If you are injured at work, your employer’s WorkCover insurer will pay for your treatment. All you need is the name of your employer’s insurer and a claim number, and we will bill the insurer directly for your treatment.
A claim number will be issued once you have notified your employer of your injury. Your employer has an obligation to inform his or her insurer of your injury within 48 hours of your notification. If you are severely injured, this notification will usually be made on your behalf.
In general, as a WorkCover patient, you will be covered for consultations, surgery and other hospital treatment (both public and private), hand therapy, artificial aids and medical supplies, provided they are ‘reasonably necessary’. In determining whether a treatment is reasonably necessary, your insurer will consider:
- the level of acceptance of the proposed treatment by clinical peers in similar cases, its safety and efficacy,
- the appropriateness of the proposed treatment – whether it has the capacity to cure, alleviate or lessen the effects of the injury,
- the availability of alternative treatments,
- the cost benefit of the proposed treatment, and
- the effectiveness of the proposed treatment.
We will provide all information required by the insurer to determine whether a specific treatment is reasonably necessary. Prior approval for surgical procedures other than emergency surgery is required by most insurers; we will seek this on your behalf. Prior approval is not generally required for hand therapy unless your hand therapy program exceeds 8 sessions or involves unusual treatments.
If you are referred to a surgeon or hand therapist at the Hand Centre in relation to a work injury, and at the time you make your appointment you have not been given a claim number, we will seek approval from your employer’s insurer for your initial consultation. If the consultation is not approved prior to your appointment, you will need to pay the fee yourself and claim it back from the insurer.
Fees for the treatment of WorkCover patients are governed by the WorkCover Authority of NSW.