Completing the Compensation and damages details via Mod C or verbal lodgement 117-01010040

Check the Compensation Management System (CMS) to see if the information is on the record. Search for ‘Compensation Management Summary’ in the Customer First workspace or ‘CMPS’ in Process Direct to view the existing compensation information. If there are no changes:

• the Mod C is not required
• do not complete the Mod C workflow
• record any action taken using Fast Note

If the customer advises of any change to an incident that has already been recorded, see Coding Compensation and damages (Mod C) to request a clearance.

The name of the person who made or is making the compensation claim (compensation claimant). If this is the partner, enter all the compensation details on their record.

State, Territory or Overseas country where the injury occurred.

Select an option:

• Australian insurer or individual
• Overseas insurer or individual
• Do not know

Name of the insurer, organisation or individual liable to pay compensation for the claim and the claim number.

Customer must respond Yes or No.

If Yes, the customer must give the employer's name and address.

Create a Fast Note detailing the employer's business name and address. This will help the Compensation Recovery Team (CRT) process the clearance.

This is the date the injury occurred or when the illness was officially diagnosed.

Identifies the date the claimant's loss of wages began due to the injury or illness. The date can be the same as Q12.

Select an option:

• At work
• Travelling to or from work
• Other - please specify

Options are:

• Worker's compensation/damages as a result of a work injury
• Third party damages as a result of a motor vehicle accident
• Criminal injuries/Victim's compensation
• Medical negligence compensation
• Public liability compensation
• Sporting injury compensation
• Personal Accident and Sickness Insurance (attach copy of policy)
• Income replacement Insurance (attach copy of policy)
• Other

Income protection policies attached to superannuation policies are not treated as compensation. See The effect of compensation on Social Security payments.

A copy of the policy must be attached for:

• Sporting Injuries
• Personal Accident and Sickness. Must include:
• Personal Injury Income Protection
• Trauma Insurance
• Total and Permanent Disability
• Income Replacement Insurance claims

Customer must respond Yes or No.

Customer must respond Yes or No. If

• No, give the current gross weekly amount (before tax)
• Yes, dates these payments stopped. Attach the letter with these details

Customer must respond Yes or No.

• Questions 19, 20 and 21 will display when 'Yes' is selected

Customer must respond Yes or No.

• If Yes give the
• give the lump sum amount
• date the lump sum was paid

Customer must attach a:

• copy of the settlement documents, or
• letter advising the lump sum details

Customer must respond Yes or No.

Customer must respond Yes or No.

Customer must respond Yes or No.

• If Yes - solicitor details