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Home | Blog | Changes to claiming for medical expenses

On 1 July 2016, some workers with accepted work injuries will no longer be entitled to claim medical and other expenses associated with their injury, subject to only very limited exceptions.

Who is affected?

A worker is affected by the changes, if:

  1. They were injured prior to 1 July 2015, and
  2. They were not receiving income support payments on 1 July 2015.

These workers have until 1 July 2016 to claim medical expenses associated with their injury. This includes medications, allied health services (e.g. physiotherapy) and doctor’s assessments and report fees. The cost of any surgery also cannot be claimed after 1 July 2016 unless the insurer pre approves payment of the surgery.

What happens after 1 July 2016?

After this date medical and other associated expenses will not be funded by the insurer. The worker must seek alternative ways of funding all medical expenses, for example through Medicare, private health insurance or by privately funding the costs.

Exceptions

There are a few exceptions to the cut off, including:

  1. Pre approval for surgery where the application is made prior to 1 July 2016.
  2. Costs associated with therapeutic appliances including hearing aids, spectacles or contact lenses, false teeth, prosthesis or crutches or wheelchairs.

If your injury or condition requires (or will require) surgery then you should act immediately to have the costs pre approved by the insurer. If your application for pre approval is not lodged by 1 July 2016 then the insurer will not be required to pay for your surgery or any costs associated with your surgery.

Our experienced workers compensation lawyers can make the pre approval application on your behalf and ensure that your entitlements are protected.

To speak with one of our workers compensation lawyers please telephone 8213 1000. Our personal injury lawyers are based in Adelaide and Whyalla.

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