Supports for your recovery and benefits

Medical treatment

You can be reimbursed for reasonable medical, hospital, pharmaceutical and other treatment costs incurred from the date of your injury or illness, when liability has been accepted under a claim for compensation.

It is important to seek approval for medical treatment in advance, wherever possible.

Medical treatment explained

Medical treatment means:

• medical or surgical treatment by, or under the supervision of, a legally qualified medical practitioner
• therapeutic treatment obtained at the direction of a legally qualified medical practitioner
• dental treatment by, or under the supervision of, a legally qualified dentist
• therapeutic treatment by, or under the supervision of, a physiotherapist, osteopath, masseur or chiropractor registered under the law of a state or territory
• an examination, test or analysis carried out on, or in relation to, an employee at the request or direction of a legally qualified medical practitioner or dentist and the provision of a subsequent report
• the supply, replacement or repair of an artificial limb or other artificial substitute, or of a medical, surgical or other similar aid or appliance
• treatment and maintenance as a patient at a hospital
• nursing care, and the provision of medicines, medical and surgical supplies and curative apparatus, whether in a hospital or not.

A legally qualified medical practitioner is a person registered as a medical practitioner in the state, territory or foreign country in which the person examines or treats the employee, including a general practitioner, surgeon, or other medical specialist.

Eligibility and making a claim

You may be eligible to have the costs of medical treatment paid by your employer if you have an accepted claim for workers' compensation and the services are required as a result of your compensable injury.

Treatment requirements should be discussed with your medical provider and employer, and may form part of a return to work plan.

Any claim for payment of the costs of medical treatment should be made to your employer in the first instance. Your employer will be able to advise on the process for making a claim.

Time limit for a decision

Your employer must decide your claim within 12 calendar days from the day your employer receives your claim.

If your employer notifies you in writing that further information is required to make a determination, the time limit may be extended. A request for more information must be made within 12 calendar days of receiving your claim.

If your employer has not decided your claim within the time limit and has not requested further information, your claim is taken to have been rejected. You can request a reconsideration of this decision.

Payment limits

An employer can decide how appropriate treatment fees are on a case-by-case basis.

Payment may be based on the fees recommended by various professional associations and other Australian workers’ compensation authorities.

Attendant care services

You may need help with personal care following a work-related injury or illness.

If you want to claim the cost of attendant care services, make sure you get approval before you engage a service provider.

Attendant care services explained

Attendant care services are services for your essential and regular personal care.

Attendant care services assist and support you to carry out daily living activities.

This may include:

• grooming
• bathing and toileting
• dressing
• eating and drinking
• using and applying artificial aids and appliances
• other essential and regular personal care needs.

Attendant care services do not include:

• medical services
• surgical services
• nursing care
• expenses for incidental travel
• accommodation
• meal costs.

Eligibility and making a claim

You may apply for attendant care services if you have an accepted claim for workers' compensation and the services are required as a result of your compensable injury.

You may be required to be assessed by an occupational therapist or other health professional.

Any claim for attendant care services should be made to your employer in the first instance. Your employer will be able to advise on the process for making a claim.

Payment for services

Payment for attendant care services is subject to a weekly maximum limit. This limit does not apply to people who have a catastrophic injury.

There are usually two ways a service provider can be paid for their services:

• from your employer, or
• directly from you.

Speak with your employer about the payment options available and whether there is a preferred method of payment.

If you have a complaint about the service

If you are unhappy with the way a service has been delivered, or with how you have been treated, you have a right to complain and have your concerns addressed.

You can:

• raise the concerns with your support worker or their employer (your service provider) if you feel comfortable to do so
• work with your employer to change your service provider, if you do not feel comfortable raising your concerns or feel your concerns have not been addressed
• raise serious or ongoing concerns about a provider’s behaviour with your employer and with the Australian Community Industry Alliance (ACIA), where the provider is accredited by them.

Household services

You may need help with household tasks following a work-related injury or illness.

If you want to claim the cost of household services, make sure you get approval before you engage a service provider.

Household services explained

Household services are basic services of a domestic nature that you require for the proper running and maintenance of your household.

Household services may include:

• cooking
• help with grocery shopping (if home delivery is not available)
• house cleaning
• laundry duties
• gardening, which may also include gutter cleaning.

Compensation is not payable for household maintenance and repairs such as:

• painting and decorating (exterior and interior)
• washing, servicing, repairing or maintaining family vehicles
• repairing fences, doors, and windows
• plumbing
• electrical repairs.

Eligibility and making a claim

You may apply for household services if you have an accepted claim for workers' compensation and the services are required as a result of your compensable injury.

