WorkCover QLD Claims

Information for injured workers attending Physiotherapy under WorkCover QLD

 

Can I attend for physiotherapy before my claim is accepted?

Yes. However, you must have an APPROVED claim number for the WorkCover component of payment to be directed to WorkCover, until you have an approved claim no. payment for treatment is the patient’s responsibility. Once the claim is accepted, patients are then able to seek reimbursement from WorkCover. If the claim is not accepted, patients will be responsible for all future appointments.

How do I claim physiotherapy service for a WorkCover injury?

  1. Speak with your employer and the occupational health and/or the safety representative at your workplace as soon as possible about the injury.
  2. Gain access to information from your employer’s insurer regarding your rights and responsibilities. Most companies are insured through Workcover QLD if so visit: http://www.workcoverqld.com.au/ or call 1300 362 128.
  3. See you GP and get a Doctor’s Referral Letter and a Workcover Medical Certificate.
  4. Lodge a claim with the insurer within 28 days from seeing your GP.

Your employer has 10 days to notify WorkCover and WorkCover have up to 20days to approve your claim, however, it usually only takes around 5 days.

How many treatments can I have?

When your claim is approved by Workcover, the physiotherapist can initially provide up to 5 treatments. In most instances you will not need more than this. However, where more treatment is required your physio will seek approval fromWorkcover, in consultation with your treating doctor. You will be advised if the insurer has not approved further treatment, in which case you are still welcome to continue physiotherapy treatment, however, this will then be at your own expense.

What will the Physiotherapy practice require from me?

  • Your approved claim number; which is usually sent to you by SMS; eg: S09CD…..
  • Your Doctor’s Referral Letter
  • A Doctor Medical Certificate that states the period in which you are needing physiotherapy treatment. Example:

Workcover medical management

*A new medical certificate would be required on the 13/02/10 if you were continuing to have physiotherapy treatment based on this medical management extracted from the example Medical Certificate.

Is there a Gap payment?

All WorkCover QLD (as well as interstate WC claims) patients are required to pay a ‘Gap’ fee on the day of services. This gap fee is the difference between our fees and the maximum amount that WorkCover pays. Physionorth prides itself on high-quality professional care with one on one ‘hands-on’ appointment’s that are the longest in Townsville, this gap fee is so we can continue delivering our excellent services to all WorkCover patients. (Private Health may be used for this out of pocket expense; however, it is at the discretion of the patient to know their Private Health Insurers policy in regards to claiming WorkCover related Gaps).

It is at the discretion of your employer whether they will pay for the Gaps in which case we can arrange to bill them directly for it or if the Gap costs will be reimbursed to you (if you do not use or have Private Health).

What should I expect from the Physiotherapist?

  • The same treatment a full-paying client receives!
  • A thorough assessment of your injury
  • Development of a treatment plan, with your consultation, that is focussed on returning you to your usual job or, if you are still at work, improving function and capacity for your work
  • Regular reviews of your agreed goals and amendments as needed.

In what other ways can the physiotherapists assist in my rehabilitation?

The Physiotherapist can assist by:

  • Communicating with your employer, the Insurer, and your treating GP.
  • Visiting your workplace to ensure you are working safely.
  • Assessing your capacity for work.

How can I get the most out of the rehabilitation?

Rehabilitation has shared responsibilities. You can do your part by:

  • Seek rehabilitation early (as encouraged by the WorkCover Queensland Act 1996). This enables more effective treatment and, therefore, less time off work or improved performance at work.
  • Attending all scheduled appointments. Your Physiotherapist plans these carefully to maximise your recovery. As well as affecting your rehabilitation, if you do not attend without advising the Physiotherapist or do not give us 24 hours notice of cancellation, YOU will be responsible for the cost of missing the session or cancelling at late notice.
  • Adhering to the exercise/rehabilitation program set by your Physiotherapist
  • Keeping your employer informed about how treatment is going.

*Please note that if for any reason claims are rejected by WorkCover then all treatment costs will be at the patients expense. 

***If you have a WC claim from interstate the same conditions apply as above, however, there may be slight differences in the process for approval of treatment. Please contact our clinic on 07 4724 0768 to discuss your claim requirements.