Psychology and Counselling Fees and Practice …
ABN: XXXXXX SIRA approval number: [where appropriate] XXXXX [Insert payee details: Street address INVOICE NUMBER: XXXX INVOICE DATE: XXXX . City, STATE/TERR, Postcode] [ Insert insurer name Street address City, STATE/TERR, Postcode] [ Worker: Insert first and last name Claim number: Insert worker’s claim number]
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www.sira.nsw.gov.auMar 01, 2021 · interpreter and report – Complex Report (see definition of Medical Examination and Report) $1,049.70 IMG005 or WIG005 Cancellation with 2 working days notice or less, worker or interpreter fails to attend the scheduled appointment/join the video appointment, or the worker or interpreter attends the appointment/joins the $147.10
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www.sira.nsw.gov.auwhomever is paying my benefits if I commence employment with some other person or in my own business, or of any change in my employment that affects my earnings, and that failure to do so is an offence. Worker’s signature Date (DD/MM/YYYY) Section 7: Employer details. When did the employer first receive the worker’s completed claim form?
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www.sira.nsw.gov.auB3 Domestic assistance 37 B4.1 Return to work assistance (new employment assistance) 40 B4.2 Return to work assistance (education or training assistance) 42 B5 Property damage 44 B6 Lump sum compensation for permanent impairment 46 B7 Payments in the event of death 51 B8 Commutation of compensation 54 B9 Work injury damages 56
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