Once an insurer accepts liability for your worker’s compensation claim, Section 60 of the Workers Compensation Act provides that the insurer is liable to pay for any reasonable treatment.
Reasonable treatment must be related to the injury sustained in the course of your employment and includes:
- Medical or related treatment;
- Hospital treatment;
- Ambulance service treatment;
- Workplace rehabilitation service.
Expert Workplace Injury Lawyers
Our lawyers practice regularly in worker’s compensation matters are approved by WIRO to obtain grants of legal assistance to pay for an injured persons legal fees and medical reports. This includes disputes involving treatment expenses. As such, you can be confident that you will receive advice from a lawyer that has an in depth understanding of the worker’s compensation legislation.
How Long Am I Entitled to Claim Treatment Expenses?
You are normally entitled to reasonable treatment expenses to be paid whilst you are receiving worker’s compensation payments (weekly benefits) and for a period of 2 years from the date your weekly benefits cease. If your injury equates to a whole person impairment greater than 10% but less than 20%, this period of treatment is extended to 5 years. If your injury equates to a whole person impairment greater than 20% then there is no timeframe for when reasonable treatment expenses will cease.
In addition, the timeframes outlined above do not apply to the following kinds of medical treatment (ie the insurer is liable for such treatment regardless of the timeframe and your level of whole person impairment):
- Provision of crutches, artificial members, eyes or teeth or any artificial aids or spectacles (including hearing aids and hearing batteries);
- The modification of your home or vehicle;
- Secondary surgery (surgery to the same part of your body which has already been subject to surgery as part of the worker’s compensation claim.
What Can I Do If the Insurer Has Denied My Treatment?
It is very common for an insurer to either deny a claim entirely where such treatment is required, or in claim which has been accepted, decline a certain type of treatment which has been recommended by your treating medical practitioners.
In such circumstances, you will require the assistance of a lawyer to dispute the decision of the insurer and to have your treatment rights reinstated. If you do not dispute this decision, then the insurer will never be liable to pay for any form of treatment now or into the future (even if your injuries deteriorate and you need surgery).
To dispute the insurer’s decision, we can seek a grant of assistance from WIRO (Workers Compensation Independent Review Office) who will in most circumstances agree to fund your legal costs and any disbursements (medical assessments and reports required). This means that you will not have to pay us for any of the legal work in disputing the insurer’s decision nor will you have to pay for any of the medical assessment and reports required to support your claim.
The above information is general information only. For a free consultation and specific advice regarding your claim from one of our experts please contact us on Free Call 1800 122 555 or complete our Free Advice Form.