ACC Weekly Compensation Claim Form
About this free form template

If you're managing ACC weekly compensation claims in New Zealand, you know the process involves meticulous documentation, earnings verification, and accurate payment calculations. This ACC Weekly Compensation Claim Form template simplifies the entire workflow for employers, HR departments, payroll teams, and injured employees.

Designed specifically for New Zealand businesses and healthcare providers, this template collects all the information required by ACC for weekly compensation claims—from injury details and medical certificates to detailed earnings verification and automated payment calculations. The form guides claimants through each step with conditional logic that shows only relevant questions, reducing confusion and ensuring complete, accurate submissions.

Why use Paperform for ACC claims?

With Paperform's calculation engine, you can build in automatic weekly earnings calculations based on the claimant's pay frequency, hours worked, and leave entitlements—helping you determine the correct compensation amount before submitting to ACC. File upload fields let claimants attach medical certificates, wage records, and supporting documentation securely, while conditional logic adapts the form based on employment type, injury circumstances, and claim duration.

For organisations managing multiple claims, Stepper can automate your post-submission workflow: route approved claims to payroll systems, notify ACC case managers, update internal tracking spreadsheets, and send confirmation emails to claimants—all without manual data entry. If you need signed employer statements or medical provider declarations, Papersign lets you turn form submissions into eSignature-ready documents that keep everything linked and audit-ready.

Whether you're an employer supporting an injured worker, a payroll officer verifying earnings, or a medical professional assisting with ACC documentation, this template gives you a professional, compliant starting point that works for the New Zealand regulatory environment.

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accor-3.png
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avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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