Cessation of workers compensation entitlements

 

Ensure you are equipped to help your patients through the changes to claims through workers compensation system.

As a result of the application of section 59A of the Workers Compensation Act 1987, some patients may soon no longer have their claim for medical, hospital and rehabilitation expenses compensated through the workers compensation system. They may need your assistance to prepare for this change.

The date these changes come into effect will vary, with some patients ceasing entitlements from September 2019.

If you are providing treatment or services to patients affected by these changes, you should gain a clear understanding from each patient when their entitlements will cease and let them know the costs of any treatment or services provided after that date will be their responsibility. Treatments or services provided after the cessation date will not be paid by the insurer, even when previously approved.

The State Insurance Regulatory Authority (SIRA) encourages you to tailor your approach to affected patients and work collaboratively with insurer case managers to ensure patients receive appropriate support before their entitlements end.

You might consider actions to:

  • discuss and inform your patients of medical and support services available to them and make referrals where appropriate. This could include through publicly funded community, state or federal systems, or where applicable, services funded by private health insurers
  • prepare a discharge plan with your patients with the goal of developing self- management strategies to promote independence from healthcare. This will assist them with longer term management of their injury or condition.

For more information, click here or contact the patient’s workers compensation insurer case manager.

 

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