Get Au Application For Industrial Disease Compensation By Worker

This guide provides clear, step-by-step instructions on how to complete the AU Application For Industrial Disease Compensation By Worker form online. It aims to help users navigate the application process easily and effectively.

Follow the steps to complete your application successfully.

1. Click ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by filling out the 'Claimant details' section. Enter your last name, first name, address, phone number, email, and date of birth. Indicate whether you are under the care of a specialist by checking 'Yes' or 'No.' If 'Yes,' provide the specialist's name and address.
3. In the 'Claim details' section, specify the date and place where you first became aware of your industrial disease. Also, indicate if you suffer from any other disorder that may contribute to your disablement, providing details if applicable.
4. If currently employed, fill in the 'Current employment details' including your employer's name, address, occupation, employment type, and weekly wage amount. If not applicable, leave this section blank and proceed.
5. Complete the 'Mining industry employment details' section if you have past employment in the mining sector. List the name and address of your last employer, your last occupation, and the date you ceased working. Indicate how long you were employed there and whether you were employed outside Western Australia for six months or more.
6. If you receive a pension, fill out the 'Pensions' section with the type of pension and weekly rate, including the date the payment commenced.
7. Enter your 'Spouse details' if applicable, providing their last name, first name, and address. Also, indicate the number of wholly and partially dependent children you have.
8. List your Employment History. Provide the names and addresses of all employers up to the date of application, including dates employed and positions held. Include whether there was any asbestos contact.
9. Finally, fill out the 'Claimant declaration and authorisation' section. Read the declaration carefully, sign, and date it. Ensure a witness signs and dates the declaration as well.
10. Once all sections are completed, you can save your changes, download, print, or share the form as needed.

Start completing your application for industrial disease compensation online today.