Statement of fitness for work - First certificate

This is the approved form for a first statement of fitness for work up to 14 days.

Section 82(1)(b) of the Return to Work Act 1986 requires a claim for compensation be accompanied by a statement of fitness for work in a form approved by the Authority. This form is the approved form for use by a medical practitioner or another person of a class prescribed by regulation that certifies a worker's capacity for work.