If you are considering making a workers compensation claim for a workplace injury, there are a range of things that can add to your stress. For example, how will you pay your bills? Will your family life be disrupted? How will you fund all the additional medical costs?
At a time when you’re trying to heal and rest, the last thing you need is more stress. That’s why it can help to understand claimable medical expenses for workplace injuries. There’s nothing like a little bit of peace of mind when you’re experiencing a difficult time of your life.
Expenses “reasonably incurred”
South Australian workers compensation law allows a person to claim for a variety of medical expenses so long as:
- The injured person is eligible to make a workers compensation claim.
- The medical expenses are incurred to treat or manage symptoms of the injury.
Claimable medical expenses vary and can include the cost of:
- Doctors’ appointments (including specialists).
- Remedial massage.
- Surgery and hospitalisation.
- Therapeutic appliances (any appliance/equipment/ required to recover or rehabilitate from the injury).
Some ambulance and travel expenses are also claimable.
How do I claim?
After you have made a workers compensation claim, you can seek pre-approval from the compensating authority (the workers compensation insurer) before you incur the expenses. This is especially important if the expenses are significant and/or your income is limited.
Applications for pre-approval are made by completing the required form. They must have supporting documents from a treating doctor outlining why the treatment is necessary. Pre-approval must be sought prior to any other medical entitlements ending.
For some expenses, pre-approval isn’t necessary but may be a good idea if the cost is significant.
For other expenses, you must seek pre-approval. Such expenses include:
- Remedial massage.
- Surgical procedures.
If there is no pre-approval, you will need to self-fund the treatments, seek a contribution from your health insurer or check if there is Medicare cover.
You may also be able to claim some household costs if you are finding it difficult to carry out your daily activities because of the work injury. This may include home modifications. You should always seek pre-approval of these expenses.
What if I’m not sure what to claim?
If you’re unsure what you can claim, it’s always a good idea to seek legal advice. An experienced workers compensation lawyer can help you work this out and can also assist you if your claim is rejected.