If you believe your patient’s injury or disease is work-related, and they want to make a claim, here’s what you and your patient need to do:
- Your patient must complete a Workers’ Compensation Claim Form. They should retain the outer cover of the form.
- You must provide your patient with a First Certificate of Capacity. The certificate will outline:
- your patient’s injury
- their capacity for work (i.e. what your patient can do and any limitations they have)
- their injury management needs.
Read more about certificates of capacity and how to use them.
- Your patient must submit their claim form and certificate to their employer. The employer then has five days to submit the completed claim form and certificate to their insurer.
If your patient wants to make a claim, please refer them to:
- the information for workers on the WorkCover WA website
- our publication Workers’ Compensation and Injury Management: A guide for workers
- WorkCover WA advisory services on 1300 794 744.
Sometimes, an injured worker and their employer will be unable to agree about the degree of permanent impairment caused by the worker’s injury. In these cases, the worker will need to be referred to an approved medical specialist (AMS) to assess the degree of impairment.
Who qualifies as an AMS?
We can designate any medical practitioner who satisfies our criteria and who we consider to be sufficiently trained in the use of WorkCover WA Guides for the Evaluation of Permanent Impairment.
Find out more about approved medical specialists.
At WorkCover WA, we strive to provide a workers’ compensation and injury management scheme that works for everyone. Learn more about our role, organisational structure and strategic direction.
Our fee schedule covers all the services most commonly required by injured workers who access the workers’ compensation scheme. If your patient requires a service that isn’t on the schedule, please consult the Australian Medical Association (AMA) Fees List or the Medicare Benefits Schedule.
Payments for items that are not listed on our schedule should be discussed with the approved workers’ compensation insurer. Make sure you include a service code (i.e. AMA or MBS code) and a clear description of the service provided on your invoice to the insurer.
Read more about rates, fees and payments. It is best to discuss these items with the insurer before costs are incurred.
Yes. It’s important for all parties involved in your patient’s recovery to collaborate closely, which is why our fee schedule for medical practitioners includes payments for the time you spend liaising with other parties (for example, telephone conversations, offsite visits and case conferences).
Our fee schedule for medical and allied health services is indexed annually using the Composite Index (CI), as calculated by the workers’ compensation scheme’s actuary – we also consult with the Australian Medical Association (WA branch) during this process.
Yes. If your patient makes a workers’ compensation claim in Western Australia, they are entitled to recover costs for reasonable medical and related treatment. However, these costs are limited – the limits are known as ‘prescribed amounts’. Only in some exceptional circumstances can injured workers claim more than the prescribed amount.
Read more about the current prescribed amounts.
If your patient is making a workers’ compensation claim, they are entitled to payments for reasonable medical and related expenses. This covers services provided by:
- medical practitioners and specialists
- dentists
- physiotherapists
- occupational therapists
- clinical and counselling psychologists
- speech pathologists
- chiropractors
- exercise physiologists
- acupuncturists.
If your patient requires treatment from an alternative health provider (for example, a naturopath), they should check with their employer’s insurer – before commencing treatment – to ensure the cost will be reimbursed.
If there’s a dispute over an unpaid invoice, your patient should first approach their employer or insurer. If the dispute cannot be resolved, your patient can lodge an application with the Conciliation and Arbitration Service (CAS).
Get more information about lodging and resolving a dispute.
