Podiatry services guidelines

The provision of podiatry services

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 podiatry services to people who have an accepted claim under the Victorian Workers Compensation Scheme. Throughout these guidelines, any reference to WorkSafe also includes WorkSafe’s agents and self-insurers.

Podiatry services

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

Podiatrists are qualified allied health professionals who specialise in the assessment, diagnosis and treatment of foot, ankle and lower limb conditions. They help with injuries to feet, heels, skin and nails as well as balance issues. Podiatrists can analyse walking to provide treatment plans and advice on footwear, mobility and long-term foot health.

What we can pay for

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

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

Consultations

WorkSafe can pay for the reasonable costs for consultations in line with the Podiatry services fee schedule.

• Initial consultations
• Standard consultations
• Orthotics

Further information can be found in the section ‘Accessing services’ in these guidelines.

Return to Work case conference

A Return to Work (RTW) case conference brings together a worker and their supports in a collaborative setting to promote recovery and return to work goals.

The case conference will include:

• the worker
• treating health practitioner(s)
• WorkSafe
• an occupational rehabilitation consultant
• the employer, where appropriate.

A RTW case conference will be requested by WorkSafe or an occupational rehabilitation consultant. A treating health practitioner can request a case conference by contacting WorkSafe or the occupational rehabilitation consultant directly. Confirmation of contact with WorkSafe and/or the occupational rehabilitation consultant must be kept in the worker’s clinical records.

Either WorkSafe or the occupational rehabilitation consultant must attend the RTW case conference. RTW case conferences are not approved for contact between treating health practitioners where a WorkSafe representative or occupational rehabilitation consultant is not present. RTW case conferences do not include a one-to-one discussion with a member of the Clinical Panel.

Administration and any follow-up required after the RTW case conference is included in the RTW case conference fee.

Requests for information – 52 week Medical and Like Entitlement Review (52 MLER) questionnaire

The 52 MLER questionnaire is used when a claim reaches 52 weeks after weekly payments have ceased. It evaluates the worker's ongoing need for medical and rehabilitation services to determine their continuing entitlement to compensation. The reasonable costs of completing a 52 MLER questionnaire can be paid only when it is requested by WorkSafe.

Services we will not pay for

Under the Victorian workers compensation legislation, WorkSafe cannot pay for the following podiatry 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 or the employer.
• Services provided by a person in the relevant profession who, under the Health Practitioner Regulation National Law either:
  • is not registered
  • is registered as a student
  • holds limited or non-practising registration.

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

• Treatment and services that do not align with the Clinical framework.
• Items that are not billed in line with the WorkSafe podiatry services fee schedule.
• The provision of multiple disciplines or concurrent physical treatments or consultations. For example, podiatry and acupuncture.
• Consultations provided more than once on the same day to the same worker in relation to a single claim number.
• A single service or consultation billed to more than one claim held by the worker. If a single service or consultation is treating injuries under multiple claim numbers, it should be billed only to the most active claim.
• More than one initial consultation by the same provider or clinic unless there are exceptional circumstances. For example, following a hospital admission or surgery, or where a significant period of time has elapsed since the worker last received treatment.
• Non-attendance or cancellation of appointments.
• Services provided to a worker without the worker requesting an appointment.
• Services provided by telephone or other non-face to face platform not in line with WorkSafe’s Telehealth policy.
• Telephone calls and telephone consultations between providers and workers, and between other providers, including hospitals, that do not align with WorkSafe's telehealth policy.
• Consumable items used during the consultation.
• Pharmacy items supplied by health professionals, such as creams and gels.

How much we can pay

WorkSafe will pay for podiatry 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 recommends the provider advise the worker before providing any services.

Podiatrists must comply with WorkSafe’s instructions for invoicing.

Who can provide these services

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

• Hold general or specialist registration with the Podiatry Board of Australia in conjunction with the Australia Health Practitioner Regulations Agency (AHPRA). This does not include student, limited or non-practising registration.
• Maintain the requisite insurance coverage to deliver podiatry services.

Find out how to register for approval as a provider.

Where there is an accepted WorkSafe claim, workers can access podiatry services for a work-related injury or illness without prior approval from WorkSafe or a referral from a medical practitioner. WorkSafe does not allow podiatrists to provide referrals to other health services.

Initial consultations

The initial consultation is the first consultation provided by the podiatrist for assessment and treatment of the work-related injury or illness. It should be delivered on a one-to-one basis with the worker. The session duration must represent reasonable and appropriate clinical practice.

It must include the following.

• Initial assessment, including history taking and physical examination.
• Intervention and/or treatment.
• Tailored goal setting and treatment planning.
• Expectation setting around recovery and return to work.
• Screening for barriers to recovery.
• Record of clinical notes.

An initial consultation can be billed only once by the same provider, clinic or clinical group.

Standard consultations

A standard consultation is any consultation occurring after the initial consultation provided by the podiatrist. It should be delivered on a one-to-one basis with the worker. The session duration should be a minimum of 20 minutes and represent reasonable and appropriate clinical practice.

It may include the following.

• Reassessment.
• Intervention and/or treatment.
• Reviewing progress towards goals and adapting treatment plan when goals are not being met.
• Expectation setting around recovery and return to work.
• Monitoring barriers to recovery and acting on these when goals are not met.
• Record of clinical notes.

Orthoses

WorkSafe can pay the reasonable costs of orthoses required as a result of a work-related injury.

Prior approval from WorkSafe is required before orthoses that cost more than $250 are provided to a worker treated at a private practice or as a hospital outpatient.

For orthoses costing more than $250, an ‘Orthotic device request form’ must be submitted to WorkSafe and prior approval obtained.

The request must include:

• clinical justification of the need for services due to the work-related injury or illness
• information about current function and limitations
• details of predicted outcomes
• cost.

For orthoses provided to an inpatient of a hospital, see the relevant hospital policy.

Accessing services

Telehealth consultations

Telehealth attendance means audio-visual or audio only consultation between the podiatrist and worker. Audio-visual connection is always preferred where possible. WorkSafe can pay for telehealth podiatrist services in line with the Telehealth policy.

Clinical Support Service

WorkSafe recognises that treating people with a work-related injury or illness often comes with challenges for providers.

The Clinical Support Service provides direct access to WorkSafe’s Clinical Panel experts, a group of highly experienced and qualified allied health and medical professionals. The service provides free support and advice for medical and health service providers related to the treatment of workers with an accepted claim.

Providers can contact the Clinical Panel for support with the following.

• Completing certificates of capacity, AHRMP, treater questionnaires, treatment plans and reporting.
• Applying the principles of the Clinical framework and using outcome measures.
• Managing complex treatment and recovery barriers.
• Preparing for, and having, difficult conversations with workers.
• Brainstorming discussions around treatment pathways and available support when

Service delivery expectations

WorkSafe expects that all providers delivering podiatry services as part of the Victorian workers compensation scheme follow these 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 podiatry 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.