Compensation (Commonwealth Employees) Regulations
STATUTORY RULES
View image in the official source1971 No. 112
REGULATIONS UNDER THE COMPENSATION (COMMONWEALTH
EMPLOYEES) ACT 1971.*
I, THE GOVERNOR-GENERAL in and over the Commonwealth of Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations under the Compensation (Commonwealth Employees) Act 1971.
Dated this nineteenth day of August, 1971.
Paul Hasluck
Governor-General.
By His Excellency’s Command,
View image in the official sourceSignature of Minister of State for Foreign Affairs acting for and on behalf of the Minister of State for Social Services
COMPENSATION (COMMONWEALTH EMPLOYEES) REGULATIONS
Citation.
- These Regulations may be cited as the Compensation (Commonwealth Employees) Regulations.
Commencement.
- These Regulations shall come into operation on the date fixed under subsection (2.) of section 2 of the Compensation (Commonwealth Employees) Act 1971.
Definitions.
- In these Regulations—
“the Act” means the Compensation (Commonwealth Employees) Act 1971;
“the Northern Territory” means the Northern Territory of Australia.
Repeat.
- The Compensation (Remuneration and Allowances) Regulations (being Statutory Rules 1971, No. 70) are repealed.
Remuneration.
- In respect of any period of office before the thirty-first day of December, 1971—
(a) the salary payable to the Commissioner is Fourteen thousand seven hundred and twenty-seven dollars per year; and
(b) the remuneration payable to a person constituting a Compensation Tribunal, being a person appointed for a period of not less than one year, is Seventeen thousand one hundred and seventy-two dollars per year.
Travelling allowances.
6.—(1.) Subject to regulation 8 of these Regulations, where the Commissioner is necessarily absent from Canberra overnight, or a person constituting a Compensation Tribunal is necessarily absent from his head-quarters overnight, in the course of performing his duties, travelling allowance is payable to him in respect of the period of absence at the rate of Twenty-one dollars per day.
View image in the official source(2.) Travelling allowance payable under this regulation is in addition to, and does not include, the cost of conveyance.
* Notified in the Commonwealth Gazette on 1971.
17564/71 —Price 15c 10/5.8.1971
Other allowances payable while in Australia.
- Subject to the next succeeding regulation, the Commissioner or a person constituting a Compensation Tribunal is entitled to be paid such allowances, other than travelling allowance, as would be payable to him under the Public Service Regulations, as in force from time to time, if he were an officer of the Public Service of the Commonwealth and were included in the Second Division.
Allowances payable while outside Australia.
8.—(1.) Where the Commissioner or a person constituting a Compensation Tribunal performs duties outside Australia and the Territories of the Commonwealth, he is entitled to be paid such allowances as he would be entitled to be paid if he were an officer of the Public Service of the Commonwealth and were included in the Second Division.
(2.) Where the Commissioner or a person constituting a Compensation Tribunal is entitled to be paid travelling allowance in respect of a period under sub-regulation (1.) of this regulation, he is not entitled to be paid travelling allowance in respect of that period under regulation 6 of these Regulations.
Prescribed authorities.
9.—(1.) For the purposes of paragraph (a) of the definition of "prescribed authority of the Commonwealth" in sub-section (1.) of section 5 of the Act, each of the following bodies corporate is declared to be a body corporate in relation to which the Act does not apply:—
Australian Apple and Pear Board
Australian Dairy Produce Board
Australian Egg Board
Australian Wheat Board
Australian Wine Board
Joint Coal Board
The Australian National University.
(2.) For the purposes of paragraph (b) of the definition of "prescribed authority of the Commonwealth" in sub-section (1.) of section 5 of the Act, each body corporate (not being a company, society or association) incorporated for a public purpose by a law of a Territory of the Commonwealth other than the Territory of Papua or the Territory of New Guinea is declared to be a body corporate in relation to which the Act applies.
Offices.
