Expenses

This section covers the receipt of compensation for reasonable medical and rehabilitation expenses, as well as claim-related travel, board and lodging costs.

If you are injured at work, you may claim for a range of reasonable medical expenses, including:

  • first aid and ambulance
  • medicines
  • medical or surgical attendance
  • treatment by specialists
  • dental
  • physiotherapy
  • chiropractic
  • charges for hospital treatment
  • other approved treatment, including osteopathy, clinical psychology, occupational therapy, speech pathology, and exercise physiology.

If you require treatment from an alternative health provider, for example a naturopath, you should check with your employer’s insurer to ensure that the cost will be reimbursed prior to commencing treatment.

Right to choose

You also have the right to be treated by a doctor or allied health provider of your choice.

Reimbursement of medical expenses

It’s important to check with your employer’s insurer before commencing any treatment to ensure it will be reimbursed.

Generally, you will need pay for your medical invoices after a consultation or treatment and be reimbursed by your employer’s insurer. However, arrangements can be made for treatment invoices to be issued directly to your employer’s insurer.

The insurer will only pay medical accounts up to the medical and allied health provider rates set by WorkCover WA. If your provider charges more than this rate, you will be responsible for the extra portion of the account (the ‘gap’).

Check the charges with the provider before making an appointment.

The amount you can receive to cover your medical expenses over the life of your claim is limited.

The insurer will notify you once 60 per cent of the maximum amount for medical expenses has been reached. For more information see the Prescribed amount.

Extension of medical expenses

In certain circumstances, you may lodge an application with the Workers’ Compensation Conciliation Service (WCCS) for an extension of the medical expenses amount. WCCS will take into account your social and financial circumstances and your reasonable financial needs when considering your eligibility for an extension.

If you exhaust the medical entitlement, an additional $2000 for medical and related expenses will be available while you pursue an extension.

If you meet exceptional medical circumstances criteria and have a whole of person impairment of not less than 15 per cent, a Conciliation Officer in the Workers’ Compensation Conciliation Service or Arbitrator in the Workers’ Compensation Arbitration Service may grant an extension of up to $250,000 beyond the additional $50,000 for medical expenses.

Note: If you accept exceptional circumstances payments, you automatically waive your right to pursue common law damages.

For more information, download the Exceptional Circumstances Medical Payments Brochure (PDF – 2.24mb).

You are entitled to claim for reasonable workplace rehabilitation expenses, but there is a limit to your entitlement. For more information see the Prescribed amount.

Workplace rehabilitation providers are approved by WorkCover WA and their costs are covered up to an approved percentage of the prescribed amount in every workers’ compensation claim. Costs may vary according to the services they provide, but the maximum amount they can charge is determined by WorkCover WA and reviewed annually.

Where you are required by your employer, their insurer or a medical practitioner to travel from your home to a medical appointment or rehabilitation provider, you can claim the cost of reasonable travel expenses.

Travel expenses incurred by a worker in obtaining an assessment by an approved medical specialist can also be claimed.

Regional workers

For workers in regional areas, reasonable costs may also include reasonable meals and accommodation expenses.

What you should do

Payment of travel costs is best arranged through your employer or their insurer. Keep a record of your travel by recording vehicle kilometres, appointment dates and times, and any public transport tickets or receipts.

Note: Insurers will only pay the rates set by WorkCover WA for travel, board and lodging expenses. See the ‘prescribed allowances’ within the Prescribed amount for more details on these rates and expenses.