-from-the-instruction.md) |

## Checking plan

**Verify against sources**

The worker completes and signs or submits the claim. The list only shows what is still missing. The tool writes nothing on the form.

- What the AI does: From the instructions, list the facts still needed for questions 1 to 6 of Part A, or for a Transport Accident Commission claim. Do not write on the form the worker completes.
- What the lawyer does: The lawyer makes the legal assessment, checks the source material and authorises the output for its intended use.
- Who reviews: Lawyer competent in this practice area
- Basis: Checked against the linked sources on 23 October 2026. Confirm the current instrument before reliance.

## Checks the lawyer makes

1. For a WorkSafe claim, the worker completes questions 1 to 6 of Part A and submits them to the employer in myWorkSafe, or completes, prints and signs the PDF and gives it to the employer. The employer completes the rest. A certificate of capacity is required for weekly payments.
2. The WorkSafe page states the mental-injury rules that took effect on 31 March 2024: significant behavioural, cognitive or psychological dysfunction, a diagnosis by a medical practitioner using the current Diagnostic and Statistical Manual, and predominant causation by employment. It states the exclusions for usual workplace stress or burnout, and for reasonable management action carried out reasonably, and that exceptions may apply if the injury occurred before 31 March 2024. Provisional payments for a mental injury are usually advised within 5 business days. If the claim is rejected, the page says treatment costs are covered for up to 13 weeks.
3. For a Transport Accident Commission claim, the lodging page says the claim is lodged within 12 months of the accident or of when an injury first becomes evident. Section 68 says a Part 3 claim is made within one year after the accident or death, or, if no injury manifested at the accident, after the injury first manifests. The Commission may accept a later claim before three years if it considers there are reasonable grounds for the delay. A person who was under 18, or a dependent child of a person who died, may claim before attaining 21 or within 3 years, whichever is later.
4. If the person was injured while working, the lodging page says to submit a WorkSafe claim before a Transport Accident Commission claim.

## Notes

- The signing wording on the PDF was not opened. Do not describe it. The worker completes that part. The tool writes nothing on the form.
- The Transport Accident Act 1986 is in force as version 158, effective 2 October 2026. The Workplace Injury Rehabilitation and Compensation Act 2013 is in force as version 054, effective 2 October 2026.

## Practical guide

Jurisdiction: Victoria: a Worker's injury claim form or a claim to the Transport Accident Commission

**Deliverable**: An internal list of missing facts. The worker completes the form.

**Inputs**

- The instructions and the known dates
- Any certificate of capacity
- Whether the injury was at work and whether the claimant was under 18

**Example**: Illustrative example: The instructions do not say when the injury first became evident. The list marks that date as missing for the 12-month Transport Accident Commission period and for section 68. Nobody completes the form until the worker supplies the date and signs or submits it.

**Stop and escalate when**

- The output is text placed on the form the worker signs or submits.
- A mental-injury claim is being completed and the injury date relative to 31 March 2024 is unknown.

Checked 2026-10-23.

## Sources

- [WorkSafe Victoria: Worker's injury claim form](https://www.worksafe.vic.gov.au/workers-injury-claim-form) (checked 2026-10-23)
- [Transport Accident Commission: How to make a claim when a person is injured](https://www.tac.vic.gov.au/what-to-do-after-an-accident/how-to-claim/how-to-lodge-a-claim-with-the-tac) (checked 2026-10-23)
- [Transport Accident Act 1986 (Vic) s 68, time for making a claim under Part 3](https://classic.austlii.edu.au/au/legis/vic/consol_act/taa1986204/s68.html) (checked 2026-10-23)
- [Transport Accident Act 1986, in force version 158 (effective 2 October 2026)](https://www.legislation.vic.gov.au/in-force/acts/transport-accident-act-1986) (checked 2026-10-23)

