Practical review
What to check in this situation
- Record the prior expiry date, consultation dates, booking attempts and the incapacity period actually claimed.
- Ask the practitioner for an accurate opinion within their clinical knowledge, not an administrative backdate.
- Separate missing certification from any later work capacity or liability decision made by the insurer.
Records that may help
Keep every certificate in date order, appointment booking evidence, consultation notes, duty proposals, treatment records, proof of delivery and any insurer warning or suspension notice.
Next procedural step
Send the corrected evidence immediately, ask what period remains disputed and obtain advice if payments are not reinstated or a separate capacity decision has been issued.
What this document or stage means
Check the diagnosis, injury date, certified period, hours, duties and restrictions before leaving the appointment. A broad label such as “some capacity” is less useful if the certificate does not say what the worker can safely sustain.
Who prepares or controls it
- The first certificate is usually completed by the worker’s nominated treating doctor or treating medical specialist after consultation with the worker.
- Later certificates may be issued by the nominated treating doctor. Current NSW arrangements also allow an approved treating physiotherapist or psychologist to issue certain subsequent certificates within their professional scope.
- The insurer, employer and recovery team use the certificate. None of them should rewrite the practitioner’s clinical opinion.
Why it is part of the claim
- The injury affects work capacity, treatment or recovery planning and the insurer needs current medical certification.
- The worker’s capacity has changed, the prior certificate has expired or a recovery-at-work plan needs review.
- The insurer is assessing weekly payments or work capacity using the available medical information.
What to check
Diagnosis and work connection
Check that the injury or condition is described accurately and that the history given to the practitioner matches the actual work event or gradual duties.
Certified period
Confirm the start and end dates. Gaps or overlapping certificates can create payment and evidence problems.
Capacity for work
The certificate should distinguish no current capacity, capacity for specified hours or duties, and pre-injury duties. Hours must be read with the restrictions.
Functional restrictions
Useful restrictions describe lifting, posture, concentration, travel, exposure, breaks or other relevant functions. They should fit the diagnosis and real job.
Treatment and review
Check the treatment plan, referrals and review date. A treatment recommendation is evidence, not automatic insurer approval.
Mistakes or gaps to look for
- Wrong injury date, employer, diagnosis or body part.
- An expired certificate or unexplained gap between certified periods.
- Hours that conflict with the stated restrictions or with the practitioner’s clinical notes.
- A return-to-work date written as certain when it is only a review target.
- Restrictions copied from an old certificate despite a material change.
- A capacity statement based on a generic job title rather than the actual duties and work setting.
Evidence to keep
- Current job description, ordinary hours, roster and a plain list of the physical or cognitive demands.
- The current recovery-at-work or suitable duties plan and a note of what happened when duties were attempted.
- Specialist reports, imaging results, treatment updates and medication effects relevant to capacity.
- Earlier certificates so the practitioner can explain any change rather than creating an unexplained contradiction.
- A copy of the completed certificate and proof it was sent to the employer and insurer.
- Appointment requests, cancellation records and consultation dates if a gap has already occurred.
What happens next
- Send the certificate promptly to the employer and insurer and keep proof of delivery.
- If there is a gap, identify the exact dates, arrange the earliest clinical review and ask the practitioner to state only what can properly be supported from the clinical history. Do not alter or seek an unsupported backdate.
- Compare it with the proposed duties and hours. Ask for the plan to be corrected if it exceeds the certified limits.
- If the insurer makes a work capacity decision that does not reflect the certificate and other evidence, request the reasons and consider review or PIC options.
Timing and deadlines
- Weekly payments usually require continuing evidence of incapacity, so avoid unexplained gaps between certified periods.
- SIRA states that an insurer may stop weekly payments within seven days after advising the worker that a completed certificate is required. This is a certificate-evidence rule; a gap does not itself prove that the worker recovered.
- The appropriate certificate duration depends on the injury and clinical review needs. A practitioner should not certify a period merely to match an insurer preference.
- If capacity changes before the next review, arrange an earlier clinical review rather than waiting for the certificate to expire.
When legal advice may be useful
- Advice may be useful where a certificate has been used to reduce payments, the employer says unsuitable duties were refused or an insurer decision misstates the certified capacity.
- A lawyer cannot direct the medical opinion, but can identify the legal issue and the evidence that needs clarification.
Illustrative example
Illustration: “some capacity” without workable limits
A nurse is certified for four hours a day, three days a week, but the certificate does not record limits on patient handling or exposure to aggressive behaviour. The employer proposes ordinary ward duties for those hours.
- Take the actual task list to the treating doctor.
- Ask the doctor to record clinically justified restrictions rather than naming a job outcome.
- Make sure the recovery-at-work plan reflects both the hours and task limits.
Common questions
Does a Certificate of Capacity approve my claim?
No. It is medical evidence about injury, treatment and capacity. The insurer separately decides liability and benefits.
Can my employer change the certificate?
No. The employer can discuss duties and provide job information, but the certifying practitioner is responsible for the clinical opinion.
Can a physiotherapist or psychologist issue a certificate?
Under current NSW arrangements, an approved treating physiotherapist or psychologist may issue certain second and subsequent certificates within their scope. The first certificate is completed by a doctor or treating medical specialist.
What if my certificate does not match the duties offered?
Raise the mismatch promptly with the employer, insurer and treating practitioner. Keep the proposed plan and identify the specific task, hour or exposure that exceeds the certified capacity.
What happens if my Certificate of Capacity expires or has a gap?
Contact the practitioner promptly, preserve the booking and consultation record, send clinically supportable evidence for the missing period and ask the insurer to identify what dates remain disputed. A later certificate does not automatically repair every gap, and the insurer separately retains its work-capacity decision powers.
Need help checking a claim document?
Send the decision, report or plan with a short explanation of what has changed. We can assess the dispute and whether an ILARS funding application may be available, subject to eligibility, merits and IRO approval.
Related claim and dispute guides
- Work capacity decisions
- When a certificate changes to some capacity
- Physiotherapist and psychologist certificates
- Weekly payments
- NSW workers compensation legal help
- Starting a workers compensation claim
- Reading a section 78 notice
- Personal Injury Commission disputes
- IRO and ILARS legal funding
- Request a claim review
Legal service provider
NSW workers compensation help from Stephen Young Lawyers
NSW Work Injury Claim is the workers compensation service of Stephen Young Lawyers. Stephen Young Lawyers provides the legal service. Stephen Young Lawyers.
Stephen Young Lawyers was established in 2012. The firm is led by Stephen Young, Principal Solicitor and Accredited Specialist in Personal Injury Law.
Workers across New South Wales can arrange telephone or video appointments. In-person appointments can be arranged at the Sydney office when appropriate.
NSW Work Injury Claim enquiries: (02) 7233 3661
- Content publisher:
- NSW Work Injury Claim
- Published:
- Last legally reviewed:
Key legal sources
- Workers Compensation Act 1987 (NSW)
- SIRA workers compensation
- IRO legal assistance for injured workers
- Personal Injury Commission
- SIRA: Certificate of Capacity
- SIRA Workers Compensation Guidelines, 1 July 2026
- SIRA guidance on work capacity assessments
- Workers Compensation Act 1987 (NSW)
This information is general in nature and is not legal advice. You should obtain advice about your own circumstances.
Last legally reviewed: . This page provides general information about NSW workers compensation procedure. It is not legal advice, and the correct response may depend on the document, injury date and dispute.