Gym and Swimming Program Policy
WorkSafe can pay the reasonable costs of a gym and/or swimming program to assist a worker in the rehabilitation of a work-related injury or illness and to transition to independence or a self-managed exercise program.
- What are gym and swimming programs?
- Who can provide gym and/or swimming program?
- When will WorkSafe pay for a gym and/or swimming program?
- When won’t the WorkSafe pay for a gym and/or swimming program?
- What information does the WorkSafe Agent require?
- Will WorkSafe pay for any subsequent gym and/or swimming programs?
- When won’t WorkSafe pay for any subsequent gym and/or swimming programs?
- How long can the gym and/or swimming program be?
- How much will WorkSafe pay for a gym and/or swimming program?
- What services are not included in the costs of a gym or swimming program?
What are gym and swimming programs?
Gym and swimming programs are exercise programs that are developed and monitored by a healthcare professional for a worker to perform independently in a gym and/or pool for the purpose of rehabilitation. Programs are for a fixed duration, generally 3 months.
Who can provide gym and/or swimming programs?
Gym and/or swimming programs can be provided by either a:
- commercial gym/pool facility, or
- gym/pool within the premises of an allied healthcare provider registered with WorkSafe.
All providers of gym and/or swimming programs need to be registered by WorkSafe to provide remedial exercise services.
When will WorkSafe pay for a gym and/or swimming program?
WorkSafe will pay the reasonable costs of a gym and/or swimming program for the rehabilitation of a work-related injury or illness when:
- it will assist the worker achieve specific work-related and functional goals and transition to independence or a self-managed exercise program,
- a medical practitioner has requested the worker’s participation in the program, and
- a written plan has been completed by a medical practitioner, physiotherapist, osteopath, chiropractor or exercise physiologist.
When won’t WorkSafe pay for a gym and/or swimming program?
WorkSafe will not pay for a gym and/or swimming program:
- that is not for the rehabilitation of a work-related injury or illness,
- which is performed outside Australia without prior written approval from the WorkSafe Agent, or
- has a primary focus on maintaining general physical fitness.
What information does the WorkSafe Agent require?
The WorkSafe Agent requires a current referral from a medical practitioner and a written plan by a medical practitioner, physiotherapist, osteopath, chiropractor or exercise physiologist.
The written plan must include the following:-
- the specific work-related and functional goals of the program;
- at least one current baseline standardised functional outcome measure (such as the Oswestry or the Upper Extremity Functional Index);
- the recommended frequency of the worker’s attendance;
- the plan for set-up, monitoring and evaluating the program;
- the recommended gym and/or pool facility;
- the duration of the program and the program cost; and
- confirmation that the worker is willing to actively participate in the program and understands how to safely perform the specific exercises within the program.
Will WorkSafe pay for any subsequent gym and/or swimming programs?
WorkSafe will consider paying for the reasonable costs of a subsequent gym and/or swimming program where it will assist in the worker’s rehabilitation.
If a healthcare professional would like the WorkSafe Agent to consider a subsequent program, the worker will need a current referral from a medical practitioner and a further written plan from a medical practitioner, physiotherapist, osteopath, chiropractor or exercise physiologist.
The written plan should also include an evaluation of the previous program and the reasons why a subsequent program is required. The evaluation of the previous program must include the following:
- the original work-related and functional goals of the program and subsequent progress;
- baseline and serial standardised functional outcome measures taken over the three month period; and
- confirmation of regular attendance throughout the previous program.
When won’t WorkSafe pay for any subsequent gym and/or swimming programs?
WorkSafe will not pay for subsequent gym and/or swimming programs:
- when the worker’s condition, injury or illness has stabilised, or
- where specific work-related and functional goals have been met and the worker has transitioned to independence or a self-managed exercise program, or
- that will not assist the worker in their rehabilitation.
How long can the gym and/or swimming program be?
Generally gym and/or swimming programs should be for a three month period. WorkSafe will consider payment for a program longer than three months (an extended program) in exceptional circumstances. For example, WorkSafe will pay for an extended program when a worker has a complex injury and will require more than three months to achieve their specific work-related and functional goals. Complex injuries may include spinal cord injuries, moderate to severe acquired brain injuries, crush injuries, extensive burns, multiple orthopaedic injuries and/or limb amputations.
If a healthcare professional recommends an extended program, they must include reasons why the extended program will be required.
How much will WorkSafe pay for a gym and/or swimming program?
WorkSafe will pay the reasonable costs of a gym and/or swimming program up to a maximum amount as specified in the WorkSafe fee schedule.
What services are not included in the costs of a gym or swimming program?
WorkSafe will not pay for the following:-
- personal trainers;
- swimming lessons;
- any extra services (such as a spa or sauna);
- any clothing or equipment associated with a gym or swimming program, such as swimming costumes, goggles or training shoes;
- casual gym sessions;
- casual swim sessions, except where required as part of a supervised hydrotherapy program provided by a physiotherapist; or
- more than one gym program or swimming program at a time.
