Published: 30 October 2014
Author: Ryan Carlisle Thomas

WorkCover cuts red tape on approvals process

Injured workers may not have to wait as long for some types of medical procedures as a result of changes made by WorkCover to their approvals processes.

The major changes apply to MRI scans, gym and pool rehabilitation, some elective surgery, a range of equipment, and home help.

While none of the changes are major, they should help relieve some of the frustrations encountered by injured workers who sometimes have to wait for weeks if not months to have their course of medical treatment approved by the Victorian WorkCover Authority (VWA) before they are able to start treatment.

In practice, anyone who is injured at work and needing medical assistance has to have their doctor send a request to their insurance agent, and have it approved before they can be confident in having the bills paid. Once treatment has WorkCover approval, invoices can be sent directly from a provider such as a general practice or a pathology centre, to the VWA for payment.

It's not uncommon for people who are injured and who are tight for money to be denied medical treatment while they wait on WorkCover’s approval. 

The problem is that delays to the start of medical treatment can jeopardise a patient’s chances of recovery.

These new changes may speed up that approval process.

Specifically, the major changes include:

• MRI – scans can now be approved by a doctor without a VWA agent’s approval.
• Gym and Swim – allied health professionals such as physios, chiropractors and osteopaths are now able to authorise courses of treatment.
• Elective surgery – it appears that “straightforward” types of surgery may be approved more promptly; although what “straightforward” and “promptly” mean has yet to be clarified.
• Household help – some help with household chores may be approved without the need for their independent experts to prepare a report and make recommendations
• Special or customised mattresses – may be approved at an agent.
• And there has been a relaxation of requirements around inpatient rehab.

The upshot of the changes is that red tape should be reduced, approval times shortened, and worker recovery sped up.

That’s in theory at least, and in that sense, the changes appear well-intentioned and sensible.

But then again, time will tell.