Depending on the nature and severity of the injury, an injured worker may be eligible for all or some of the following benefits:
- medical or related treatment
- hospital treatment
- ambulance service
- workplace rehabilitation service
- travel expenses to attend medical, hospital and rehabilitation appointments.
The Scheme Agent or insurer will only approve and pay these expenses after determining they are reasonably necessary. ‘Reasonably necessary’ is defined as treatment and services that are considered:
- appropriate for the injury and relieve the effects of the injury
- effective in promoting recovery
- cost effective
- the best option to other forms of treatment available
- accepted by the professional body in achieving optimum recovery and return to work.
Medical or related treatment
Medical and related treatment can include:
- treatment by medical practitioners, physiotherapists, chiropractors, osteopaths, psychologists, counsellors, exercise physiologists, remedial massage therapists
- provision of artificial aids
- domestic assistance services
- nursing, medical and medicine supplies (provided outside of hospital treatment).
The maximum amount payable for medical or related treatment is $50,000. This amount can be increased on a case-by-case basis by application to WorkCover or a direction from the Workers Compensation Commission.
Hospital treatment
Hospital treatment can include treatment at public and private hospitals and/or rehabilitation centres.
The Scheme Agent or insurer will only approve and pay for hospital treatment costs that are considered reasonably necessary.
The maximum amount payable for hospital treatment is $50,000. This amount can be increased on a case-by-case basis by application to WorkCover or a direction from the Workers Compensation Commission.
Ambulance service
Ambulance service expenses are for emergency, non-emergency and inter-hospital transfers provided by the Ambulance Service of NSW.
The Scheme Agent or insurer will only approve and pay for ambulance service costs that are considered reasonably necessary.
The maximum amount payable for ambulance service is $10,000. This amount can be increased on a case-by-case basis by application to WorkCover or a direction from the Workers Compensation Commission.
Workplace rehabilitation services
Approved workplace rehabilitation providers include occupational therapists, rehabilitation counsellors, physiotherapists and psychologists.
Approved workplace rehabilitation providers provide a range of services that focus on:
- return to work and case management
- specialised rehabilitation services such as:
- vocational and workplace assessments
- job analysis and modification
- identification of suitable duties
- worker re-training and placement in suitable employment.
The Scheme Agent or insurer will only approve and pay for workplace rehabilitation services that are considered reasonably necessary to return the worker to durable employment.
Travel expenses to attend medical, hospital and rehabiliation appointments
If an injured worker needs to travel for medical, hospital and rehabilitation appointments, the Scheme Agent or insurer will pay the reasonably necessary travel costs, if approved.
The injured worker will need to keep:
- a record of the mileage if the worker uses his/her car
- receipts for public trainsport.
The maximum amount payable for private car travel associated with attending medical, hospital and rehabilitation appointments is currently $0.55 per kilometre. This amount is reviewed every 12 months.
The Benefits guide contains the past and current benefits payable for medical, hospital and rehabilitation expenses.
Call 13 10 50 for more informtaion about medical, hospital and rehabilitation expenses.