## Forms and precedents for this task

| Form or precedent | Kind | AI level | Summary |
| --- | --- | --- | --- |
| [Limitation and notice diary procedure](https://ailawframework.com/precedents/personal-injury-and-compensation/firm-limitation-notice-diary.md) | Policy | Yellow | Firm procedure for recording limitation and pre-action notice dates on a plaintiff injury file.… |
| [Worker's injury claim form (SIRA): weekly payments and treatment expenses](https://ailawframework.com/precedents/personal-injury-and-compensation/form-nsw-sira-workers-injury-claim.md) | Form | Yellow | Link to SIRA's worker's injury claim form for weekly payments and treatment costs, with the sections every claim needs, the signed declaration, and the certificate of capacity to send with it. |
| [Notice of accident claim, non-fatal injury (MAIC Form F1)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-maic-noac-non-fatal.md) | Form | Yellow | Link to MAIC Form F1 V8 Oct 2022, the Notice of Accident Claim Form (Non-Fatal Injury). The claimant certificate is a statutory declaration. |
| [Application for review (SAET form A02, Return to Work): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-saet-a02-review.md) | Form | Yellow | Link to SAET form A02, Application for Review (Return to Work), on the start-a-new-case page.… |
| [TAC online claim lodgement: what to gather and when the claim is lodged](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-tac-claim-lodgement.md) | Form | Yellow | Guide to the Transport Accident Commission's online claim form: the 12-month lodgement period, the documents the form asks for, and the rule that a saved draft is kept for 10 days. |
| [Workers compensation claim form (WorkCover WA): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-wa-wc-claim.md) | Form | Yellow | Link to the WorkCover WA claim form page. The page links a PDF titled Workers Compensation Claim Form. The PDF was not opened, so this guide does not describe its fields or give it a form number. |
| [Request to the Transport Accident Commission for a serious injury certificate](https://ailawframework.com/precedents/personal-injury-and-compensation/vic-tac-serious-injury-certificate-request.md) | Letter | Yellow | Letter asking the Transport Accident Commission to determine impairment and, if it is under 30 per cent, to issue a serious injury certificate for a common law damages claim. |
| [Certificate of capacity / certificate of fitness (SIRA)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-nsw-sira-certificate-of-capacity.md) | Form | Yellow | Link to SIRA's certificate of capacity and certificate of fitness for workers compensation and CTP, including the doctor's certificate and the person's employment declaration. |
| [Notice of accident claim, fatal injury (MAIC Form F4)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-maic-noac-fatal.md) | Form | Yellow | Link to the MAIC Notice of Accident Claim Form (Fatal Injury). The claimant certificate is a statutory declaration. |
| [Application for expedited decision (SAET form A03): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-saet-a03-expedited.md) | Form | Yellow | Link to SAET form A03, Application for Expedited Decision (Return to Work), named on the start-a-new-case page. The page links an online form. That form was not opened.… |
| [TAC funeral and dependency benefits claim form: completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-tac-funeral-dependency.md) | Form | Yellow | Link to the TAC form for funeral expenses and dependency benefits after a death in a transport accident, with the online form and the PDF the TAC publishes on the same page. |
| [Notice to a road authority of an incident, asking for inspection and complaint records](https://ailawframework.com/precedents/personal-injury-and-compensation/road-authority-incident-notice-letter.md) | Letter | Yellow | A letter giving a Victorian road authority the particulars of a notice of incident, and asking a road authority in Victoria, Queensland or New South Wales for the inspection, complaint and repair… |
| [Request that the Transport Accident Commission accept a late Part 3 claim](https://ailawframework.com/precedents/personal-injury-and-compensation/vic-tac-late-part-3-claim.md) | Letter | Yellow | Letter asking the Transport Accident Commission to accept a Part 3 claim made after one year and before three years, setting out the grounds for the delay. |
| [Additional information form (MAIC Form F2)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-maic-additional-information.md) | Form | Yellow | Link to MAIC Form F2 V7 Apr 2022. Section 37A requires the claimant to return the approved additional information form within 1 month after the insurer asks. |
| [Application for suitable employment (SAET form A04): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-saet-a04-suitable-employment.md) | Form | Yellow | Link to SAET form A04, Application for Suitable Employment (Return to Work), named on the start-a-new-case page. The page links an online form. That form was not opened.… |
