Form and content
9.01 Form and content
(1) A statement of claim is to be in accordance with Form 9A and contain:
a concise statement of the nature of the claim;
the particulars of the claim; and
(c) the specific amount of compensation sought or the relief or remedy sought.
(2) The pleadings in a statement of claim are to comply with Part 8 but a failure to comply does not invalidate the statement of claim.
(3) If a worker claims compensation for an injury or disease, the statement of claim is to contain clear and concise details of the following (as applicable):
the worker's date of birth and occupation;
(b) the date when and the workplace where the injury occurred or the disease was contracted;
the nature of the injury or disease;
(d) the manner in which the injury occurred or the disease was contracted;
(e) the nature of the disability suffered as a result of the injury or disease;
(f) the worker's normal weekly earnings at the date the injury occurred or the disease was contracted;
(g) the dates of the periods for which compensation payments are claimed;
(h) the amount claimed for permanent impairment and the nature of the permanent impairment;
(j) the amount claimed for hospital, medical, surgical or rehabilitation treatment and the nature of treatment.
(4) If a party's application was made under section 62(2) of the Act, the party's statement of claim is to contain clear and concise details of the following:
(a) the deceased worker's full name, address, occupation and date of birth;
the employer's full name and address;
(c) the date when and the workplace where the injury occurred or the disease was contracted;
the date of death;
(e) the name and address (if known) of each dependant who was wholly or partially dependent on the deceased worker at the date of death and the relationship of each dependant to the deceased worker.
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