An accepted WorkCover claim entitles you to seek payment of the “reasonable” costs of medical treatment required for a workplace injury. However, sometimes WorkCover will refuse to fund certain types of treatment, particularly those that are considered to be new or “alternative”.
While Workcover does publish a list of approved treatments, it should be considered a guide only. The fact that a particular treatment is not included on this list does not mean that the treatment cannot be funded. Ultimately, this will be determined based on whether the treatment can be proven to be reasonable and necessary in the particular circumstances of each case.
WorkCover’s list of treatments should and indeed has evolved over time as medical treatment itself evolves. This has been the case for treatments like acupuncture, naturopathy and myotherapy. In the past, these treatments would often be rejected; however, they are now commonly funded expenses included on the list.
More recently, a number of our clients have been recommended medicinal cannabis for treatment of chronic pain and/or depression arising from a workplace injury. Often, medical cannabis is recommended as an alternative to other medications which can be highly addictive and lead to undesirable side effects.However, despite the support of treating doctors, many clients have had this treatment refused on the grounds that there is insufficient evidence of its effectiveness.
Ryan Carlisle Thomas has recently had great success for a client in appealing a decision of WorkCover to reject funding for medicinal cannabis.The treatment request was reviewed by an Independent Medical Panel who, having regard to all the circumstances, determined it was a reasonable treatment. As a result, WorkCover are now required to fund this. We are also aware that similar issues have also arisen in the context of transport accident (TAC) related injuries.
Ryan Carlisle Thomas strongly believes that recipients of WorkCover and TAC benefits should be able to access all available medical treatment which will assist with their condition and should not be prevented form accessing new or emerging therapies. It is important to note that there are strict timeframes to appeal under both WorkCover and TAC.