---
title: "Reconcile an NSW injury claim form with the records and wage evidence"
url: "https://ailawframework.com/practice/personal-injury-and-compensation/reconcile-the-claim-form-with-the-medical-chronology-and-payroll-evidenc/new-south-wales"
type: "task_jurisdiction_version"
site: "AI Law Framework"
id: "A21-A20260923-1-NSW"
practice_area: "Personal Injury & Compensation (workers compensation, CTP/TAC, medical negligence)"
tier: "yellow"
lawyer_review: "required"
jurisdictions: ["NSW"]
last_reviewed: "2026-10-25"
---

# Reconcile an NSW injury claim form with the records and wage evidence

> Compare the injury date, mechanism, body parts and time off work on the worker's injury claim form or the motor accident claim particulars with the medical records, the certificate of capacity and the wage records, and…

Canonical page: https://ailawframework.com/practice/personal-injury-and-compensation/reconcile-the-claim-form-with-the-medical-chronology-and-payroll-evidenc/new-south-wales  
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 | Yellow: Lawyer and AI draft together |
| How AI is used | Compare the injury date, mechanism, body parts and time off work on the worker's injury claim form or the motor accident claim particulars with the medical records, the certificate of capacity and the wage records, and list each inconsistency with its source. |
| What the lawyer must review | Decide which form is being lodged and whether the client must declare its contents Check each listed inconsistency against the source page before anyone relies on it Keep medical and wage records in a firm-controlled tool. A leak may be notifiable |
| Written for | New South Wales |
| Applies to | [Reconcile the claim form with the medical chronology and payroll evidence](https://ailawframework.com/practice/personal-injury-and-compensation/reconcile-the-claim-form-with-the-medical-chronology-and-payroll-evidenc.md) |

## Checking plan

**Verify against sources**

The lawyer checks the NSW form against the records. The tool only lists inconsistencies.

- What the AI does: Compare the injury date, mechanism, body parts and time off work on the worker's injury claim form or the motor accident claim particulars with the medical records, the certificate of capacity and the wage records, and list each inconsistency with its source.
- What the lawyer does: Decide what the inconsistency means and whether the form can be lodged.
- 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 workers compensation claim, use the SIRA worker's injury claim form and a certificate of capacity. Section 3A is where a relevant-conduct psychological injury is described.
2. Guideline 4.24 applies where the claimant gives some details by phone: notice is not given until the completed pre-filled form is returned. If the claimant cannot provide the information the insurer asks for under guideline 4.12, guideline 4.13 requires a statutory declaration, including whether police provided an event number. The tool writes nothing in that declaration.
3. Match the claimed injury date, mechanism, body parts and time off work to the clinical notes and the wage records used for pre-injury average weekly earnings.
4. Do not smooth a conflict to make the form consistent. The lawyer decides what needs a further account from the client.

## Notes

- Practice Note SC Gen 23 and Procedural Direction PIC13 prohibit using generative AI to generate the content of a person's evidence. The comparison table is a working list, not the form.
- Health and wage records stay in a firm-controlled tool. Australian Solicitors' Conduct Rules rule 9 and Australian Privacy Principle 11 apply, and a breach may be notifiable under the Privacy Act 1988 (Cth).

## Practical guide

Jurisdiction: NSW workers compensation claim, or a motor accident claim under the Motor Accident Injuries Act 2017

**Deliverable**: A table of inconsistencies between the draft claim particulars and the records, for the lawyer to resolve before lodgement.

**Inputs**

- Draft worker's injury claim form or motor accident claim particulars
- Certificate of capacity, where the claim is for workers compensation
- Clinical notes and wage records selected by the lawyer

**Example**: Illustrative example: The draft says the person stopped work on the day of the injury. The payslips show two further weeks of ordinary hours. The table records both dates and the page of each source. It does not change the form.

**Stop and escalate when**

- The form asks the client to declare facts that the records contradict and the client has not resolved them.
- The records are incomplete, so an apparent conflict cannot be checked.

Checked 2026-10-23.

## Sources

- [SIRA: Weekly payments](https://www.sira.nsw.gov.au/workers-compensation/what-you-can-claim/weekly-payments) (checked 2026-10-23)
- [SIRA: Part 4 of the Motor Accident Guidelines: Claims](https://www.sira.nsw.gov.au/resources-library/motor-accident-resources/publications/for-professionals/motor-accident-guidelines/part-4-of-the-motor-accident-guidelines-claims) (checked 2026-10-23)

## Forms and precedents for this task

| Form or precedent | Kind | AI level | Summary |
| --- | --- | --- | --- |
| [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. |
| [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. |
| [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.… |
| [Authority for an employer to release wage and incident records](https://ailawframework.com/precedents/personal-injury-and-compensation/authority-employer-wage-and-incident-records.md) | Form | Yellow | Signed authority for one employer to release incident, wage, leave and role records for a stated period, with a short covering letter.… |
| [Economic loss workings: past, future and superannuation](https://ailawframework.com/precedents/personal-injury-and-compensation/economic-loss-workings.md) | Other | Yellow | Workings for loss of earning capacity, the three-times earnings cap, the discount rate, superannuation at the rate for each period, and tax on weekly payments that must be repaid gross. |
| [Letter to an employer asking for incident documents, a footage hold and wage records](https://ailawframework.com/precedents/personal-injury-and-compensation/employer-incident-and-wages-letter.md) | Letter | Yellow | A letter, with the worker's authority, asking an employer for time and wage records and for the incident report, and asking the employer to keep any footage of the incident.… |
| [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.… |
| [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.… |
| [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.… |
| [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.… |
| [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.… |
| [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. |
| [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… |
| [Treatment chronology from health records](https://ailawframework.com/precedents/personal-injury-and-compensation/treatment-chronology.md) | Other | Yellow | A page-cited chronology of treatment, complaints and findings drawn from health records, with a verification log. It is a working document, not the witness's evidence. |
| [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. |
| [Medical records index](https://ailawframework.com/precedents/personal-injury-and-compensation/medical-records-index.md) | Other | Yellow | An index of health records by provider, date, source and page, marking subpoenaed or suppressed material that must not go into a generative tool unless the court's conditions are met. |
| [Work capacity certificate for a Queensland workers' compensation claim](https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-work-capacity-certificate.md) | Form | Yellow | Link to the WorkSafe work capacity certificate page: the claim is not valid without it. Only a doctor, a nurse practitioner for a minor injury, or a dentist for an oral injury may issue it. |

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.*