Online lodgement
WorkCover WA provides an online lodgement facility for submitting applications for arbitration. An electronically writeable and printable version of the appropriate application form for use by unrepresented workers, unrepresented dependants or uninsured employers, or when the online system is unavailable, is below.
Forms
Please note all forms need to be printed single-sided. Forms may be printed and completed by hand or electronically filled.
Application for Arbitration
Complete this form to apply to have your dispute dealt with by the Workers’ Compensation Arbitration Service.
Application for Arbitration Workplace Fatality Compensation
Complete this application for a workplace fatality claim to be determined by the Workers Compensation Arbitration Service.
Application to Extend Time to Lodge an Application for Arbitration
Complete this form to apply for an extension of time to lodge an Application for Arbitration.
Statement of Social and Financial Circumstances
Complete this form and lodge with the Application for Arbitration when applying for additional income compensation or a standard increase in the medical and health expenses general limit amount and/or an increase for special expenses in the medical and health expenses general limit amount.
Reply to an Application for Arbitration
Complete this form to reply to an application for arbitration.
Certificate that Document was Given
Complete this form to certify you have given documents pursuant to the Arbitration Rules
Interlocutory Application
Complete this form to lodge an Interlocutory Application.
Notice Consenting or Opposing Interlocutory Application
Complete this notice to reply to an Interlocutory Application
Memorandum of Consent Order
Complete this form to seek consent orders from an arbitrator
Order for Production of Documents or Material
Complete this form and lodge it with an Interlocutory Application when requesting an order to produce documents.
Summons to Witness
Complete this form if you are seeking a summons to be issued by the Registrar or an arbitrator requiring the attendance of a person before an arbitrator.
Multiple Respondent Form
Complete this form if there is more than one respondent to the dispute and lodge it with the Application for Arbitration.
Notice of Representation
Complete this form to notify the Workers Compensation Arbitration Service of an appointment or cessation of representation.
Notice of Discontinuance
Complete this form if you wish to discontinue arbitration of the dispute.
Application for Order and/or Assessment of Costs
Complete this application if you wish to apply to the arbitrator or the Registrar for an order and/or assessment of costs.
Notice Consenting or Opposing Application for Order and/or Assessment of Costs
Complete this form in response to an Application for Order and/or Assessment of Costs.
Arbitration Order for Joinder of Party
Complete this form to give notice of an arbitrator’s order that another person be joined as a party to the proceedings.
