1. Injured person lodgement form

    Forms PDF [0.2 MB]

    Injured people can use this form to notify us of a workplace injury or incident by email or post...

  2. Permanent impairment claim form

    Forms PDF [0.1 MB]

    This form should be submitted to make a claim for workers compensation for permanent impairment...

  3. Applying for icare dust diseases workers compensation benefits info sheet

    Forms PDF [0.3 MB]

    You may be able to obtain financial and health care support from icare Dust Diseases Care if you have a NSW work-related dust disease...

  4. Authority to release medical records form

    Forms PDF [38 KB]

    Dust Diseases Care requires access to your medical records to determine your application. Please complete this authority form to allow Dust Diseases Care to access those records...

  5. Dependant application for compensation form

    Forms PDF [0.1 MB]

    This application is for any person who was dependent for support on a worker who has passed away and who did not receive compensation from Dust Diseases Care...

  6. Request for a medical examination form

    Forms PDF [0.1 MB]

    You should use this form if you have been exposed to a hazardous dust while employed as a worker in NSW and would like to have a medical assessment to determine if you have contracted a dust disease...

  7. Application for compensation form

    Forms PDF [0.2 MB]

    This application is for people who have been medically examined and diagnosed with, or suspected to have, a compensable dust disease as a result of exposure to a hazardous dust while employed in NSW...

  8. Authority by next of kin to release medical records

    Forms PDF [48 KB]

    Dust Diseases Care requires access to all the deceased worker’s medical records to determine your application. Please complete this authority form to allow Dust Diseases Care to access those records...

  9. Authority by next of kin to release employment records

    Forms PDF [42 KB]

    Dust Diseases Care requires access to any and/or all of the deceased worker's apprenticeship and/or employment records to determine your application. Please complete this authority form to allow Dust...

  10. Applying for workers compensation benefits

    Information PDF [0.2 MB]