Many injured workers in New South Wales suffer psychologically after they sustain injuries of a physical nature whilst at work.
What most workers do not know is that, in addition to the insurer paying for any physical treatment such as physiotherapy, an injured worker can also claim the cost of psychological treatment with a psychologist or psychiatrist.
Primary injury vs Consequential injury
Imagine a worker is on a job site and as he is walking he trips and falls on a piece of building material and suffers a fractured wrist. The fracture to the workers wrist in this scenario is what is known as a primary injury.
Now imagine as a result of that primary injury, the worker is unable to return to work for an extended period of time. In addition to being unable to return to work, they are unable to attend to the hobbies that once gave them happiness and satisfaction. This situation can be psychologically damaging to anyone. As a result, the injured worker develops a psychological condition such as depression or anxiety. Had it not been for the primary physical injury, the worker would not have developed the consequential psychiatric injury.
Approval of treatment for psychiatric injuries
As previously mentioned, workers who have suffered a consequential psychiatric injury are able to claim the costs of any psychiatric treatment. However, this treatment will be subject to the same scrutiny that any other modalities of treatment is subject to by the insurer. Pursuant to section 60 of the Workers Compensation Act 1987 (NSW) the insurer is only liable to pay for treatment that is deemed reasonably necessary.
When determining whether a modality of treatment is reasonably necessary the insurer will apply principles that derive from the matter of Rose v Health Commission (NSW) 2 NSWCCR 2 (Rose). In the case of Rose Burke CCJ found that reasonableness is determined by the following criterion:
- The appropriateness of the treatment;
- Whether any alternative treatments are available;
- The cost of the recommended treatment;
- The effectiveness of the recommended treatment; and
- Whether the treatment is accepted by medical experts as being appropriate and likely to be effective.
So long as the need for the psychiatric treatment recommended by your treating doctor satisfies the above criteria, the insurer will cover the cost of the treatment.
With that said, though you may think your need for psychiatric treatment may cover the above criteria, the insurer may still decline the request based on medical material that they have obtained themselves. If this occurs then do not panic. Simply contact our office and we will guide you through the process and ensure you receive all that you are entitled to.
Get in touch with us
At Turner Freeman, we have specialist workers compensation lawyers who will assess your case and provide personalised advice regarding your legal entitlements. Our lawyers are located across NSW including offices in Parramatta, Sydney, Penrith, Campbelltown, Newcastle. Contact us today on 02 8833 2500.
