---
title: "Form 5C: commutation determination for a legally incapacitated worker"
url: "https://ailawframework.com/precedents/personal-injury-and-compensation/form-nsw-pic-form-5c-commutation"
type: "precedent"
site: "AI Law Framework"
id: "a21-form-nsw-pic-form-5c-commutation"
area_id: "A21"
kind: "form"
ai_level: "yellow"
version: 1
task_ids: ["A21-T1-R10", "A21-T1-R11"]
law_stated_as_at: "2026-10-23"
---

# Form 5C: commutation determination for a legally incapacitated worker

> Link to the Personal Injury Commission's Form 5C for a commutation determination where the worker is legally incapacitated, including the SIRA certificate the form requires.

Canonical page: https://ailawframework.com/precedents/personal-injury-and-compensation/form-nsw-pic-form-5c-commutation  
Law stated as at: 2026-10-23

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

## Key facts

- Kind: Form. A form to complete, or a guide to completing an official one.
- Practice area: [Personal Injury & Compensation](https://ailawframework.com/precedents/personal-injury-and-compensation.md)
- Jurisdictions: New South Wales
- AI level: Yellow. You and the tool draft together, with you directing. You check every statement you rely on.
- Law stated as at: 2026-10-23
- Status: Maintained. Checked on 2026-10-23 against the official form at pi.nsw.gov.au and the 2 authorities it cites, for New South Wales.

## When to use it

Use when asking the Personal Injury Commission to determine a commutation of liability under the Workers Compensation Act 1987 for a worker who is legally incapacitated. Where the worker is not legally incapacitated, the form says to use Form 5A.

## Used for these tasks

- [Draft a settlement advice and conference paper](https://ailawframework.com/practice/personal-injury-and-compensation/draft-a-settlement-advice-and-conference-paper.md)
- [Prepare court-approval papers for a child or protected-person settlement](https://ailawframework.com/practice/personal-injury-and-compensation/prepare-court-approval-papers-for-a-child-or-protected-person-settlement.md)

## How AI may be used

The tool may list the documents the form asks to attach and the office named on the instrument of appointment, and it writes nothing in the signed application.

**AI may:**

- List whether a SIRA certification, the instrument of appointment and the medical material are on the file
- Record the office title exactly as it appears on the instrument of appointment
- Extract the lump sum figure proposed in a draft only where that figure is already written on the file

**AI must not:**

- Must not write the signed application or describe the worker's capacity
- Must not replace the form's names Public Trustee, Protective Commissioner or Protected Estates Act 1983 with later office names
- Must not decide that the worker is legally incapacitated or that a commutation should be made
- Must not lodge the form

**The lawyer checks:**

- The worker is legally incapacitated. If not, the form says use Form 5A. Form 5A was not opened
- SIRA certification under section 87EA is attached before the Commission can determine the application. The form says section 87G is the determination power
- The form still names the Public Trustee, the Protective Commissioner, and a financial manager appointed under the Protected Estates Act 1983. Quote the form. Do not translate those names
- The form notes that if liability is only partially commuted, section 87I(1) means the balance continues to be payable under the Workers Compensation Act 1987
- Hand delivery is Level 21, 1 Oxford Street, Darlinghurst NSW 2010. Postal address is PO Box 594, Darlinghurst NSW 1300
- Court approval for a protected person is a separate question from lodging this form
- Health, wage and other personal information stays in a firm-controlled tool. Check confidentiality under ASCR r 9 and APP 11, and whether any breach is notifiable under the Privacy Act 1988 (Cth).

## Authorities

- [Personal Injury Commission, Form 5C Application for Determination to Commute Liability (August 2023)](https://www.pi.nsw.gov.au/__data/assets/pdf_file/0004/1196437/Form-5C-ApplicationtoforDeterminationtoCommuteLiability-August-2023.pdf)
- [Personal Injury Commission, Applying online](https://www.pi.nsw.gov.au/lodge-a-dispute/applying-online)

## Official form

[Official form](https://www.pi.nsw.gov.au/__data/assets/pdf_file/0004/1196437/Form-5C-ApplicationtoforDeterminationtoCommuteLiability-August-2023.pdf)

## Where this comes from

The official form is published by pi.nsw.gov.au; this page is a completion guide. Last checked on 2026-10-23.

## Full text and drafting notes

The full text and the drafting notes are not part of this public page. Signed-in firm accounts can read them at https://ailawframework.com/precedents/personal-injury-and-compensation/form-nsw-pic-form-5c-commutation and through the signed-in MCP connector https://ailawframework.com/mcp/firm.

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