10.—(1.) For the purposes of sub-paragraph (i) of paragraph (c) of subsection (2.) of section 7 of the Act, the offices established by the following Acts are declared to be offices in relation to which the Act does not apply:—
Apple and Pear Organization Act 1938-1966
Australian National University Act 1946-1971
Coal Industry Act 1946-1966
Dairy Produce Export Control Act 1924-1966
Egg Export Control Act 1947-1966
Papua and New Guinea Act 1949-1971
Wheat Industry Stabilization Act 1968-1970
Wine Overseas Marketing Act 1929-1966.
(2.) For the purposes of sub-paragraph (ii) of paragraph (c) of sub-section (2.) of section 7 of the Act, each office established by a law of a Territory of the Commonwealth other than the Territory of Papua or the Territory of New Guinea is declared to be an office in relation to which the Act applies.
Prescribed class of persons.
11.—(1.) Each class of persons specified in the first column of the following table is prescribed for the purposes of paragraph (a) of sub-section (5.) of section 7 of the Act and each class of acts specified in the second column of that table opposite to the reference to a class of persons in the first column is prescribed in relation to persons included in that class of persons for the purposes of paragraph (b) of that sub-section:—
| First Column | Second Column |
|---|---|
| Class of persons | Class of acts |
| Members of the Air Training Corps established by regulations under the Air Force Act 1923-1965 | Acts performed in connexion with the activities of the Corps |
| Members of the Australian Cadet Corps established under section 62 of the Defence Act 1903-1970 | Acts performed in connexion with the activities of the Corps |
| Members of the Naval Reserve Cadets established under section 38 of the Naval Defence Act 1910-1971 | Acts performed in connexion with the activities of the Cadets |
| Persons employed under an agreement or arrangement made between the Commonwealth and the Government of another country for the purpose of rendering services to the Government of that other country outside Australia | Acts performed under the agreement or arrangement |
| Persons who, without receiving any remuneration, place their services at the disposal of the Chief Fire Control Officer appointed by the Bush Fire Council constituted under the Careless Use of Fire Ordinance 1936-1967 of the Australian Capital Territory for the purpose of extinguishing, or preventing the spread of, a fire in a part of the Territory | Acts performed at the direction of the Chief Fire Control Officer |
| Persons who, under the control or direction of a Commonwealth officer, assist, without receiving any remuneration, in extinguishing, or preventing the spread of, a fire at the Weapons Research Establishment at Woomera | Acts performed in connexion with extinguishing, or preventing the spread of, the fire |
| Persons who, under the control or direction of a Commonwealth officer, take part, without receiving any remuneration, in search and rescue activities carried out by the Department of Civil Aviation or the Department of Shipping and Transport | Acts performed in connexion with the carrying out of the search and rescue activities |
| Persons rendering assistance to a prescribed Commonwealth officer in the performance of his duty at the request of that officer or in the honest and reasonable belief that the assistance was necessary for the performance by the officer of his duty | Acts performed in rendering the assistance |
| Persons receiving treatment or training provided or arranged by the Director-General of Social Services in pursuance of section 135 of the Social Services Act 1947-1971 | Acts performed in the course of receiving the treatment or training |
| Persons who, under the control or direction of a Commonwealth officer, render services, without receiving any remuneration, at the Alice Springs Hospital or in an institution conducted by the Repatriation Department | Acts performed in connexion with the rendering of the services |
| Persons who, under the control or direction of a Commonwealth officer, take part, without receiving any remuneration, in the carrying out of a health survey in the Australian Capital Territory | Acts performed in connexion with the carrying out of the survey |
| Persons who, under the control or direction of a Commonwealth officer, take part, without receiving any remuneration, in activities relating to civil defence carried out in the Australian Capital Territory or the Northern Territory | Acts performed in connexion with the carrying out of the activities |
| Persons who attend any place in pursuance of a notice served under section 19, 22, 26 or 52 of the National Service Act 1951-1968 | Acts performed in connexion with the attendance |
| Persons, other than a Minister of State of a State, a member of the Parliament of a State or a person holding, or acting in, an office (including a judicial office) established by a law of the Commonwealth, of a State or of a Territory of the Commonwealth, who are members of a board, committee or other body or group of persons (not being a body corporate) to which they are appointed by, or on the nomination or with the approval of, the Governor-General, a Minister of State, a prescribed authority of the Commonwealth, an officer of the Public Service of the Commonwealth or a person holding, or acting in, an office established by a law of the Commonwealth or by a law of a Territory of the Commonwealth other than the Territory of Papua or the Territory of New Guinea | Acts performed as a member of the board, committee or other body or group of persons |
(2.) A reference in this regulation to remuneration does not include a reference to remuneration by way of payment for expenses incurred.
