Information and Forms For Workers

Visit the WorkSafe worker page for the latest forms and information and FAQs.

Forms

• Workers’ compensation claim Form – PDF / Word
• Statement of Fitness for Work Submission/Medical Certificate – online
• Medical & Pharmaceutical Items Reimbursement Form – online
• Travel Reimbursement Form – online / hardcopy
• Bank Account Details – for EFT Payments – online
• Miscellaneous/all other items Reimbursement Form – online
• Remittance Advice Form – online
• Re-open Claim Application – PDF / Word
• Secondary Injury Claim Application – PDF / Word

About GB’s services

• GB Injury Hotline Flyer- PDF

Information

• Frequently asked questions – Web
• Guidelines for settling of journey claims – PDF / Word
• Workers right to cease or refuse unsafe work – PDF / Word

Publications

• Workers guide to workers’ compensation – PDF / Word
  

Support Services

• Interpreting and Translating Services – web / email / phone 1800 334 944
• Indigenous Support Services – email / phone 1800 334 944

Useful Links

• NT WorkSafe
• Northern Territory Government