Worker’s injury claim form - EMpower

nswempower.employersmutual.com.au

Use this form to make a workers’ compensation claim for weekly payments or medical, hospital and rehabilitation expenses in New South Wales, Queensland or Victoria. Information for workers. Before completing this form, you should: • notify your employer of your work-related injury or illness • update your employer’s injury register •

  Form, Injury, Claim, Compensation, Worker, Worker s injury claim form, Claim compensation