· Competency | Competency Requirements | Client Review Conditions | Upload Requirements | Examples |
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Medical.Certificate.Queensland Coal Board | Coal Board Medical, Chest X-Ray Or Coal Board Medical (Sub-Contractor), Chest X-Ray (Sub-Contractor) | - Must include QLD Section 4 certificate or
- Health Assessment Report
- Applicant name on medical to match the name registered in the system
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· - Applicant date of birth (DOB) must be displayed on medical and match the DOB
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in onsite· If the fitness for duty section is ticked - · Must be stamped and signed by the medical practitioner
· Must be a QLD Section 4 certificate
· Must include accurate Job role
- Must include accurate Job role
- Company name must match Contractor portal name UNLESS the Coal Board Medical (Sub-Contractor) competency has been selected and uploaded against.
- Name of mine must be either Various or Fitzroy entities eg. Carborough Downs, Ironbark No.1, Broadlea, Exploration (if unsure refer to HSR)
- Must include Respiratory function & chest Xray summary
- Fitness for duty outcome:
- CMW is fit to undertake the proposed / current position – & date of review
Or - CMW is fit to undertake the proposed / current position subject to restrictions & date of review
Or - Section 4.3(e) – Medical is to be cleared when the ticked box is:
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 |
)” OR ) (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)” |
- Do not process as the medical- refer to HSR· is ticked, refer to HST Dept who will assess the Medical. - Must be stamped and signed by the medical practitioner (AMA)
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: - Hearing conservation/ protection related restrictions
- Corrective lenses related restrictions
- Medical condition related restrictions IF the restriction is generalised and non-specific. E.g. “Adhere to Medical Management Plan by own GP/Specialist”
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. | - Issue Date: Date of the AMA sign off (bottom of last page Section 4.5) or Assessment Date (bottom of last page)
- Expiry Date: Whichever is earliest –
- As listed in section 4.3(c)
or - As listed in section 4.3(a)
*Ensure this date is 5 years after date listed in section 4.1(h)or - Recommended date of next full periodic
- Subsequent assessment (review) date
- All restrictions must have an MMP attached to the Section 4.
A generic MMP will be available from the contractor portal or can be requested from the HST Dept
Common restrictions which Avetta personnel are authorised to accept: - Hearing conservation/ protection related restrictions
- Corrective lenses related restrictions
- Medical condition related restrictions IF the restriction is generalised and non-specific. E.g. “Adhere to Medical Management Plan by own GP/Specialist”
REMINDER – All these restrictions MUST have an accompanying MMP which has been scanned into the same document as the Section 4.
Please see forms below to download and complete if required: Medical Declaration Medical Management Plan Template (Contractors) |
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Medical.Certificate.Queensland Coal Board | - Applicant name on medical to match the name registered in the system
- Applicant date of birth (DOB) must be displayed on medical and match the DOB in onsite
- Must be stamped and signed by the medical practitioner
- Must be a QLD Section 4 or health assessment provided by Resources Safety & Health (ResHealth)
- Must include accurate Job role (This does not need to match Onsite role)
- The health assessment provided by Resources Safety & Health (ResHealth) is accepted
- Must include Respiratory function & chest Xray
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summary · - Company name must match Contractor portal name
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· - Name of mine must be either Various or Fitzroy entities eg. Carborough Downs, Ironbark No.1, Broadlea, Exploration, CHPP (if unsure refer to HSR)
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· Issue Date: date of examination by the EMO
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 | Avetta verifiers click here for additional business rule information prior to verification of this competency
- Issue Date: Date of examination (this applies to both section 4 and reshealth assessment)
(EMO date not the NMA sign off date on Sec 4) |
· - Expiry Date: five (5) years from the date of examination UNLESS there is a review date which then becomes the end date
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Induction Medical Declaration form | · CDCMC-FRM-0021-7 Induction 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
· 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