Follow the steps to complete the form online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred tool for editing.
2. Begin by filling out the employee’s details, including their name, employee number, job title, description of injury or sickness, and employment type—select from full-time, part-time, casual, or contractor.
3. Indicate the current work status of the employee—options include employed, resigned, or terminated. Record the dates for the commencement of employment, the date of injury or sickness, the date the employee was last actively at work, and the date incapacity commenced.
4. Determine if the employee was on alternative duties prior to the incapacity date and select 'Yes' or 'No'. If applicable, fill in the expected return to work date and the date ceased for project-specific work.
5. Enter the employee’s gross weekly earnings in the provided field.
6. If the employee is fit for alternative duties, specify if you are prepared to take them back on these duties by selecting 'Yes' or 'No'.
7. Indicate whether your company has submitted any forms to other insurance companies or government entities regarding this condition. If 'Yes', provide details.
8. State if the employee has received any employer entitlements since incapacity commenced. If 'Yes', complete the additional wage report for that period.
9. Answer whether you believe the employee’s condition is work-related, and if applicable, provide details about your company's income protection policy and workers' compensation status.
10. Fill out the occupational questionnaire by detailing pre-disability work hours and the work environment, as well as any special skills or qualifications required for the occupation.
11. List the usual duties performed by the employee in their pre-disability position, along with the frequency of these duties and any relevant comments.
12. Complete the employer's declaration, providing your company name, your name as paymaster/manager, job title, contact details, and your signature along with the date.
13. Finally, save your changes, download, print, or share the completed form as needed.

Complete documents online today for efficient processing.