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Medical and Like Services
With accepted WorkCover claims workers are entitled to 'reasonable medical and like services'.
This is a very broad statement and it is not spelt out clearly in WorkCover publications. This is not surprising as there is no definitive list, but it is important to understand that 'like services' can cover lots of things that injured workers need but don't realise that WorkCover might provide.
So we'll have a go at giving some idea of the range of services that might be considered to be 'reasonable' if you need them because of work related injuries and illnesses.
Medical services obviously covers things such as:
Ø Doctors' services, including GPs and Specialists;
Ø Hospital services, such as surgery or emergency services;
Ø Nursing services;
Ø Attendant Care
Ø Chiropractic services;
Ø Dental services;
Ø Osteopathy;
Ø Physiotherapy;
Ø Counselling e.g. from a psychologist;
Ø Occupational therapy;
Ø Hearing Aids;
Ø Speech Therapy; and
Ø Podiatry services, i.e. a foot doctor, also called a Chiropodist.
Some of the things that are covered under this but often people don't realise it and therefore don't claim (which means that people pay for the services themselves or miss out on the treatment because it costs too much) include:
Ø Pharmacy;
Ø Acupuncture;
Ø Naturopathy;
Ø Remedial massage;
Ø Dietician's services;
Ø Remedial gymnasium/swimming/exercise fees; and
Ø Aids and appliances, ranging from orthotics (boots or callipers), or TENS machines to particular types of chairs or beds.
As can be seen by the range of things that can be considered as aids and appliances, what might be covered by is not always what leaps to mind.
One of the things that is always covered by WorkCover, but workers often don't know that they can claim are travel expenses. This means travel to treating practitioners (any of the above) and to independent medical practitioners or rehabilitation providers that the Claims Agent is sending you to. Note, in general this means the cost of public transport or mileage, transport by taxis will only be paid for if it is the only way possible because of the injury.
Some other services that are needed because of the injuries or illnesses could come under the heading of 'like services'. Unfortunately, very few workers know that they can claim and WorkCover Claims Agents do not usually volunteer information about the possibility of claiming. Examples of such services include:
Ø Child Care;
Ø Lawn mowing or gardening;
Ø Household help;
Ø Car modifications, e.g. the injury might make it necessary to have power steering or an automatic transmission or it would be impossible to drive safely;
Ø Home modification which could be simple things such as hand rails or different kinds of taps ranging to major modifications that could be required if the worker became a paraplegic;
Ø Removalist costs, e.g. when it is not really possible to modify the home appropriately.
As can be seen, the term of 'reasonable medical and like expenses' means more than just going to the doctor once a WorkCover claim has been accepted. We do not pretend that this is a definitive list.
You may be entitled to a range of services, however, in order to obtain WorkCover payment for a lot of the services you need to put in a request to the Claims Agent. In most cases the request needs to be supported by an explanation from your treating practitioner about why you need the service.
Don't assume that your request will be granted but 'reasonable medical and like expenses' are your entitlements. If you don't make the request you will not get any of it. If the WorkCover Claims Agent refuses your request you can appeal this decision through the Conciliation Process and the AMIEU will help members through this process.
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