Question 1

What medical expenses are covered by a workers compensation claim?

Accepted Answer

Generally, the cost of reasonable and necessary medical expenses incurred by the worker are covered for up to one year after their entitlement to weekly compensation payments ceases. However, the Workers Rehabilitation and Compensation Tribunal (Tribunal) has the power to extend the employer’s liability for medical expenses in what are wide ranging circumstances.

Medical expenses may include costs associated with pharmaceutical, ambulance, hospital, nursing, rehabilitation or constant attendance services, as well as examination or treatment by medical practitioners, physiotherapists, dentists, opticians, chiropractors, osteopaths, etc. The injured worker’s reasonable travelling expenses in connection with medical appointments will also be reimbursed. Travel involving the use of a motor vehicle is reimbursed at the rate set down in the Tasmanian State Service Award.

Regardless of whether a new claim is accepted (pending further information), an employer is generally required to meet the cost of a worker’s medical and rehabilitation expenses, up to a limit of $5,000.

Accounts for medical expenses must be forwarded by a worker to their employer within 7 days of receipt, and similarly by the employer to their insurer within 7 days of receipt.

Question 2

Can workers compensation benefits be altered or stopped?

Accepted Answer

If the employer or worker wishes to query the rate of weekly compensation payments being made, a reference needs to be filed with the Tribunal seeking a review of those payments.

An employer may reduce or stop a weekly payment to a worker only when;

A worker has returned to work
A worker is receiving more than the amount of the weekly payment (payment above compensation)
When a medical practitioner who has examined the worker has certified that they have wholly or substantially recovered from the work injury
The Tribunal may make a determination that payment should be either reduced or stopped or in some cases increased
If there is a change in the ordinary hourly rate of pay during a period of incapacity, the weekly payment should be increased or decreased by the like amount

If an employer intends to stop weekly compensation payments altogether, they generally will need to have medical reasons for doing so and advise the worker in writing ten days beforehand.

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