Neuropsychology services guidelines

About these guidelines

These guidelines are in line with the Workplace Injury Rehabilitation and Compensation Act 2013 (WIRC Act) and the Accident Compensation Act 1985.

WorkSafe will have regard to these guidelines when making decisions for the provision of neuropsychology services to people who have an accepted claim under the Victorian Workers Compensation Scheme.

These guidelines also apply when a person is entitled to provisional payments on a claim that includes a mental injury.

Throughout these guidelines, any reference to WorkSafe also includes WorkSafe’s agents and self-insurers.

Neuropsychology services

WorkSafe can fund neuropsychology services to assist people to effectively recover from workplace injuries and safely return to work and life.

Neuropsychologists perform the following services.

• Provide assessment and treatment for a wide range of brain conditions that affect learning, reading, attention span and decision making.
• Assess behavioural, cognitive and emotional effects to diagnose mental conditions.
• Plan treatments for people with brain conditions.
• Identify strengths and weaknesses of an individual to diagnose cognitive impairment.

Neuropsychologist can provide services, together with other health professionals, to plan and manage treatment. A treatment plan will consider a person’s lifestyle, activities and general health.

What we can pay for

WorkSafe can pay the reasonable costs of neuropsychology services a person needs as a result of a work-related injury or illness under Victorian workers compensation legislation.

WorkSafe can also pay for the reasonable costs of neuropsychology for people who are entitled to provisional payments that include a mental injury.

The treatment or service must meet the following criteria.

• Be clinically justified, safe and effective.
• Be likely to achieve measurable improvement in a person’s functioning.
• Promote progress toward a person’s functional independence, participation and self-management.
• Be for rehabilitation purposes for a work-related injury only.
• Be delivered in line with the Clinical Framework.

The treatment or service must be referred by a medical practitioner.

WorkSafe can pay for the following services.

• Comprehensive neuropsychological assessments.
• Individual neuropsychology consultations.
• Group neuropsychology consultations.
• Treatment and Recovery Planning Conferences.
• Return to Work Case Conferences.
• Completion of the ‘Treatment planning’ form and ‘Treatment review’ form by neuropsychologists.

WorkSafe will periodically review a person’s entitlement to neuropsychology services to make sure treatment and services remain reasonable, clinically justified, outcome focused and payable under the legislation.

Services we will not pay for

Under the Victorian workers compensation legislation, WorkSafe cannot pay for the following neuropsychology services.

• Services that are not required as a result of a worker’s accepted injury or illness.
• Services for a person other than the person with an accepted claim.
• Services that are not a reasonable cost as determined in accordance with the Victorian workers compensation legislation.
• Services provided outside of Australia without prior approval from WorkSafe.
• Services provided by a person who, under the Health Practitioner Regulation National Law either:
  • is not registered
  • is registered as a student, or
  • holds provisional registration to practice in the relevant profession.
• Services that were provided without a referral from a medical practitioner.

Under WorkSafe’s determination of reasonable cost, WorkSafe will not pay for costs relating to the following.

• More than one neuropsychology service on the same day by the same clinician. This excludes comprehensive neuropsychological assessments.
• Non-attendance or cancellation of appointments.
• Telehealth services not provided in line with our Telehealth policy.
• Costs of accessing e-therapy or telehealth treatment. This includes costs such as those associated with using a computer, telephone, tablet, software or the internet.

Worksafe will not pay for neuropsychology services provided without prior approval from WorkSafe.

How much we can pay

WorkSafe will pay for neuropsychology services in line with our fee schedules.

Sometimes there is a difference between what a provider charges and what WorkSafe will pay as the reasonable cost. If the provider charges more than what WorkSafe will pay, workers will need to pay the difference. In this instance, WorkSafe recommend the provider advise the worker prior to providing any services.

Who can provide these services

WorkSafe will only fund services delivered by providers that meet the following conditions.

• Hold general registration with the Psychology Board of Australia in conjunction with the Australian Health Practitioner Regulation Agency (AHPRA) (other than as provisional registration or as a student).
• Are able to provide evidence that they have an accredited qualification in clinical neuropsychology with endorsement as a clinical neuropsychologist.
• Hold the requisite insurance coverage to deliver neuropsychology services.

Find out how to register as a provider.

Accessing services

WorkSafe can fund neuropsychology services only if a medical practitioner provides a referral prior to the commencement of the service.

WorkSafe does not allow neuropsychologists to provide referrals to other health services.

For WorkSafe to approve comprehensive neuropsychology assessments, it requires the following information.

• Detail on the amount of hours required to complete the assessment.
• Detail on the amount of hours required to complete the report.
• Clinical justification for the comprehensive neuropsychological assessment.

WorkSafe expects providers of neuropsychology services to submit the following forms to meet service expectations.

WorkSafe also expects neuropsychologists to use the following methods to engage with agents and other treating providers to meet service expectations.

Service delivery expectations

WorkSafe expects that all providers delivering neuropsychology services as part of the Victorian workers compensation scheme follow the below principles.

• Provide culturally safe and respectful services.
  • Protect the person’s human rights and report any concerns of abuse, neglect or discrimination to an appropriate regulatory or complaints body.
  • Support the person to maximise their independence, promote recovery and self-advocacy.

WorkSafe also expects that any treatment provided is reasonable, clinically justified, outcome focused, and in line with the Clinical Framework.

WorkSafe has reporting and engagement expectations for all providers delivering neuropsychology services to workers. WorkSafe expects providers to communicate, collaborate and provide information to WorkSafe and other relevant parties as required.

For example:

• Providers should work with treating health practitioners or other providers, such as medical practitioners to enable the most appropriate treatment
• Providers should work with occupational rehabilitation providers, treating health practitioners and employers in relation to return to work.

Providers are required to comply with the requirements set out in these guidelines and in the Application for registration to provide services to workers.

If a provider does not meet these requirements or WorkSafe has concerns about the provider’s conduct or services delivered, WorkSafe may take appropriate action in accordance with the legislation.