IMPORTANT ANNOUNCEMENT ABOUT MEDICAL EXPENSES NSW

workcover-nsw-pre-approval

According to the WIRO, the Workers Compensation Amendment (Medical Expenses) Regulation 2013 has today been gazetted.

WORKCOVER NSW MEDICAL EXPENSES

The regulation allows for payment of compensation for certain specified medical treatments, for which no compensation would be otherwise payable, after the cut-off date of 1 January 2014 only if they were approved by the insurer before that date.
To be eligible the worker had to be in receipt of compensation before the commencement of s59A of the 1987 Act (1 October 2012).

A copy of the regulation can be found here.

FOR MORE INFORMATION
Please contact:
Kim Garling
WorkCover Independent Review Officer
(02) 8258 7109
kim.garling@wiro.nsw.gov.au

Issued 20 December, 2013

 

Source: http://www.wiro.nsw.gov.au/media/29179/2013___DECEMBER_20___WIRO_WIRE___MEDICAL_EXPENSES.pdf

 

Revised May 2014



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7 Responses to “IMPORTANT ANNOUNCEMENT ABOUT MEDICAL EXPENSES NSW”

  1. In English, what is that actually saying?

    Is it saying that we need to get approval before 1 Jan 2014, to enable us to see the Dr for ANY future appointments/prescriptions etc after 1 Jan 2014, or does it mean that if we were an ‘existing injured worker’ already receiving these services paid for by the Insurer, that they have already ‘approved’ it and we should be OK to go back to our Dr/Pharmacy etc and not have to worry that we would have to foot the bill ourselves?

    How does this work, considering our Case Managers are now all on Xmas Holidays and I need to go the the Dr to get my updated prescriptions whilst they are on holidays?

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  2. The new regulation states the following:

    Schedule 1 Amendment of Workers Compensation
    Regulation 2010
    Schedule 8 Savings and transitional provisions
    Insert after clause 5:
    5A Compensation for medical and other expenses for existing claimants
    (1) Compensation is payable in accordance with Division 3 of Part 3 of the Act to
    an existing injured worker for any of the following treatments, services or assistance if approved by the insurer before 1 January 2014:
    (a) treatment by a medical practitioner, a registered dentist or a dental prosthetist,
    (b) hospital treatment and any related workplace rehabilitation services,
    (c) any nursing, medicines, medical or surgical supplies or curative apparatus, supplied or provided for the worker otherwise than as hospital treatment,
    (d) the provision of artificial members, hearing aids, hearing aid batteries, crutches, spectacles, eyes or teeth and other artificial aids.
    (2) This clause has effect despite any provision of section 59A of the Act but does not affect the operation of section 151A of the Act.
    (3) In this clause:
    existing injured worker means a worker who was in receipt of compensation under Part 3 of the Act before the commencement of section 59A of the Act.

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    workcovervictim3 December 23, 2013 at 1:50 pm
  3. Thanks WCV3.
    I did see this, but it still appears unclear to me.
    Item 1. states “if approved by the insurer before 1 January 2014” – does this mean we are already “approved” if we are an existing injured worker and have been receiving these benefits up to now, or do we now need special approval to be granted now, for anything after 1 Jan 2014?

    Hope I’m not confusing the situation.

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  4. On 16 December the NSW Government put out a new Regulation regarding workers compensation medical expenses.

    Before the Regulation, all injured workers who were not receiving weekly payments on 1 January 2013 would be cut off medical payments from 1 January 2014.

    The Regulation means those of you who were due to be cut off from medical expenses can continue to get certain medical expenses covered if you get pre-approval from your insurer before 1 January 2014. (Please find below the amendment with explanatory note as well as what treatments would be covered).

    If you’ve had an injury and still require medical treatment but have not been in receipt of weekly compensation payments, then this applies to you should you require ongoing medical treatments.

    If you had pre-approval for treatment but were unable to organise that treatment before 1 January 2014, that pre-approval should now apply.

    However, if you’ve already settled your case then this does not apply to you.

    Given the time of year we understand this pre-approval will be very difficult for most of you to organise.

    However if you’ve been injured and are impacted by this change we strongly encourage you to organise pre-approval of any upcoming medical costs as a matter of urgency.

    The regulation can be read here: Workers Compensation Amendment (Medical Expenses) Regulation 2013
    Source:
    http://www.nswnma.asn.au/workers-compensation-medical-expenses/

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  5. Thankyou for that link Jon, and funny I notice that the NSW Finance Minister Andrew Constance is also using that new corporate word ‘incentivised’, it must be spreading like wildfire amongst insurance case managers, sort of like collateral damage when it spread amongst the military. Those ‘buzz’ words are always an alarm bell to me, those who use them in common language only do so because they are in environments where it is acceptable. So if we see it used on this forum, we know it is suspicious. This whole destruction of Workers Comp has been to dehumanise the victims, vilify them, make them suffer, deny medical treatment and on top of it all use the corporatisation of the English language to justify the inhumane treatment. How much more can injured workers take?

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