I sustained an injury at work… How do I get treatment?
Published on March 31, 2021 by Nadia Baker
First published by BlueStar – AFPA Magazine, March 2021 Edition.
Have you been injured at work? If so, you may have a potential claim for benefits under Comcare.
The Safety Rehabilitation and Compensation Act 1988 (SRC Act) provides an injured worker with the following entitlements:
- Payment of your reasonable medical treatment and rehabilitation.
- Payment of weekly payments of compensation where you are suffering a total or partial incapacity to undertake your pre-injury work.
- A lump sum for permanent impairment and non-economic loss, where the work injury results in a whole person permanent impairment of 10% as medically assessed under the Comcare guidelines. This assessment cannot be made until your injuries have stabilised.
- In rarer cases, benefits such as the cost of domestic care.
Should you have suffered an injury at work, it is essential that you report the injury to your employer. Once the injury has been reported, it is also essential that you consult your doctor to obtain medical advice and obtain a certificate of capacity for work. You should then proceed to lodging a Workers’ Compensation Claim Form, which can be obtained from your employer, doctor or the Comcare website.
If you are claiming compensation for a psychological injury you must also submit a statement of the event(s) that you say caused your injury.
Comcare is required to assess your claim and will issue a decision to let you know if they have accepted your claim.
Should your claim not be accepted, it is essential that you obtain legal advice as you only have 30 days to request Comcare review their decision not to accept your claim.
Once Comcare has accepted your claim, you will begin receiving your workers’ compensation entitlements.
Comcare will appoint a Claims Manager.
It is essential that you know your rights when dealing with Comcare – that you are entitled to choose your treating doctors and rehabilitation provider.
It is often the case that an injured worker will use their local general practitioner as their nominated treating doctor. This is good practice, as your local doctor is best suited to advise the workers’ compensation insurer of your injury, treatment and recovery, in order for you receive the best possible outcome for your recovery.
Comcare will fund an initial 5 sessions of physiotherapy with a Physiotherapist who is registered with the Physiotherapy Board of Australia without requiring prior approval.
If you require more than 5 sessions of physiotherapy, your physiotherapist must submit a Physiotherapy Treatment Notification Plan.
If further physiotherapy sessions are required after your treatment plan is completed, your physiotherapist must contact your Comcare Claims Manager to discuss your further treatment needs.
Comcare will fund an initial 5 sessions of psychological or counselling treatment without requiring prior approval.
Psychological and counselling sessions are limited to 60 minutes per day. If your sessions are likely to exceed 60 minutes, your psychologist or counsellor must obtain approval from Comcare by submitting a Psychology or Counselling Extended Consultation Request Form.
If you require more than 5 sessions of psychological or counselling treatment, your psychologist or counsellor must submit a Psychology and Counselling Treatment Notification Plan.
If further psychological or counselling sessions are required after your treatment plan is completed, your psychologist or counsellor must contact your Comcare Claims Manager to discuss your further treatment needs.
It is necessary to request approval from Comcare prior to commencing treatment with any other treatment providers.
There are a number of steps to obtain approval for further treatment that you should follow:
- Discuss your treatment needs with your treating doctor.
- Obtain a referral and/or treatment plan from your treating doctor.
- Submit your referral and/or treatment plan to your Comcare Claims Manager for approval.
- Comcare will advise whether the further treatment has been approved.
Should your request for treatment not be accepted, it is essential that you obtain legal advice as you only have 30 days to request Comcare review their decision.
Workers should also be aware Comcare will not reimburse an injured worker for a non-attendance fee incurred where an appointment is missed.
Should you have any questions regarding your rights in workers’ compensation or have been injured at work, please contact our offices to speak with highly experienced experts in workers compensation for further advice.