Work Injury Compensation Claim (Singapore)
WORK INJURY COMPENSATION CLAIM
Work Injury Compensation Act 2019 (WICA)
Date of Claim: [Claim Date]
PART 1: INJURED EMPLOYEE DETAILS
Full Name: [Employee Name]
NRIC/FIN: [Employee NRIC]
Date of Birth: [Employee DOB]
Address: [Employee Address]
Contact: [Employee Phone]
Nationality: [Employee Nationality]
Work Pass Type: [Work Pass Type]
PART 2: EMPLOYER DETAILS
Employer: [Employer Name] (UEN: [Employer UEN])
Address: [Employer Address]
Employee's Job Title: [Employee Job Title]
Average Monthly Earnings: [Monthly Salary]
PART 3: ACCIDENT DETAILS
Date of Accident: [Accident Date]
Time: [Accident Time]
Location: [Accident Location]
Description of Accident:
[Accident Description]
Witness: [Witness Name]
PART 4: INJURY AND MEDICAL TREATMENT
Nature of Injury: [Injury Description]
Hospital / Clinic: [Hospital Name]
Medical Expenses: [Medical Expenses]
MC Leave Granted: [MCL Days]
Permanent Incapacity Assessed: [Permanent Incapacity]
Percentage of Permanent Incapacity: [Permanent Incapacity Percent]
WICA COMPENSATION ENTITLEMENTS
Under the Work Injury Compensation Act 2019, the following compensation entitlements apply: (a) Medical expenses: up to S$45,000 or 1 year from accident date; (b) Temporary incapacity (MC leave): two-thirds of average monthly earnings for each day of MC, up to 1 year; (c) Permanent incapacity: lump sum based on percentage incapacity x compensation cap; (d) Death: lump sum up to S$225,000 (2024 rates).
The employer must report the accident to MOM within 10 days via iReport if the employee is absent for 4 or more days, or is hospitalised for 24 hours or more. Failure to report is an offence under the WICA.
The employee may file a WICA claim at MOM within one year of the accident. Claims are assessed by MOM. If the employer disputes the claim, the matter may be referred to the Commissioner for Labour. WICA claims are no-fault — the employee does not need to prove negligence.
DECLARATION
I, [Employee Name] (NRIC/FIN: [Employee NRIC]), declare that the information provided in this claim is true and accurate to the best of my knowledge. I understand that providing false information in a WICA claim is an offence under the Work Injury Compensation Act 2019.
Injured Employee
________________
Signature
Date: ________________
Employer Representative
________________
Signature
Date: ________________
What Is a Work Injury Compensation Claim (Singapore)?
A Work Injury Compensation Claim in Singapore is a formal application filed under the Work Injury Compensation Act 2019 (WICA) by an employee (or the employee's dependants) seeking compensation for injuries sustained in a work-related accident or for occupational diseases contracted in the course of employment. WICA, which replaced the former Workmen's Compensation Act (Cap. 354), provides a no-fault compensation framework administered by the Ministry of Manpower (MOM) — the injured employee does not need to prove employer negligence to receive compensation.
WICA applies to all employees under a contract of service, regardless of salary level, including foreign workers on Work Permits, S Passes, and Employment Passes. Section 3 of WICA covers injuries arising out of and in the course of employment, including accidents that occur while the employee is travelling between the workplace and the employee's place of residence (commuting accidents). Section 4 covers occupational diseases listed in the Second Schedule to the Act — diseases such as hearing loss from noise exposure, respiratory conditions from hazardous substances, and musculoskeletal disorders from repetitive work.
The compensation amounts under WICA are prescribed by the Minister for Manpower and are periodically revised. As of the current rates, the maximum compensation for permanent incapacity is S$289,000, the maximum for death is S$204,000, and medical expenses are covered up to S$45,000 (or S$76,000 for injuries requiring surgery). The compensation is computed based on the employee's monthly earnings, the nature and severity of the injury, and the degree of permanent incapacity as assessed by a WICA-designated medical practitioner.
The Commissioner for Labour at MOM adjudicates WICA claims. Employers are required to report all workplace accidents resulting in more than 3 days of medical leave or hospitalisation to MOM within 10 days under Section 12 of WICA. Failure to report is an offence punishable by a fine of up to S$5,000. Employers must also maintain work injury compensation insurance under Section 23 of WICA for all employees performing manual work and for all non-manual employees earning S$2,600 or less per month. The General Insurance Association of Singapore (GIA) publishes approved WICA insurance policies.