(3.) A reference in this regulation to a prescribed Commonwealth officer shall be read as a reference to—
(a) a Commonwealth Police Officer or a special Commonwealth Police Officer;
(b) a member of the Police Force of the Australian Capital Territory or of the Police Force of the Northern Territory;
(c) the Sheriff of the Australian Capital Territory or a person appointed under section 3 of the Sheriff Ordinance 1934 of that Territory to assist him in the execution of his duties;
(d) the sheriff of the Northern Territory or an officer of the sheriff within the meaning of the Sheriff Ordinance 1962-1966 of that Territory;
(e) the Marshal or a Deputy of the Marshal of the High Court or an officer appointed under section 55 of the Judiciary Act 1903-1969 to assist the Marshal and his Deputies; or
(f) an officer of Customs within the meaning of the Customs Act 1901-1971.
Diseases related to employment.
- For the purposes of section 30 of the Art, a disease of a kind specified in the first column of the First Schedule to these Regulations is related to employment of a kind specified in the second column of that Schedule opposite to the reference to that disease in the first column.
Prescribed Life Tables for purposes of section 50.
- For the purposes of paragraph (a) of sub-section (2.) of section 50 of the Act, the prescribed Life Tables are the Australian Life Tables, 1960-1962, published by the Commonwealth Statistician.
Prescribed weekly amounts for purposes of section 50.
14.—(1.) For the purposes of paragraph (b) of sub-section (2.) of section 50 of the Act, the following amounts are prescribed:—
(a) in respect of married persons without dependent children—Seventeen dollars per week;
(b) in respect of married persons with dependent children—an amount per week equal to the sum of Seventeen dollars and an amount ascertained by multiplying Four dollars by the number of children dependent on the person;
(c) in respect of unmarried persons without dependent children—Ten dollars per week; and
(d) in respect of unmarried persons with dependent children—an amount per week equal to the sum of Ten dollars and an amount ascertained by multiplying Four dollars by the number of children dependent on the person.
(2.) In this regulation—
“children” means children in relation to whom the Act applies;
“dependent” means wholly or mainly dependent;
“married person” includes a person who, although not legally married, is living with another person as the husband or wife of that other person on a permanent and bona fide domestic basis and has so lived with that other person throughout a period of three years;
“unmarried person” means a person who is not a married person.
Notice to Commonwealth of injury, disease or loss of or damage to property.
15.—(1.) The notice of an injury caused to an employee that is required to be served in pursuance of sub-section (1.) of section 53 of the Act shall state-
(a) the name, and the address of the place of residence, of the employee;
(b) the place at which, the date on which and the time at which the injury occurred;
(c) the circumstances in which the injury occurred; and
(d) whether any persons other than the employee were present when the injury occurred and, if known to the person serving the notice, the names, and the addresses of the places or residence, of those persons.
(2.) The notice of the contraction by an employee of a disease, of the commencement of an aggravation or acceleration of a disease suffered by an employee or of a recurrence of a disease suffered by an employee that is required to be served in pursuance of sub-section (2.) of section 53 of the Act shall state—
(a) the name, and the address of the place of residence, of the employee;
(b) the place at which, the date on which and the time at which symptoms of the disease, or of the aggravation, acceleration or recurrence of the disease, first became apparent;
(c) the circumstances in which those symptoms became apparent; and
(d) whether any persons other than the employee were present at the time when those symptoms became apparent and, if known to the person serving the notice, the names, and the addresses of the places of residence, of those persons.
