Medical Treatment for Injured Workers – Wait, I can claim that?!
This article was written by Thomas Ryan.
Consultations, surgery, medicine – These are well recognised medical services and treatments that you might seek after being injured. But what many injured workers may not know is that they can claim many other items under their workers compensation claim.
Under section 60, a worker can claim medical or related treatment that is ‘reasonably necessary’ as a result of their work injury. This is evaluated on multiple factors such as the effectiveness of the treatment, costs involved, and any alternative treatment available.
What many workers might not realise is that under section 59, ‘medical or related treatment’ has quite a broad definition. In addition to what would be considered standard medical services, the Act also includes domestic assistance (such as cleaning or caring services) or modifications to an injured worker’s home or vehicle (such as converting a manual car to automatic transmission).
A broad catch term is also known as a ‘curative apparatus’ and this has enabled workers to obtain ‘paid-for’ services which might not have been obvious as claimable.
In the case of Honarvar v Professional Painting AU Pty Ltd, a painter fell off a ladder and suffered significant injury to his spine and ankle. During his recovery, the painter asked the insurer to cover the costs of an orthopaedic bed base and mattress. This was denied by the insurer as they believed that the claim did not fall under the legislative definition of medical or related treatment – specifically, that it did not come under the term ‘curative apparatus’.
However, the painter returned with medical evidence on the topic and the issue escalated to an appeal to the Deputy President of the Personal Injury Commission. On 31 March 2022, the Commission found in favour of the painter – overturning the insurer’s decision and allowing the bed and mattress.
On this occasion, the Deputy President favoured the painter’s medical evidence from his treating neurosurgeon and occupational therapist. In their reports, the specialists clearly indicated how the bed would be therapeutic to the painter’s particular injury and how it was recommended for him with a clear medical purpose. To the Deputy President, this evidence was enough for the bed to be considered a ‘curative apparatus’.
In the case of Parsons v Corrective Services NSW, an Emergency Response Officer suffered a severe psychological injury in his employment. He later claimed the costs of getting an assistance dog and this was disputed by the insurer. However, the Commission again determined in favour of the worker and held the dog to be a reasonably necessary medical treatment under the Act.
What you might claim under workers compensation is broader than many may first believe. We suggest that when your doctor recommends a treatment, that you ask them to also explain in writing how that treatment will be of particular benefit to you and your specific injury. This is likely to help the insurer consider the request more fairly, and if necessary, support any claim you might escalate to the Personal Injury Commission.
If you need assistance under workers compensation, including claiming medical treatment or challenging an insurer’s decision, please contact us at Carroll & O’Dea Lawyers on 1800 059 278. Alternatively, you can contact Scott Dougall, Partner on 02 8661 0206 or Thomas Ryan, Lawyer on 02 8661 0220.
Please feel free to check out Carroll & O’Dea Lawyers compensation page here to read our other compensation articles.