A WICA claim is distinct from a common law negligence claim. An employee may choose either WICA compensation or a common law damages claim against the employer, but not both. Common law claims — filed in the State Courts or the High Court — require proof of employer negligence and may result in higher compensation, but also involve longer proceedings and the risk of losing the claim entirely. Under Singapore law, the common-law requirements for a valid contract — offer, acceptance, consideration, and intention to create legal relations — and Section 8 of the Employment Act 1968 (Cap. 91) govern the core requirements for this type of document.
When Do You Need a Work Injury Compensation Claim (Singapore)?
A Work Injury Compensation Claim is needed in Singapore when an employee suffers a work-related injury or contracts an occupational disease and seeks statutory compensation under WICA.
When an employee is injured in a workplace accident — such as a fall from height at a construction site, a machinery-related injury in a factory, or a slip-and-fall in an office — the employee must notify the employer as soon as practicable. The employer must report the accident to MOM within 10 days if the injury results in more than 3 days of medical leave or hospitalisation, or within 24 hours if the accident is fatal or results in dangerous occurrences specified in the Workplace Safety and Health (Incident Reporting) Regulations.
When an employee develops an occupational disease listed in the Second Schedule of WICA — including noise-induced deafness, occupational asthma, carpal tunnel syndrome, or chemical poisoning — the employee may file a claim for compensation. The disease must be attributable to the nature of the employee's work, and a designated medical practitioner must certify the diagnosis and the degree of incapacity.
When a foreign worker on a Work Permit or S Pass is injured and requires medical treatment, the employer is responsible for all medical expenses under Section 15 of WICA, including hospitalisation, surgery, rehabilitation, and prosthetic devices. The employer must continue to pay the foreign worker's salary during the period of medical leave, subject to the limits prescribed by WICA.
When a workplace fatality occurs, the deceased employee's dependants — spouse, children, parents — may file a WICA claim for death compensation. The maximum death compensation is S$204,000, computed based on the deceased employee's monthly earnings and the statutory formula in the Third Schedule of WICA.
When an employee is uncertain whether to pursue a WICA claim or a common law claim, the employee should seek legal advice. The Tripartite Alliance for Dispute Management (TADM) provides advisory services for employees considering their options, and the Legal Aid Bureau offers assistance to employees who meet the means test for legal representation. Under Singapore law, the common-law requirements for a valid contract — offer, acceptance, consideration, and intention to create legal relations — and Section 8 of the Employment Act 1968 (Cap. 91) govern the core requirements for this type of document.
What to Include in Your Work Injury Compensation Claim (Singapore)
A properly completed Singapore Work Injury Compensation Claim should contain the following elements, in compliance with WICA and MOM's filing requirements.
Claim Date: The date the claim is filed. Under Section 11 of WICA, a claim for compensation must be made within one year from the date of the accident, or within one year from the date the occupational disease is diagnosed.
Injured Employee Details: The employee's full name, NRIC or FIN number, date of birth, nationality, occupation, monthly earnings (including basic salary, allowances, and overtime), and the employer's name and UEN. Monthly earnings are critical for computing the compensation amount under the Third Schedule of WICA.
Employer Details: The employer's full legal name, UEN, registered address, and contact details of the HR or safety officer responsible for workplace injury reporting. The employer's work injury compensation insurance policy number and insurer's name should be recorded.
Accident Details: The date, time, and location of the accident, a factual description of how the accident occurred, the activity the employee was performing at the time, and the names of any witnesses. For commuting accidents, the route and mode of transport should be specified.
Injury and Medical Details: A description of the injuries sustained, the medical treatment received, the name and address of the treating doctor or hospital, the medical leave period, and the degree of permanent incapacity (if assessed). A medical report from a WICA-designated medical practitioner is required to support the claim. Medical expenses claimed must be itemised and supported by receipts.
WICA Statutory Notes: A reference to the employee's right to choose between a WICA claim and a common law negligence claim, with the caveat that the employee cannot pursue both. A reference to the limitation period under Section 11 of WICA (one year from the date of accident or diagnosis). A note on the employer's obligation to maintain WICA insurance under Section 23 for eligible employees.
Declaration: A statement by the employee (or the employee's dependant, in the case of a death claim) confirming the accuracy of the information provided and authorising MOM to obtain medical records and employment records for the purpose of adjudicating the claim.
Employer's Report: A section for the employer to confirm the facts of the accident, the employee's monthly earnings, and the insurance coverage. Employers who dispute the claim may file a response with the Commissioner for Labour. Organisations preparing WICA claims through forms-legal.com can customise the form to include additional fields relevant to their industry.
