Form · Personal Injury & Compensation

Certificate of capacity / certificate of fitness (SIRA)

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.

Kind: Form. A form to complete, or a guide to completing an official one.
Where it applies: New South Wales
AI use: Yellow You and the tool draft together, with you directing. You check every statement you rely on.
Law stated as at: 23 October 2026
Status: Maintained. Checked on 23 October 2026 against the official form at sira.nsw.gov.au and the 2 authorities it cites, for New South Wales.
Version: 1
Source: Link to the official form. Licence: © State Insurance Regulatory Authority. Link only: download the current form from SIRA each time. Do not copy or adapt it.

Where this comes from

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

When to use it

Use when a treating medical practitioner certifies capacity for work after a work injury or a CTP injury in NSW, and when the injured person must complete the employment declaration before the certificate goes to the insurer or employer.

Used for these tasks

Each task page says how far AI may help with the task and what the lawyer must review.

How AI may be used

The tool may check that the certificate on the file has the practitioner's section and the person's employment declaration, and it writes nothing in either of those sections.

AI may

Check a certificate already on the file for the injured person's details, the review date and whether section 3 is signed
List certificates by date so a gap in certification can be seen
Record the practitioner's name, provider number and the date of examination from the certificate

AI must not

Must not write the treating practitioner's certificate, diagnosis, capacity opinion or clinical reasoning
Must not write section 3, the employment declaration, or state whether the person has worked
Must not sign the certificate or send it to the insurer or employer
Must not put health information into a tool that is not firm-controlled

The lawyer checks

The certificate is the current SIRA form. The PDF opened is catalogue SIRA08719, copyright 0718, as linked from the forms index on 23 October 2026
For a CTP claim, the form says certificate of fitness means certificate of fitness for work, whether or not the person was employed
If the next review is more than 28 days away, the form asks for clinical reasoning
Section 3 is completed by the person, not the doctor, before the certificate is sent
The form states a penalty of imprisonment for 2 years or 500 penalty units, or both, for a false or misleading statement in making a claim
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).

Method: how the Green, Yellow and Red levels are decided. This is guidance for planning, not legal advice.

Authorities

Official form

Open the official form. Always use the current version from the issuer. Licence: © State Insurance Regulatory Authority. Link only: download the current form from SIRA each time. Do not copy or adapt it..

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