Competency | Competency Requirements | Client Review Conditions | Upload Requirements | Examples |
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Coal Board Medical, Chest X-Ray Or Coal Board Medical (Sub-Contractor), Chest X-Ray (Sub-Contractor) |
Or
Or
o “Is fit to undertake any position” and no restrictions are written below. Or, o “Is fit to undertake the proposed / current position” and no restrictions are written below. Or, o “Is fit to undertake the proposed/current position subject to the following restriction(s) (if necessary, outline a management program)” AND Restrictions are written below AND A Medical Management Plan (MMP) is attached (scanned) to the section 4 as one document which is signed by the employee and their supervisor. (does not need to be signed by a Fitzroy representative) See notes for more detail on what restrictions |
Avetta are authorised to accept. |
o If “Is not fit to undertake the proposed/current position because of the following restriction(s)” is ticked, refer to HST Dept who will assess the Medical.
IF SUBCONTRACTOR IS STATED IN THE COMMENT SECTION ON ONSITE OR IF THE COMPANY NAMES DO NOT MATCH - PLEASE ESCALATE TO SITE. DO NOT REJECT. | Restricted medicals with the MMP will be escalated by Avetta for Client Review (to HST Dept) where the restriction[s] relate to anything other than:
IF SUBCONTRACTOR IS STATED IN THE COMMENT SECTION ON ONSITE OR IF THE COMPANY NAMES DO NOT MATCH - PLEASE ESCALATE TO SITE. DO NOT REJECT. |
Common restrictions which |
Avetta personnel are authorised to accept:
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REMINDER – All these restrictions MUST have an accompanying MMP which has been scanned into the same document as the Section 4. |
All other restrictions, including an MMP, must be forwarded to the HST Dept for authorisation.
Please see forms below to download and complete if required: | |
Medical.Certificate.Queensland Coal Board |
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IF SUBCONTRACTOR IS STATED IN THE COMMENT SECTION ON ONSITE - PLEASE ESCALATE TO THE SITE. DO NOT REJECT. | If the fitness for duty section is ticked - “Is fit to undertake the proposed/current position subject to the following restriction(s)” OR “Is not fit to undertake the proposed/current position because of the following restriction(s)” the Medical will be required to be sent to site for review |
· Must include Respiratory function & chest Xray summary
· Company name must match Contractor portal name
· Name of mine must be either Various or Fitzroy entities eg. Carborough Downs, Ironbark No.1, Broadlea, Exploration (if unsure refer to HSR)
Avetta verifiers click here for additional business rule information prior to verification of this competency
(EMO date not the NMA sign off date on Sec 4) |
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Induction Medical Declaration form
- CDCMC-FRM-0021-6 Medical Declaration form Employee section & physical assessment section must be completed in full excluding HST Superintendent Name & signature
- Employee name on form must be the same as name registered in the system
- DOB on form must match the DOB in onsite
- Form must be signed by employee and supervisor
- Where a medication is declared, form must be referred to HSR team
- Where employee ticks yes for any condition in physical assessment section or lists other- refer form to HSR team
If no medications or conditions, form can be cleared by Pegasus team.
- Must be signed by employee
- Must be signed by workers supervisor