104Making a claim for personal injury compensation

104 Making a claim for personal injury compensation

(1) A claim for personal injury compensation must—

(a) be in a form approved by the Chief Executive Officer; and

(b) if a claim for loss of income is made, be accompanied by—

(i) a medical certificate in the form required by subregulation (3) in respect of a period of incapacity not exceeding 28 days; and

(ii) proof of loss of earnings, including but not limited to taxation returns, profit and loss statements, PAYG pay assessments and statements from an employer or the member's accountant; and

(c) if the personal injury arose out of a transport accident, be accompanied by the police report required by regulation 106; and

(d) in respect of the death of a member, be accompanied by a copy of the death certificate.

(2) In approving a form under subregulation (1)(a), the Chief Executive Officer must have regard to the forms approved by the Victorian WorkCover Authority for the purposes of—

(a) the Accident Compensation Act 1985, for a claim relating to injuries sustained before 1 July 2014; or

(b) the Workplace Injury Rehabilitation and Compensation Act 2013, for a claim relating to injuries sustained on or after 1 July 2014.

(3) A medical certificate must—

(a) be in a form approved by the Chief Executive Officer, having regard to the form approved by the Victorian WorkCover Authority for the purposes of section 25 of the Workplace Injury Rehabilitation and Compensation Act 2013; and

(b) be issued by a medical practitioner; and

(c) specify—

(i) the expected duration of the member's incapacity; and

(ii) whether the member has a current work capacity or has no current work capacity during the period, not exceeding 28 days, stated in the certificate.

(4) Despite subregulation (3)(c), the Authority may accept a medical certificate covering a period exceeding 28 days if the certificate states reasons why the certificate covers the longer period.

(5) A medical certificate is of no effect to the extent that it relates to a period of time more than 90 days after the date the certificate is issued, unless the Authority otherwise determines.

(6) A claim must be lodged with the Authority.

(7) If a claim or the material accompanying the claim is incomplete or is insufficient to enable the Authority to make a determination of the claim, the Chief Executive Officer may request further information from the member or the claimants before the Authority determines the claim.