Restricted consultations are in-rooms consultations with injured workers who require treatment beyond that of a standard consultation, including:
- moderate to severe acquired brain injuries
- crush injuries
- extensive burns
- spinal cord injuries
- multiple orthopaedic fractures
- limb amputations.
Chiropractors, osteopaths and physiotherapists may apply to provide a restricted consultation for injured workers with severe injuries and complex treatment needs.
Payment for restricted consultations cannot be made unless prior approval is obtained from WorkSafe.
WorkSafe expects that the restricted consultation is in line with the principles of the Clinical Framework for the delivery of healthcare services to injured workers.
If you identify a worker with severe injuries that are not covered under the criteria listed above, an application can be made for the application to be assessed 'on merit'.
Applying for restricted consultation
You must complete a restricted consultation application form and fax it to the managing WorkSafe Agent.
WorkSafe Agents aim to give notification within 5 business days of whether an application has been successful.
It is recommended that you do not use the restricted consultation item number until you have been advised in writing of the outcome of your application.
If you would like to check on the status of your application, you should contact the managing WorkSafe Agent.
Appealing a decision
You are able to appeal a decision of denial, regardless of whether the decision was made by the managing WorkSafe Agent or the WorkSafe Clinical Panel. All appeals are considered by two different members of the WorkSafe Clinical Panel and will contact you to discuss the application.
If you wish to lodge an appeal, please forward a copy of the original application, the reasons that you are requesting a review, and any other supporting documentation to email@example.com or mail to:
WorkSafe Clinical Panel
Health Services Group
Level 21, 222 Exhibition St
Completion of the restricted consultation application form can be invoiced under the appropriate restricted consultation application item code:
- Chiropractic: CR106
- Osteopathy: OS106
- Physiotherapy: PY106
Once written approval is provided from the WorkSafe Clinical Panel, you can invoice restricted consultations using the following codes within your fee schedules:
- Chiropractic: CR105
- Osteopathy: OS105
- Physiotherapy: PY105
Treatment for claims which do not meet the criteria for restricted consultations should be billed under the standard consultation item number.
Restricted consultations may be approved for a period of up to 6 months per application. If further restricted consultations are required after this period, you must re-apply by completing a new application form.