For property, motor vehicle and workers' compensation claims your agency may be able to process the claim via our online system (eClaims). Please contact your Client Service Manager should you require access.
We work to manage claims efficiently and effectively, and the completion of the appropriate claim form will assist in this process. Please complete the form as required and lodge with us shortly after an incident.
Worker's Compensation Claims
Employer Forms
- Workers' Compensation Claim Form
- Employer’s Report Form
- Claim Advice Slip - Optional
- Compensation Reimbursement Invoice
Employee Forms
- Consent Authority
- Declaration of Employment
- Electronic Funds Transfer (EFT) Form - Application for Claimants
- Recurrence of Injury Form
- Reimbursement of Travelling Expenses
- Travel Incident
WorkCover WA Forms
- Workplace Fatality Compensation Claim Form (WorkCover WA Regulated Form)
- Declaration of worker not residing in Western Australia (WorkCover WA Form)
- Worker not residing in Western Australia (WorkCover WA Information Sheet)
- Statement of Social and Financial Circumstances
Witness Forms
Injury Management
Property Claims
- Property Claim Form - agency property
- Property Claim Form - personal property
- Fire Protection Impairment Form
Employee Property In Transit
- Property in Transit Claim Form - Employee to complete, employer to approve
- Application for Property in Transit - Employee to complete
Motor Claims
- Motor Vehicle Claim Form - Driver to complete, employer to authorise
Liability Claims
- Clinical Incident Notification Form - Optional
- General Liability Claim Form - Authorising person to complete
- Professional Liability Claim Form - Authorising person to complete
- Damage to Underground Services Claim Form
- Consent Authority - Optional
Miscellaneous
- Application for Events Cover Form - Event organiser to complete
- DFES Volunteer Injury Claim Form
- DFES Volunteer Witness Statement
- Electronic Funds Transfer (EFT) Form - Application for Claimants
- Electronic Funds Transfer (EFT) Form for Service Providers
- Fire Protection Impairment Form
- Industrial Disease Claim Form
- Personal Accident Claim Form - Injured party to complete
- Personal Injury and Property Damage Report Form
- Statutory Declaration Form
- Travel Claim Form
Contact us if the above forms do not meet requirements.
Page Last Updated 06 Jul 2023