You may be entitled to compensation for treatment expenses
If you have a work-related injury or illness, you may be entitled to compensation of the associated treatment expenses. WorkSafe can pay the reasonable costs of approved services.
You can choose which healthcare provider you use, as long as they meet the requirements of Victorian workers compensation legislation.
WorkSafe prefers that your provider sends their invoices directly to your WorkSafe agent, however you can also pay, keep your receipt, and then be reimbursed.
Services you can access without a referral
After a workplace injury or illness you may need fast access to healthcare services to help you recover and return to work.
You can access these services without a referral or initial approval from your WorkSafe agent:
- Dental services (where your compensable injury relates to dental)
- Family counselling (where it meets criteria stated in the related Policy)
- MRI scan
- Optometry (where your compensable injury is eye related)
- Podiatry (where your compensable injury directly relates to podiatry services)
Services that require a referral
WorkSafe may also pay for other healthcare services that you can access with a medical referral and with approval from your WorkSafe agent.
Requires both Medical practitioner referral and agent approval
- Attendant care
- Aids and appliances
- Community access
- Child care
- Car modifications
- Elective surgery
- External case management
- Exercise physiology
- Hearing device
- Home exercise equipment
- Home modifications
- Household help
- Grief and loss counselling
- Gym or swim programs
- Implantable pain therapy
- Network occupational therapy
- Network psychology
- Occupational therapy
- Pain management program
- Network pain management program
- Private psychiatric hospital
- Remedial massage
- Removalist costs
- Respite care
- Social work
- Speech pathology.
Note: Physiotherapists, Osteopaths and Chiropractors can make referrals for treatment or services such as: Aids and Appliances, Equipment, Household Help, Gym/Swim, Exercise Physiology.
WorkSafe will only fund one type of physical treatment (physiotherapy, osteopathic or chiropractic) at a time because it's difficult to effectively measure the benefits and outcomes of the treatments when delivered at the same time.
If a healthcare provider is registered with WorkSafe for more than one type of service (eg acupuncture and remedial massage) WorkSafe will only pay for one of the treatments on the same day.
When making decisions about the payment of your treatment, your WorkSafe agent will consider all available information including:
- medical certificates
- reports from treating health practitioners
- your individual needs and circumstances at the time of the request
- the nature and benefit of the treatment
- whether the service has been approved by WorkSafe and whether the service provider is appropriately registered
- whether the cost of the service is reasonable and necessary
WorkSafe agents must provide you with clear reasons for their decisions about the treatment services they approve.
Reimbursement for costs
WorkSafe prefers that your healthcare provider invoices your employer or your WorkSafe agent directly. Talk to your WorkSafe agent or employer to determine who your provider should invoice. WorkSafe will only pay for the approved cost of treatment.
If you choose to pay an account at the time of the service, then you should be reimbursed within 30 days from the time your WorkSafe agent receives your receipt. You need to send your receipts to your employer or WorkSafe agent within six months of the treatment.
Please note that payment of the reasonable costs of services does not necessarily mean payment of the full costs. In some cases there may be a gap between what the provider charges and what WorkSafe will pay. Check the fee schedule for the treatment or service that you are seeking and ensure you have prior approval where needed.
Network providers are healthcare providers who specialise in the treatment of injured workers and are contracted by WorkSafe. Talk to your WorkSafe agent about finding a network provider. Network providers will not charge fees above WorkSafe's approved costs.