| [TAC serious injury application form (Common Law Protocols 2026): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-tac-serious-injury-application.md) | Form | Yellow | Guide to the TAC form lawyers use to request a serious injury certificate under Part 6 of the Transport Accident Act 1986 and the Common Law Protocols 2026, including the section 93(17) limbs and… |
| [Application for arbitration (WorkCover WA): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-wa-wc-arbitration.md) | Form | Yellow | Link to the WorkCover WA Application for Arbitration. The worker forms page says to use it to have a dispute dealt with by the Workers' Compensation Arbitration Service.… |
| [Queensland Notice of Accident Claim: time, service and a reply to noncompliance](https://ailawframework.com/precedents/personal-injury-and-compensation/qld-maic-notice-and-compliance-reply.md) | Checklist | Yellow | Checklist for a Queensland CTP Notice of Accident Claim, and a short reply when the insurer says the notice does not comply. |
| [Law practice certificate for a Queensland CTP claim (MAIC)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-maic-law-practice-certificate.md) | Form | Yellow | Link to the MAIC law practice certificate page. Section 36B requires the supervising principal to sign the certificate and verify it by statutory declaration. |
| [Work injury claim (ReturnToWorkSA online): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-sa-rtw-claim.md) | Form | Yellow | Link to the ReturnToWorkSA page for reporting an injury or making a claim. The opened page describes an online claim through the employer or the claims agent. It does not give a paper form number. |
| [Application for payment of wages (SAET form A06): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-saet-a06-wages.md) | Form | Yellow | Link to SAET form A06, Application for payment of wages under the Return to Work Act, named on the start-a-new-case page. The page links an online form. That form was not opened.… |
| [Letter of claim to a public health service, including an initial notice](https://ailawframework.com/precedents/personal-injury-and-compensation/letter-of-claim-public-health-service.md) | Letter | Yellow | Letter of claim to a public health service. In Queensland it is an initial notice under the Personal Injuries Proceedings Act 2002 s 9A, and the Victorian and New South Wales variants ask the… |
| [Queensland part 1 notice of claim and reply to a compliance response](https://ailawframework.com/precedents/personal-injury-and-compensation/qld-pipa-part-1-notice-and-compliance-reply.md) | Letter | Yellow | Letter and checklist for giving part 1 of a Queensland notice of claim under the Personal Injuries Proceedings Act 2002, and for answering a respondent who says part 1 does not comply. |
| [Application for mediation (NT WorkSafe): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-nt-wc-mediation.md) | Form | Yellow | Link to the NT WorkSafe application for mediation under the Return to Work Act 1986. The form page gives no form number.… |
| [PIPA notice of claim, non-health care (Form 1, version 7)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-pipa-notice-non-healthcare.md) | Form | Yellow | Link to Personal Injuries Proceedings Act Form 1, version 7, in force from 1 September 2025. Part 1 and Part 2 are each an Oaths Act statutory declaration and are given at different times. |
| [Workers compensation claim form (WorkSafe Tasmania): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-tas-wc-claim.md) | Form | Yellow | Link to the WorkSafe Tasmania page for accessing a workers compensation claim form. The page gives a printable PDF and a fillable PDF. It does not state a form number.… |
| [TAC common law time limit notification form: completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-tac-common-law-time-limit.md) | Form | Yellow | Guide to the TAC form used when a serious injury certificate application will be lodged outside the six-year period in the Limitation of Actions Act 1958, under the Common Law Protocol 2026. |
| [Queensland notice of claim for damages: assembly checklist](https://ailawframework.com/precedents/personal-injury-and-compensation/qld-workcover-notice-of-claim-for-damages.md) | Checklist | Yellow | Checklist for assembling a notice of claim for damages under section 275 of the Workers' Compensation and Rehabilitation Act 2003 (Qld) before a proceeding is started. |
| [Workers compensation claim (WorkSafe ACT): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-act-wc-claim.md) | Form | Yellow | Link to the WorkSafe ACT page on how to make a workers compensation claim. Claim forms come from the employer. The page states the notification and claim steps.… |