(3.) The notice of an accident that resulted in the loss of, or damage to, an artificial limb or other artificial substitute, or a medical, surgical or other similar aid or appliance, used by an employee that is required to be served in pursuance of sub-section (3.) of section 53 of the Act shall state—
(a) the name, and the address of the place of residence, of the employee;
(b) the place at which, the date on which and the time at which the accident occurred;
(c) the circumstances in which the accident occurred; and
(d) whether any persons other than the employee were present when the accident occurred and, if known to the person serving the notice, the names, and the addresses of the places of residence, of those persons.
(4.) Subject to sub-regulation (6.) of this regulation, a notice of an injury or accident shall be served on the person who was the employee's immediate superior officer in the employment in which he was employed at the time when the injury or accident recurred or, if the employee was at that time engaged in work as part of that employment, on the person who was in charge of that work at that time.
(5.) Subject to the next succeeding sub-regulation, a notice of the contraction of a disease, or of the aggravation, acceleration or recurrence of a disease, shall, if the employee had not ceased to be an employee at the time when symptoms of the disease, or of the aggravation, acceleration or recurrence, first became apparent, be served on the person who was the employee's immediate superior officer in his employment at that time or, where the employee was at that time engaged in work as part of that employment, on the person who was in charge of that work at that time.
(6.) A notice referred to in either of the last two preceding sub-regulations may be served—
(a) by leaving the notice at, or sending the notice by post in a registered letter properly addressed to, the office of—
(i) in the case of an employee other than an employee who was a member of the Defence Force at the time when the injury or accident occurred or symptoms of the disease, or of the aggravation, acceleration or recurrence of the disease, first became apparent—the Permanent Head of the Department, or the chief executive officer of the authority or Administration, by which he was employed at that time;
(ii) in the case of an employee who was a member of the Naval Forces at that time—the Secretary to the Department of the Navy;
(iii) in the case of an employee who was a member of the Military Forces at that time—the Secretary to the Department of the Army; or
(iv) in the case of an employee who was a member of the Air Force at that time—the Secretary to the Department of Air; or
(b) in a case to which the last preceding paragraph is not applicable— by leaving the notice at, or sending the notice by post in a registered letter properly addressed to, the office of the Director-General of Social Services or, if the Director-General of Social Services is the employee, the Minister of State for Social Services.
Period for nomination of members of medical board.
- For the purposes of sub-section (3.) of section 57 of the Act, the prescribed period is the period of twenty-one days commencing on the day on which the Commissioner serves on the employee a requirement that the employee submit himself for an examination by a medical board.
Form of requirement to employee to submit for medical examination.
- For the purposes of sections 58 and 60 of the Act, a requirement that an employee submit himself for an examination shall be in writing and shall be served on the employee.
Intervals between medical examinations.
- For the purposes of sub-section (6.) of section 58, and sub-section (5.) of section 60, of the Act, the following intervals are prescribed in relation to an employee who is receiving weekly payments of compensation under the Act:—
(a) in relation to the period commencing at the expiration of one month after the date on which the first of those payments was made and ending at the expiration of two months after that date—intervals of one week;
(b) during the period commencing at the expiration of two months after that date and ending at the expiration of six months after that date —intervals of one month; and
(c) after the expiration of six months after that date—intervals of two months.
Fees on request for reference to Compensation Tribunal and request for extension of time.
- For the purposes of paragraph (d) of sub-section (1.) of section 76, and paragraph (d) of sub-section (2.) of section 77, of the Act, the prescribed fee is Two dollars.
Fees for witnesses.
- For the purposes of section 88 of the Act, the prescribed fee is the fee ascertained in accordance with the scale of witnesses fees set out in the Second Schedule to these Regulations.
Prescribed Tribunals.