You may be required to be assessed by an occupational therapist or other health professional.

Your request for household services can be considered if you are no longer able to complete the household tasks required to properly run and maintain your home.

Compensation for household services is not payable for the first 28 days after an injury or illness, unless:

• you have a catastrophic injury
• your employer determines you have financial hardship
• your employer determines that you require childcare services to supervise your dependent children.

Payment for services cannot be approved if it is reasonable to expect other members of your family to carry out the tasks. This is the case even if family members did not normally undertake the tasks before your injury or illness.

Any claim for household services should be made to your employer in the first instance. Your employer will be able to provide information on the claims process.

Payment for services

Payment for household services is subject to a weekly maximum limit. This limit does not apply to people who have a catastrophic injury.

There are usually two ways a service provider can be paid for their services:

• from your employer, or
• directly from you.

Speak with your employer about the payment options available and whether there is a preferred method of payment.

If you have a complaint about the service

If you are unhappy with the way a service has been delivered, or with how you have been treated, you have a right to complain and have your concerns addressed.

You can:

• raise the concerns with the worker doing your household services or their employer (your service provider) if you feel comfortable to do so
• work with your employer to change your service provider, if you do not feel comfortable raising your concerns or feel your concerns have not been addressed
• raise serious or ongoing concerns about a provider’s behaviour with your employer and with the Australian Community Industry Alliance (ACIA), where the provider is accredited by them.

Aids, appliances and modifications

You may be able to claim the cost of buying, repairing or modifying an aid or appliance you need to help with your work-related injury or illness.

Make sure you get approval before you buy, repair or modify an aid or appliance if you want to claim the cost.

Aids, appliances and modifications explained

A medical aid directly assists a person with their physical or bodily functioning. Medical aids include:

• hearing aids
• surgical footwear
• crutches
• prosthetic devices
• artificial limbs
• consultations and fittings.

There are also other aids and appliances which help people adjust and function with the injury or illness. Some examples are:

• backrests
• telephones for people with a visual impairment
• door openers
• angled writing boards
• altering household furniture.

Essential home and car modifications, such as converting a car from manual to automatic transmission, and workplace modifications (in cases where your employer may not have a duty of care) may be required as a result of an injury or illness.

General household items such as toasters, vacuum cleaners and dishwashers are not considered to be aids or appliances.

Eligibility and making a claim

You must need the aid, appliance or modification as a result of your accepted claim for workers' compensation. The request must also be a reasonable one.

Your request can only be considered if you:

• are carrying out a rehabilitation program
• have completed a rehabilitation program, or
• have been assessed as not capable of undertaking a rehabilitation program.

Any claim for an aid, appliance or modification should be discussed in the first instance with your employer and/or rehabilitation provider. Your employer will be able to provide you with information on how to make a claim.

Travel expenses

You may be entitled to be reimbursed for the cost of travel to attend medical treatment that you need because of a work-related injury or illness.

If you want to claim travel expenses, make sure you meet the requirements and have the necessary evidence and approval before you travel.

Travel expenses explained

You may be entitled to be reimbursed for:

• travel costs to attend medical treatment
• any reasonable expenses such as accommodation or parking related to obtaining compensable medical treatment, attending a rehabilitation assessment, or participating in a rehabilitation program.

Eligibility and making a claim

To reimburse travel costs, the medical treatment you require must be as a result of your work-related injury or illness.

You must also need to travel:

• in an ambulance or by public transport because of your work-related illness or injury, or
• by private motor vehicle more than 50 kilometres round trip to a single treatment session.

If the type of treatment you need is available from another medical provider who practices within the 50-kilometre round-trip limit, you are not eligible to be reimbursed for travel expenses unless your employer can determine that there are special circumstances.

Your employer will be able to provide you with information on how to make a claim for travel related expenses.

Payment limits

Payment is made at a specific rate per kilometre travelled. This rate is reviewed regularly and updated as appropriate.

Property loss or damage

You may be entitled to be compensated for property loss or damage as a result of the work-related injury or illness.

Property loss or damage explained

You may be able to claim compensation where you are involved in an accident that results in the loss or damage to specified property.

Property that can be compensated for are:

• an artificial limb or other artificial substitute
• a medical, surgical or other similar aid
• appliance used by the employee.

Examples include prescription glasses, prosthetic limbs, crutches, walking sticks and wheelchairs.

Eligibility and making a claim

You do not need to claim for compensation for a personal injury in order to claim compensation for property loss or damage.

Your employer will be able to provide you with information on how to make a claim for property loss or damage.