If a worker sustains an injury during the course of their employment they are entitled to payment of their reasonable medical expenses (i.e. expenses which relate to and provide a therapeutic benefit for the worker). The entitlement to payment of medical expenses has been preserved under the Return to Work Act 2014 (SA), however, the period of entitlement has changed significantly.
What is the time limit?
An injured worker is entitled to medical expenses for a period of 52 weeks (1 year) after the date of their work related injury. If a worker is “seriously injured” they will qualify for medical expenses for the rest of their life.
Exceptions to the thresholds for medical expenses are provided in the Return to Work Act, however, are limited to specific circumstances (such as for therapeutic devices like hearing aids or wheelchairs or for surgery) and can require pre-approval from Return to Work SA (formerly WorkCover SA) during the 12 month period after the accident.
Injury sustained before 1 July 2015
If you suffer from an existing injury (i.e. an injury which was sustained prior to 1 July 2015) you will be entitled to payment of your reasonable medical expenses for a period of 1 year after the Return to Work Act came into force (i.e. until 1 July 2016), or 12 months after your entitlement to weekly payments ceases, whichever is later.
If you have suffered an existing injury for which you require ongoing medical treatment or if you are injured at work and may need treatment to assist in your recovery you should contact our office to ensure you receive specialist legal advice about your entitlement periods and to ensure that any arrangements for treatment outside of your entitlement periods can be applied for within the relevant time limits.
What if you don’t meet the threshold?
If you have a serious injury but do not meet the threshold for a “seriously injured” worker you should contact us to determine whether you may be able to access benefits under your superannuation policy such as ongoing income protection payments or a lump sum Total and Permanent Disablement or Terminal Illness Benefit to assist you with payment of your ongoing medical expenses.
How can we help with your WorkCover claim?
If you have a claim for worker’s compensation and require specific advice regarding the nature of your entitlements under the Return to Work Act then you should contact Turner Freeman Lawyers (SA) on (08) 8213 1000 to obtain specialist legal advice specific to your work related injury.