- Each of the following tribunals is prescribed for the purposes of paragraph (c) of sub-section (1.) of section 103 of the Act:—
Fire Brigades Arbitral Tribunal constituted under the Fire Brigades Arbitral Tribunal Ordinance 1966-1969 of the Northern Territory
Police Arbitral Tribunal constituted under the Police and Police Offences Ordinance 1923-1971 of the Northern Territory
Prison Officers Arbitrai Tribunal constituted under the Prisons Ordinance 1950-1969 of the Northern Territory.
Service of documents on Commissioner.
- For the purposes of the Act, service of a document on the Commissioner shall be effected—
(a) by delivering the document to, or sending the document by post in a registered letter properly addressed to, a delegate of the Commissioner in—
(i) if the employee concerned was not a member of the Defence Force at the time when the injury or accident occurred or symptoms of the disease, or of the aggravation, acceleration or recurrence of the disease, first became apparent—the Department, authority or Administration by which he was employed at that time;
(ii) if the employee concerned was a member of the Naval Forces at that time—the Department of the Navy;
(iii) if the employee was a member of the Military Forces at that time—the Department of the Army; or
(iv) if the employee was a member of the Air Force at that time— the Department of Air; or
(b) if the last preceding paragraph is not applicable—by leaving the document at the office of the Commissioner or sending the document by post in a registered letter properly addressed to the Commissioner at his office.
Service of documents on Commonwealth.
23.—(1.) For the purposes of the Act but subject to these Regulations, service of a document on the Commonwealth or on an authority of the Commonwealth shall be effected—
(a) by leaving the document at, or sending the document by post in a registered letter properly addressed to, the office of—
(i) if the employee concerned was not a member of the Defence Force at the time when the injury or accident occurred or symptoms of the disease, or of the aggravation, acceleration or recurrence of the disease, first became apparent—the Permanent Head of the Department, or the chief executive officer of the authority or Administration, by which he was employed at that time;
(ii) if the employee concerned was a member of the Naval Forces at that time—the Secretary to the Department of the Navy;
(iii) if the employee was a member of the Military Forces at that time—the Secretary to the Department of the Army; or
(iv) if the employee was a member of the Air Force at that time—the Secretary to the Department of Air; or
(b) if the last preceding paragraph is not applicable—by leaving the document at the office of the Director-General of Social Services or sending the document by post in a registered letter properly addressed to the Director-General of Social Services at his office.
(2.) A copy of a request by a party to a determination for the reference of a matter or question to a Compensation Tribunal for reconsideration or a copy of an application to a prescribed Court for a judicial review of a determination shall be deemed to be served on the Commonwealth if the copy is delivered to a Deputy Crown Solicitor for the Commonwealth or is sent by post in a registered letter properly addressed to such a Deputy Crown Solicitor at his office.
Service of documents generally.
24. Subject to these Regulations, a document may be served on a person for the purposes of the Act or these Regulations by being sent by post in a registered letter properly addressed to the person at his place of residence or employment last known to the person serving the notice.
Forms of certificates.
25.—(1.) A certificate for the purposes of section 41 of the Act shall be in accordance with Form 1 in the Third Schedule to these Regulations.
(2.) A certificate for the purposes of section 42 of the Act shall be in accordance with Form 2 in the Third Schedule to these Regulations.
(3.) A certificate for the purposes of section 59 of the Act shall be in accordance with Form 3 in the Third Schedule to these Regulations.
(4.) Strict compliance with the forms contained in the Third Schedule to these Regulations is not necessary, and substantial compliance is sufficient.
THE SCHEDULES
FIRST SCHEDULE Regulation 12.
