Medicare Compensation Recovery Section 23A statement form (MO023)

Use this form to declare you received no benefits or received no further benefits since your most recent expired notice, for your compensable injury or illness.

Download and complete the Medicare Compensation Recovery Section 23A statement form.

After the compensation claim is finalised by judgment or settlement, the injured person, claimant or their authorised third party can complete and give us this statement, only if one of the following applies:

  • a notice of past benefits has not been issued by us in the last 6 months
  • a notice of past benefits was issued before, but had expired at the time of judgment or settlement.
Page last updated: 30 June 2026.
QC 19956