| [PIPA notice of claim, health care (Form 2, version 7)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-pipa-notice-healthcare.md) | Form | Yellow | Link to Personal Injuries Proceedings Act Form 2, version 7, for a health care claim. Part 1 and Part 2 are Oaths Act statutory declarations. |
| [TAC common law application form (Common Law Protocol 2026): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-tac-common-law-application.md) | Form | Yellow | Guide to the TAC form used after a proactive or fast track serious injury grant, which must be sent before a common law conference is arranged. |
| [Request that a NSW CTP insurer concede impairment greater than 10 per cent](https://ailawframework.com/precedents/personal-injury-and-compensation/nsw-mai-damages-impairment-concession.md) | Letter | Yellow | Letter asking a New South Wales CTP insurer to concede that permanent impairment from a motor accident is greater than 10 per cent, and recording the section 6.14 time for a damages claim. |
| [Workers compensation claim form (NT WorkSafe): completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-nt-wc-claim.md) | Form | Yellow | Link to the NT WorkSafe approved workers compensation claim form for a claim other than death. The page cites section 82(1) of the Return to Work Act 1986. The Word and PDF files were not opened. |
| [PIPA notice of claim, dependency (Form 3, version 6)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-pipa-notice-dependency.md) | Form | Yellow | Link to Personal Injuries Proceedings Act Form 3, version 6, for a dependency claim. All dependency claimants are nominated in the one notice, and each part is an Oaths Act statutory declaration. |
| [WorkSafe worker's injury claim form: completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-worksafe-injury-claim.md) | Form | Yellow | Guide to the WorkSafe worker's injury claim form, in myWorkSafe or as a PDF, including the certificate of capacity, the signed medical authority and declaration, and mental-injury rules from 31… |
| [NSW work injury damages: claim letter and pre-filing checklist](https://ailawframework.com/precedents/personal-injury-and-compensation/nsw-work-injury-damages-prefiling.md) | Letter | Yellow | Letter to a New South Wales workers compensation insurer claiming work injury damages, with a checklist for the section 315 pre-filing statement.… |
| [WorkCover Queensland application for compensation](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-workcover-application-for-compensation.md) | Form | Yellow | Link to the WorkSafe page for making a workers' compensation claim: a valid application needs the approved form and a work capacity certificate. Section 131 states the six-month lodging rule. |
| [Victorian WorkSafe impairment benefit: stability checklist](https://ailawframework.com/precedents/personal-injury-and-compensation/vic-worksafe-impairment-benefit-checklist.md) | Checklist | Yellow | Checklist and short letter asking a WorkSafe agent to assess a permanent impairment benefit once the injury is stable. The public page states no percentage, so this checklist states none. |
| [WorkSafe claim for compensation following a work-related death: completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-worksafe-death-claim.md) | Form | Yellow | Link to the WorkSafe form used after the death of a worker from a work-related injury or illness, including dependency, grief and loss, and funeral expenses. |
| [Notice of claim for damages (WorkCover Form 275)](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-wc-notice-of-claim-damages.md) | Form | Yellow | Link to Form 275, version 3, the approved notice of claim for damages under section 275. Statements in the claimant's personal knowledge must be verified by statutory declaration. |
| [WorkSafe Form A, application for common law damages: completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-worksafe-form-a-common-law.md) | Form | Yellow | Guide to WorkSafe Form A for an application under section 328 of the Workplace Injury Rehabilitation and Compensation Act 2013 or section 134AB(4) of the Accident Compensation Act 1985. |
| [WorkSafe Form D, authority to release medical information: completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-worksafe-form-d.md) | Form | Yellow | Link to WorkSafe Form D, the signed authority and consent to release medical information that accompanies a common law damages application. |
| [Wrongs Act Form 4, claimant's prescribed information: completion guide](https://ailawframework.com/precedents/personal-injury-and-compensation/form-vic-wrongs-form-4.md) | Form | Yellow | Guide to Form 4, the claimant's prescribed information named on the Medical Panels Wrongs Act referrals page, including the section 28LZC(b) certification. |

Signed-in accounts can read the full text of each one.

*Practice guidance for planning and review. Confirm current primary sources and the requirements of the actual matter. This is general information, not legal advice.*