Get Reporting Employer Issues

This guide provides step-by-step instructions for filling out the REPORTING EMPLOYER ISSUES form online. It is designed to assist users in reporting employer non-compliance with their obligations under the Workplace Injury Rehabilitation and Compensation Act 2013.

Follow the steps to complete the reporting employer issues form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Indicate if your complaint relates to a current claim for compensation by selecting 'Yes', 'No', or 'Unsure'.
3. In the section about the employer's obligations under the WIRC Act, check all relevant boxes that apply to your complaint, including options like failure to forward a claim for compensation or discriminatory conduct.
4. Provide your personal details in the 'YOUR DETAILS' section, which includes entering your full name, telephone number, email address, and mobile number.
5. Indicate if you are willing to provide a signed statement regarding your complaint by selecting 'Yes', 'No', or 'Unsure'. If you are not an injured worker, describe your relationship to the injured worker in the space provided.
6. In the 'COMPLAINT SUMMARY' field, describe the main issues related to your complaint in as much detail as possible.
7. Fill in the 'INJURED WORKER INFORMATION' section with the injured worker's full name, telephone number, date of birth, mobile number, address, and claim number.
8. Complete the 'INJURY EMPLOYER INFORMATION' section by entering the employer's name, address, and type of business.
9. Review all the information provided to ensure accuracy before submitting the form.
10. Once satisfied with the completed form, you can save changes, download, print, or share the form as needed.

Take action today and complete the REPORTING EMPLOYER ISSUES form online.