Diseases Related to Employment
| First Column | Second Column |
|---|---|
| Disease | Employment |
| 1. Anthrax....................... | Employment in connexion with— |
| (a) animals infected with anthrax; | |
| (b) animal carcasses or parts of such carcasses; or | |
| (c) wool, hair, bristles, hides or skins | |
| 2. Ankylostomiasis | Employment in or about a mine |
| 3. Chrome ulceration of skin or mucous membrane; any of the sequelae of such an ulceration | Employment involving exposure to or contact with— |
| (a) chromic acid; or | |
| (b) bichromate of— | |
| (i) ammonium; | |
| (ii) potassium; or | |
| (iii) sodium, | |
| or a preparation containing any of those substances | |
| 4. Pathological condition caused by— | Employment involving exposure to or contact with radium, other radioactive substances or x-rays |
| (a) radium or another radioactive substance; or | |
| (b) x-rays | |
| 5. Pneumoconiosis................. | Employment involving inhalation of matter capable of causing pneumoconiosis |
| 6. Poisoning by antimony or a compound of antimony; any of the sequelae of such a poisoning | Employment involving exposure to or contact with antimony, a compound of antimony or a preparation containing antimony or such a compound |
| 7. Poisoning by arsenic or a compound of arsenic; any of the sequelae of such a poisoning | Employment involving exposure to or contact with arsenic, a compound of arsenic or a preparation containing arsenic or such a compound |
| 8. Poisoning by benzene, a homologue of benzene or a nitro-derivative or amido-derivative of benzene; any of the sequelae of such a poisoning | Employment involving exposure to or contact with benzene, a homologue of benzene or a nitro-derivative or amido-derivative of benzene |
| 9. Poisoning by beryllium or a compound of beryllium; any of the sequelae of such a poisoning | Employment involving exposure to or contact with beryllium, a compound of beryllium or a preparation containing beryllium or such a compound |
| 10. Poisoning by cadmium or a compound of cadmium; any of the sequelae of such a poisoning | Employment involving exposure to or contact with cadmium, a compound of cadmium or a preparation containing cadmium or such a compound |
| 11. Poisoning by carbon bisulphide...... | Employment involving exposure to or contact with carbon bisulphide |
| 12. Poisoning by carbon monoxide....... | Employment involving exposure to carbon monoxide |
| 13. Poisoning by copper or a compound of copper; any of the sequelae of such a poisoning | Employment involving exposure to or contact with copper, a compound of copper or a preparation containing copper or such a compound |
| 14. Poisoning by a halogen derivative of a hydrocarbon of the aliphatic series | Employment involving exposure to or contact with a halogen derivative of a hydrocarbon of the aliphatic series |
| 15. Poisoning by hydrogen cyanide or a compound of hydrogen cyanide | Employment involving exposure to or contact with hydrogen cyanide, a compound of hydrogen cyanide or a preparation containing hydrogen cyanide or such a compound |
| 16. Poisoning by hydrogen sulphide...... | Employment involving exposure to hydrogen sulphide |
| 17. Poisoning by lead or a compound of lead; any of the sequelae of such a poisoning | Employment involving exposure to or contact with lead, a compound of lead or a preparation containing lead or such a compound |
| 18. Poisoning by manganese or a compound of manganese; any of the sequelae of such a poisoning | Employment involving exposure to or contact with manganese, a compound of manganese or a preparation containing manganese or such a. compound |
First Schedule—continued
| First Column | Second Column |
|---|---|
| Disease | Employment |
| 19. Poisoning by mercury or a compound of mercury; any of the sequelae of such a poisoning | Employment involving exposure to or contact with mercury, a compound of mercury or a preparation containing mercury or such a compound |
| 20. Poisoning by an oxide of nitrogen; any of the sequelae of such a poisoning | Employment involving contact with nitric acid or the inhalation of oxides of nitrogen |
| 21. Poisoning by phosphorus or a compound of phosphorus; any of the sequelae of such a poisoning | Employment involving exposure to or contact with phosphorus, a compound of phosphorus or a preparation containing phosphorus or such a compound |
| 22. Poisoning by vanadium or a compound of vanadium; any of the sequelae of such a poisoning | Employment involving exposure to or contact with vanadium, a compound of vanadium or a preparation containing vanadium or such a compound |
| 23. Poisoning by zinc or a compound of zinc; any of the sequelae of such a poisoning | Employment involving exposure to or contact with zinc, a compound of zinc or a preparation containing zinc or such a compound |
| 24. Primary epitheliomatous cancer of the skin | Employment involving exposure to or contact with tar, pitch, bitumen, mineral oil, paraffin or a compound, product, or residue of any of those substances |
| 25. Q Fever...................... | Employment involving exposure to or contact with Coxiella burnetii |
View image in the official sourceSECOND SCHEDULE Regulation 20.
