Medical practitioners, including general practitioners, surgeons and specialists play a critical role in improving health and return to work outcomes for injured workers.
Medical practitioners are responsible for the overall management of an injured worker's recovery, rehabilitation and return to work, including:
- primary care of the injury
- monitoring and reviewing the injured worker's progress and outcomes
- assessing work capacity and providing Certificates of Capacity to WorkSafe Agents
- the safe prescription of clinically appropriate pharmacy items in accordance with WorkSafe's pharmacy policy
- referrals to other healthcare services and monitoring the effectiveness of these services
- facilitating return to work, which may include liaison with the employer.
WorkSafe Victoria can pay the reasonable costs of medical services provided by a medical practitioner to an injured worker.
- Medical Services – Reimbursement Rates (available from the fees A to Z page)
WorkSafe's policies provide guidance to health professionals on how to invoice WorkSafe, and what considerations are involved in determining what WorkSafe can and cannot pay.
- Medical practitioner policy
- Pharmacy policy
- Elective surgery policy
- Implantable pain therapy policy
- Pain management and network pain management policy
- Surgically implanted prosthesis policy for private hospitals
To ensure that invoices can be processed promptly medical practitioners are encouraged to adhere to WorkSafe's published guidelines.
All invoices should include information about the injured worker, your details and the service you provided. This will assist in the prompt processing of invoices.
- Invoicing guidelines for medical practitioners
- Clarification of Medicare Benefits Schedule billing rules
When providing a health service to an injured worker, please ensure that the worker has an accepted workers' compensation claim.
Billing review program
WorkSafe has a billing review program which checks that payments for services provided to injured workers are reasonable and appropriate.
A Treating Medical Practitioner Report is used to obtain clinical information about an injured worker's condition, as an alternative to arranging an Independent Medical Examination.
Information requested in a medical report may be used to assist in:
- managing an injured worker's rehabilitation and return to work
- determining if an injured worker has an entitlement, or continuing entitlement, to weekly payments of compensation or medical and like expenses
- determining liability to accept or deny a claim.
Return to work
A treating medical practitioner can help facilitate return to work by:
- setting early expectations with an injured worker about the importance of returning to work, and explaining that full health is not required to return to work
- exploring what the injured worker can do rather than what they can't do
- being clear about the restrictions of an injured worker's capacity (what they should restrict themselves to) as this will make it easier for an employer to identify suitable employment options
- responding to proposals from the employer about suitable employment options for the injured worker and supporting return to work planning
- recommending a referral to an occupational rehabilitation provider or other return to work support services to the WorkSafe Agent when appropriate
- encouraging active treatment programs, such as independent home exercises.
Further information can be found in the returning to work section of this website.
WorkSafe and its Agents collect health information about injured workers from medical practitioners.