Medical, Hospital and Rehabilitation Expenses – NSW

Medical or related treatment includes:

  • treatment by medical practitioners, physiotherapists, chiropractors, osteopaths, psychologists, counsellors, exercise physiologists, remedial massage therapists, other allied health practitioners
  • provision of artificial aids
  • domestic assistance services
  • nursing, medical and medicine supplies (provided outside of hospital treatment)

The insurer will only approve and pay expenses after determining they are reasonably necessary. Most treatment requires prior approval, however some treatment does not require prior approval.

These may include:

  • treatment provided within the first 48 hours following the injury
  • consultation with the nominated treating doctor (with the exception of mental health consultations using treatment items AA905 and AA910)
  • the first consultation and treatment provided within that consultation with the first specialist medical practitioner
  • pharmacy items prescribed by the nominated treating doctor or specialist medical practitioner in the first 3 weeks post injury, to a maximum of $500 and for pharmacy items excluded from the Pharmaceutical Benefits Scheme to a maximum amount of $100
  • all plain x rays performed on referral from the nominated treating doctor or specialist medical practitioner in relation to the injury claimed and provided within one week of injury
  • services provided in public hospital’s that are provided by or consequent upon presentation at the hospital’s emergency department for the injury claimed that are within one month of the date of injury
  • some consultations for physiotherapy, osteopathy or chiropractic treatment
  • some psychology treatment or counselling

Note: Medical and related expenses are not payable more than 12 months after a claim for compensation is made, unless weekly payments of compensation have been paid or are payable to the worker. Exemptions may apply for workers who made a claim for compensation before 1 October 2012.

Hospital treatment

Hospital treatment includes treatment at public and private hospitals and/or rehabilitation centres.

Ambulance services

Ambulance services include emergency, non emergency and inter hospital transfers provided by the Ambulance Service of NSW.

Workplace rehabilitation services

Workplace rehabilitation services include:

  • return to work and case management
  • vocational, functional and workplace assessments
  • job analysis and modification
  • identification of suitable employment
  • worker retraining and placement in suitable employment

These services are provided by approved workplace rehabilitation providers.

Travel expenses

To claim for payment for travel to attend medical, hospital and rehabilitation appointments, the worker will need to keep:

  • a record of the mileage if the worker uses his/her car
  • receipts for public transport

The maximum amount payable for private car travel associated with attending medical, hospital and rehabilitation appointments is currently $0.55 per kilometre. This amount is reviewed every 12 months.