The following frequently asked questions will provide you with information to help you achieve your workers’ compensation requirements.

What is the difference between the Progress and Final Certificate of Capacity?

Certificates of Capacity are designed to focus on what your patient can do to remain in or return to work, improve communication that supports their recovery, and enable you to share your assessment of your patient’s progress and needs so the insurer can make informed decisions about a workers’ compensation claim.

The First Certificate outlines the type and extent of the injury, fitness to work, and any recommended restrictions on work duties.

The Progress Certificate keeps the employer and insurer updated on your patient’s progress, ongoing treatment requirements and capacity to return to work.

A Final Certificate is provided when the patient is fully fit and no longer requires treatment. The Certificates and explanatory notes can be downloaded from the gpsupport page.

When is the next training to become an approved medical specialist?
Call WorkCover WA’s Advice and Assistance line on 1300 794 744 to obtain more information about training dates.
Where can I get a copy of the WorkCover WA Guidelines for the Evaluation of
Permanent Impairment (WorkCover Guidelines)?
Publications for Approved Medical Specialists can be downloaded from the Health providers resources page.

If you need a hard copy, please contact Advice and Assistance on 1300 794 744.

What do I charge for workers' compensation treatment?
WorkCover WA specifies rates billable under the workers’ compensation system for medical and allied health treatment. These rates represent the amount that the insurer will reimburse the worker. If your rates are higher than those specified, the worker may be responsible to pay the ‘gap’. You should highlight this to the worker prior to their appointment..

To view these fees, see the Rates, fees and payments page.

What codes do I use for different procedures?
Treatment codes can be accessed in the Resources Tab on the Rates, Fees and Payments page.  If codes for medical treatment are not shown, medical practitioners can use the code provided in either the Australian Medical Association’s (AMA) List of Medical Services and book or on the Medicare Benefits Schedule Online website

Please remember to include a clear description of the service provided on your invoice to the workers’ compensation insurer.

For more information, call WorkCover WA’s Advice and Assistance line on 1300 794 744.

How much should I be charging for a medical service that does not have a WorkCover WA fee?
If a medical service does not have an applicable WorkCover WA fee, then you will need to discuss the payment of the service fee with the workers’ compensation insurer. As a general rule, the fee shown in the Australian Medical Association’s (AMA) List of Medical Services and Fees is usually acceptable to the insurers in most instances.

Please remember to include the service code and a clear description of the service provided on your invoice to the workers’ compensation insurer.

What is an approved treatment?
A worker is entitled to recover their costs for reasonable medical and related expenses. These fall under the heading of approved treatments and include such things as, visits to and treatments by your general practitioner and specialist, physiotherapist and occupational therapist.

If a worker requires treatment from a non-approved health provider for example a naturopath, they should check with their employer’s insurer to ensure that their cost will be reimbursed prior to commencing treatment.

How do I become an approved workplace rehabilitation provider?
WorkCover WA approves persons capable of providing workplace rehabilitation services and sets conditions of approval.

Further information is contained in the application package for approved workplace rehabilitation providers on the Health Providers page.

Who do I make an account to?
The account should be made out to the patient.
Where do I send accounts?
If the claim status is unknown or pending, then send the account to the worker.  But if the claim has been accepted, then send the account to the insurer.  The employer is not liable for paying the treatment accounts.
How do I get paid for treatment if the worker has not made a workers' compensation claim or it is pending?
Your practice will have a billing policy.  It may stipulate, for example, that the worker pays for service prior to treatment, or an invoice be issued to the patient for payment by a later date, or service can be bulk billed to Medicare.