Witnesses’ Fees and Travelling Expenses
1. A witness summoned to appear before the Tribunal to give evidence because of his professional, scientific or other special skill or knowledge shall be paid a fee of such amount as the Tribunal, or the person taxing costs in relation to the proceeding, determines, being not less than Ten dollars fifty cents and not more than Fifty-two dollars fifty cents, for each day on which he so appears.
2. A witness, other than a witness referred to in item 1 of this Schedule, summoned to appear before the Tribunal to give evidence shall be paid—
(a) if he is remunerated in his occupation by wages, salary or fees—
(i) a fee equal to the amount of wages, salary or fees lost by him by reason of his so appearing; or
(ii) a fee of Sixteen dollars for each day on which he so appears, whichever is the less; or
(b) if he is not so remunerated—a fee of Six dollars for each day on which he so appears.
3. A witness summoned to appear before the Tribunal to give expert evidence shall be paid, in addition to any other fee payable to him under item 1 or item 2 of this Schedule, such amount as the Tribunal, or the reason taxing costs in relation to the proceeding, thinks reasonable for qualifying to give that evidence.
4. A witness summoned to appear before the Tribunal to give evidence shall be paid such amount as the Tribunal, or the person taxing costs in relation to the proceeding, thinks reasonable—
(a) in respect of his conveyance to and from the place at which he so attends; and
(b) if he is required to be absent overnight from his usual place of residence—for meals and accommodation.
THIRD SCHEDULE
Form 1 Regulation 25 (1.).
Compensation (Commonwealth Employees) Act
CERTIFICATE UNDER SECTION 41
I [or We], , certify that, on the
day of , 19 , I [or we] examined [full name of person
examined] (in this certificate referred to as "the employee") of [postal address] and I [or we] state that—
1. The employee is suffering [or has suffered] from [or from an aggravation, acceleration or recurrence of] [specify nature of injury or disease],
2. The injury [or disease or aggravation, acceleration or recurrence of the injury or disease, as the case may be] suffered by the employee has [or has not] resulted in severe and permanent facial disfigurement to the employee.
*3. The amount of compensation that in my [or our] opinion should be paid in respect of that disfigurement is dollars.
Dated this day of ,19 .
[Signature(s)]
View image in the official source*Strike out if inapplicable.
Form 2 Regulation 25 (2.).
Compensation (Commonwealth Employees) Act
CERTIFICATE UNDER SECTION 42
I [or We], , certify that, on the
day of , 19 , I [or we] examined [full name of person
examined] (in this certificate referred to as "the employee") of [postal address] and I [or we] state that—
1. The employee is suffering [or has suffered] from [or from an aggravation, acceleration or recurrence of] [specify nature of injury or disease].
- The injury [or disease or aggravation, acceleration or recurrence of the injury or disease, as the case may be] suffered by the employee has [or has not] resulted in total and permanent loss of the sense of taste [or smell or taste and smell, as the case may be] by the employee.
Dated this day of ,19 .
View image in the official source[Signature(s)]
Form 3 Regulation 25 (3.).
Compensation (Commonwealth Employees) Act
CERTIFICATE UNDER SECTION 59
I [or We], , certify that, on the
day of , 19 , I [or we] examined [full name of person
examined] (in this certificate referred to as "the employee") of [postal address] and I [or we] state that—
1. The employee is suffering from [or from an aggravation, acceleration or recurrence of] [specify nature of injury or disease].
*Strike out if inapplicable.
2. The employee—
*(a) is not fit to undertake employment in any occupation;
*(b) is not fit to undertake his usual employment;
*(c) is fit to undertake his usual employment;
*(d) is fit to undertake employment in such occupations as [specify occupations].
3. [Specify any other information that the Commissioner has required to be specified].
Dated this day of ,19
[Signature(s)]
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