Full list of forms

NEW Forms

The Workers Compensation Commission has updated its entire set of Forms and Guides. The new forms are available below and will be accepted from 1 October 2008.

The Commission will continue to accept the old forms until 31 October 2008.

Click here to read a summary of the changes that have been made to the Commission's forms.

To open the Word version of these forms it is recommended that Word 2000 or later be used. If you are unable to open the word version please use the PDF format.




  • Form 5A - Application to Register a Commutation Agreement.
  • MS Word or Pdf
  • Form 5B - Application to Register a Redemption Agreement. MS Word or Pdf
  • Form 5C - Application for Determination to Commute Liability. MS Word or Pdf
  • Form 5D - Application to Determine to Redeem Liability. MS Word or Pdf





  • Form 11 - Direction for Access to Information and Premises. MS Word or Pdf
  • Form 11A - Certificate of Service for Work Injury Damages Claims. MS Word or Pdf
  • Form 11B - Application to Cure a Defective Pre-filing Statement. MS Word or Pdf
  • Form 11C - Application for Mediation to Resolve Work Injury Damages Claim. MS Word or Pdf
  • Form 11D - Response to an Application for Mediation to Resolve Work Injury Damages Claim. MS Word or Pdf
  • Form 11E - Application to Strike Out of Pre-Filing Statement. MS Word or PDF
  • Form 11F - Opposition to Application to Strike Out of Pre-Filing Statement. MS Word or PDF


  • Form 13 - Application for Leave to Refer a Question of Law.
  • MS Word or Pdf
  • Form 13A - Notice of Opposition to Application for Leave to Refer a Question of Law. MS Word or Pdf

  • Form 15 - Application for Assessment of Costs - Schedule 6 before 1 November 2006. MS Word or Pdf
  • Form 15A - Application for Assessment of Costs - Schedule 6 on or after 1 November 2006 MS Word or Pdf
  • Form 15B - Application for Assessment of Costs -Schedule 7 MS Word or Pdf

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