Governing Law: A statement that the claim is governed by the Work Injury Compensation Act 2019 and is subject to adjudication by the Commissioner for Labour at the Ministry of Manpower (MOM), with appeals heard by the High Court of Singapore. Under Singapore law, the common-law requirements for a valid contract — offer, acceptance, consideration, and intention to create legal relations — and Section 8 of the Employment Act 1968 (Cap. 91) govern the core requirements for this type of document. Under Singapore law, Section 169 of the Companies Act 1967 (Cap. 50) and Section 4 of the Stamp Duties Act (Cap. 312) govern the core requirements for this type of document.
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Forms Legal. (2026). Work Injury Compensation Claim (Singapore) (Singapore) [Legal document template]. Forms Legal. https://forms-legal.com/singapore/employment/health-safety/work-injury-compensation-claim-singapore
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author = {{Forms Legal}},
title = {Work Injury Compensation Claim (Singapore) (Singapore)},
year = {2026},
howpublished = {\url{https://forms-legal.com/singapore/employment/health-safety/work-injury-compensation-claim-singapore}},
note = {Free legal document template. Based on Employment Act 1968 (Cap. 91)}
}Frequently Asked Questions
Under the Work Injury Compensation Act 2019 (WICA), an injured worker in Singapore may claim compensation for three categories of loss. First, medical expenses — including hospitalisation, surgery, medication, rehabilitation, and prosthetic devices — are covered up to S$45,000 (or S$76,000 for injuries requiring surgery). Second, medical leave wages are payable for the period of absence from work due to the injury, computed based on the employee's average monthly earnings. Third, permanent incapacity compensation is payable if the injury results in lasting disability — the maximum is S$289,000 for permanent total incapacity, with partial incapacity calculated as a percentage of the total based on the injury type (as specified in the Second Schedule of WICA). In the event of death, the maximum compensation is S$204,000, payable to the deceased employee's dependants. Compensation amounts are computed based on the employee's monthly earnings and the statutory formula in the Third Schedule of WICA.
Under Section 11 of the Work Injury Compensation Act 2019 (WICA), an injured worker must file a claim for compensation within one year from the date of the accident. For occupational diseases, the limitation period runs from the date the disease is diagnosed or the date the employee first becomes aware of the connection between the disease and their employment, whichever is later. The Commissioner for Labour at the Ministry of Manpower (MOM) may extend the time limit in exceptional circumstances — for example, if the employee was hospitalised and unable to file within the one-year period. Employees who miss the WICA filing deadline may still pursue a common law negligence claim in the State Courts, subject to the Limitation Act (Cap. 163), which provides a three-year limitation period for personal injury claims running from the date of the accident.
An injured worker in Singapore cannot pursue both a WICA claim and a common law negligence claim for the same injury. Section 33 of the Work Injury Compensation Act 2019 (WICA) requires the employee to elect one avenue of compensation. A WICA claim provides no-fault compensation — the employee does not need to prove employer negligence — but the compensation is capped at the statutory limits. A common law claim filed in the State Courts or the High Court requires proof that the employer breached the duty of care owed to the employee, but may result in higher damages including general damages for pain and suffering, loss of future earnings, and special damages for medical expenses. If an employee accepts WICA compensation, the employee cannot subsequently file a civil suit for the same injury. The Tripartite Alliance for Dispute Management (TADM) and the Legal Aid Bureau provide advisory services to help employees choose the most appropriate avenue.
Under Section 23 of the Work Injury Compensation Act 2019 (WICA), employers in Singapore must maintain work injury compensation insurance for two categories of employees: (1) all employees performing manual work, regardless of salary level; and (2) all non-manual employees earning S$2,600 or less per month. Employers who fail to maintain the required insurance commit an offence punishable by a fine of up to S$10,000 or imprisonment of up to 12 months, or both, under Section 23(3) of WICA. The General Insurance Association of Singapore (GIA) publishes a list of approved insurers and standard WICA policy terms. Employers with non-manual employees earning above S$2,600 per month are not legally required to maintain WICA insurance for those employees, but remain liable for any WICA compensation awarded — meaning the employer must pay compensation out of its own funds. Prudent employers maintain WICA insurance for all employees regardless of salary level.
Under Section 12 of the Work Injury Compensation Act 2019 (WICA), employers in Singapore must report workplace accidents to the Ministry of Manpower (MOM) within 10 days if the accident results in the employee receiving more than 3 consecutive days of medical leave, or if the employee is hospitalised for at least 24 hours. Fatal accidents and dangerous occurrences specified in the Workplace Safety and Health (Incident Reporting) Regulations must be reported to MOM within 24 hours. Reports are filed through MOM's iReport portal. Failure to report a workplace accident within the prescribed timeline is an offence punishable by a fine of up to S$5,000 under WICA. Employers must also notify their WICA insurer of the accident within the timeline specified in the insurance policy. MOM publishes annual workplace safety statistics and enforcement actions to promote compliance.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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