An injured worker may see the doctor of their choice. You or the
doctor will often be their first contact. If you identify the
injury is work-related, reassure the person that it will be managed
so that they can return to work as soon as is safely possible. It
is important to establish this return to work expectation from the
outset.
In the majority of cases, the rehabilitation goal is for the
worker to return to work. In situations where the injury prevents
the worker returning to work, rehabilitation must focus on
maximising functional independence.
Advise the doctor that the injury is work-related and ensure a
workers' compensation medical certificate is available for them to
complete. Books of workers' compensation medical certificates are
sent to medical practices and hospitals upon request and some
medical practice software includes a template of the workers'
compensation medical certificate.
Please note that while Q-COMP distributes the
certificates, once completed they must be sent to the workers'
compensation insurer.
Completion of a workers'
compensation medical certificate
Medical treatment and workplace rehabilitation are based on a
medical model and a current doctor's certificate and approval is
required for all treatment and rehabilitation services and for
ongoing payment of benefits. The medical certificate is essentially
a communication tool between insurers, employers and medical
practitioners. The information supplied in the medical certificate
is used in the determination and management of the claim.
To make a claim, the worker will need to send the insurer a
workers' compensation medical certificate completed by the doctor
along with an Application for Compensation which the worker must
complete. An Application for Compensation can be obtained from the
insurer. If WorkCover Queensland is the person's workers'
compensation insurer and your practice wishes to assist the worker
lodge their claim, you can invoice WorkCover Queensland for an extra 'fax
fee'.
The doctor's role
The doctor's role is to complete the medical certificate and
provide clinical assessment and opinion.
The insurer's role
The insurer's role is to assess and determine whether the person
is a worker and if the injury is one that attracts benefits in
accordance with the Workers' Compensation and Rehabilitation
Act 2003.
Fees
96% of claims are accepted by insurers in an average of nine
days. Once a claim is accepted the insurer will pay for reasonable
medical services according to the Medical Items
Schedule of Fees . The item numbers and descriptors are the same
as those in the Commonwealth Medical Benefits Schedule (CMBS) but
generally attract a slightly higher fee due to the complexity of
some workers' compensation claims.
Payment for any required communication that would not be
considered part of a normal consultation (fax, teleconference,
reports etc) is made according to the Medical Table of Costs -
Supplementary Schedule (General Practitioner or Specialist Medical
Practitioner).
Insurers
If your question is about a specific claim/case or payment for
specific services you will need to speak to the insurer's case
manager.
- WorkCover Queensland - If possible, use the
direct number for the WorkCover Queensland staff member managing
the claim. If you don't have their direct number you can call 1300
362 128 and give the name of your patient, their date of birth or
the claim number (if you know it) or visit WorkCover
Queensland's
website
- Self-insured employers - Contact the employer
directly (current list of insurers)
Q-COMP - contact Q-COMP's
Health Services Team on 1300 789 881.