Forms

• Berths and Levy Return form (PDF 522.7 KB)
• Claim for Compensation for a Work-related Death form (PDF 184.2 KB)
• Claim for Permanent Impairment and Non-economic Loss form (PDF 181.4 KB)
• Claim for Workers' Compensation form (PDF 190.2 KB)
• Claim Update Report form (PDF 66.8 KB)
• Declaration that Seacare Legislation Does Not Apply to a Ship Request form (PDF 104.8 KB)
• Declaration that Seacare Legislation Applies to a Ship Request form (PDF 118.5 KB)
• Employee and Ship Details form January to June (DOCX 481.8 KB)
• Employee and Ship Details form July to December (DOCX 481.3 KB)
• Employee and Ship Details online reporting
• Extension of Time to Determine Workers' Compensation Liability Request form (PDF 160.5 KB)
• Health and safety representative (HSR) network registration online form
• Report on the Employer's Determination of a Claim for Compensation for a Work-related Death form (PDF 173.9 KB)
• Report on the Employer's Determination of a Claim for Permanent Impairment form (PDF 173.6 KB)
• Report on the Employer's Determination of a Claim for Workers' Compensation form (PDF 171.4 KB)
• Request for Exemption from the Application of the Seafarers Act form (PDF 273.8 KB)
• Exemption guidelines (PDF 165.5 KB)
• Seacare Online User Access Request form (PDF 151.5 KB)
• Workers' Compensation Insurance Arrangements online reporting