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10 things to know when seeking medical treatment while on workers compensation

10 things to know when seeking medical treatment while on workers compensation

You do not need to accept treatment from a company doctor

Some employers try and convince injured workers to be assessed and treated by a doctor chosen by the business. The employer cannot force a worker to see the company doctor for treatment.  They can, however, require an injured worker to attend a doctor of their choice for assessment (not ongoing treatment) but must give you notice in writing of this.

You should always be treated by your doctor of choice

A worker has every right to see their own GP or other doctor for treatment. Workers often feel more comfortable dealing with their own family GP, or a doctor they are familiar with.

It generally assists with your workers compensation claim if you have a solid relationship with your treating doctor - you often won't achieve this relationship with the company doctor.

You can change doctors if you are unhappy with the treatment you are receiving

If you have consulted with the company doctor, or even your own doctor, and you are unhappy with the treatment you have been receiving, do not hesitate to change your treating doctor.

You are not bound to continue to see the same doctor during the course of your workers compensation claim.

You have the right to seek a second opinion

If you disagree with a medical report or recommendations of a company doctor or other medical examiner, you do not need to accept this opinion. You should seek advice from a lawyer and get a second opinion from another medical expert.

Reimbursement for medical and other expenses

You should never be personally out of pocket for medical and like expenses (including medication) relating to your workers compensation injury, as long as the expenses are reasonable, and they have been incurred during the allowable timeframes.

Sometimes you do need to pay for expenses and then seek reimbursement from your case manager. But reimbursement should be provided quickly, and if several weeks go by without receiving reimbursement, you should seek legal advice.

Never perform duties that your doctor has restricted you from performing

Even if your employer or case manager is pressuring you to perform duties beyond your capacity, you should not do anything beyond what the doctor has cleared you to perform.

For example, if the doctor has said that you should not lift more than 5kg, but your employer wants you to perform heavy lifting, you should refuse the employer's request.

Always have an up-to-date Return to Work Capacity Certificate

It is sometimes helpful to carry around a copy of your up-to-date medical certificate in case you are asked to perform tasks beyond your capacity. It helps to be able to easily show the certificate in the workplace to ensure you are only performing duties that a doctor has cleared you to perform.

If you are concerned about the way your workers compensation matter is being handled, speak with a lawyer immediately

Unfortunately, many employers and case managers are looking out for the financial best interests of the company or the Return to Work Corporation. The less compensation or rights they provide to the worker, the more money they save.

If you think that decisions are being made that are not in your best interest, seek legal advice immediately, particularly if your concerns relate to medical treatment.

Employers often ask injured workers to sign documents giving the company the right to obtain all of your medical records, speak directly with your doctor and even be present when you consult with doctors. Do not sign any document without seeking legal advice.

Even if you have signed a document consenting to your employer accessing all your records, you can always subsequently withdraw your consent.

Most decisions of your case manager or employer can be disputed

Do not simply accept a decision of your case manager or your boss in relation to your workers compensation claim if you disagree with the decision. Most decisions can be appealed to the Workers Compensation Tribunal.

Be wary of time frames regarding your entitlements

As mentioned above, strict time-frames apply to an entitlement to be compensated for medical treatment following a work-related injury.

The simple rule is that medical expenses can be incurred for 12 months following the last date a worker received income support payments (weekly payments).

This is a tricky area of law and multiple factors can impact whether a worker is entitled to seek compensation for medical expenses, whether pre-approval needs to be sought before the expiration of a deadline, whether exceptions apply to the time-frame rule, etc. If you have any doubt about the applicable time frame associated with your injury, seek advice from lawyer experienced in workers compensation claims.

You may want to download and/or print our guide to "Return to Work and medical treatment" or our infographic on "Return to Work and medical expenses".


Please note, this Blog is posted in Adelaide, South Australia by Andersons Solicitors. It relates to South Australian legislation. Andersons Solicitors is a medium sized law firm servicing metropolitan Adelaide and regional South Australia across all areas of law for individuals and businesses.


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