Claim & RTW FAQs
- I am a contractor and was due to finish a contract next week. Am I covered?
- I further aggravated my work injury at home. Am I covered?
- What types of treatment are covered and to what level?
- Is the full cost of treatment covered?
- Do I need to claim the difference on Medicare or my private health insurance?
- Will I be able to get home assistance?
For other Frequently Asked Questions on making a claim, see also:
I am a contractor and was due to finish a contract next week. Am I covered?
Whilst you have an incapacity to work, provided your claim is accepted, you are entitled to WorkSafe compensation.
I further aggravated my work injury at home. Am I covered?
No.
What types of treatment are covered and to what level?
- WorkSafe will pay reasonable medical and like costs directly related to a workplace injury or illness even if time off work isn't required
- As long as they are recommended by a doctor and are approved by the WorkSafe Agent
- There is no complete list of what types of treatment are covered as the needs of each worker are different and WorkSafe will consider each request for service on its merits
- Whether a service is considered reasonable will depend on the amount charged and on how appropriate it is for a worker's personal circumstances
Is the full cost of treatment covered?
- WorkSafe has a maximum fee structure for medical and like services
- However, a medical provider may charge more for a particular service than WorkSafe's set maximum
- In such cases, WorkSafe will only reimburse up to the set maximum - the provider may not seek payment from the worker for the difference
- You may wish to speak with your medical provider before starting your treatment to establish what is being charged
- It is advisable to forward the account to your employer rather than paying on the spot
Do I need to claim the difference on Medicare or my private health insurance?
The difference (or 'gap') between WorkSafe's maximum fee and your medical provider's fee can not be claimed through Medicare or your private health insurance. You can however claim your medical expenses through Medicare or your private health insurance only if the claim is rejected. You should speak to Medicare or your private health insurer for more information.
Will I be able to get home assistance?
If you are requesting home assistance you will require a letter from your doctor stating what you require and how your injuries will prevent you from completing these tasks yourself. A request for home assistance will be assessed by your WorkSafe Agent along with the claim. More information - Household Help Factsheet
