If you are injured or develop an illness due to your work – whether in the workplace or travelling to or from work – you may be entitled to compensation.
The NSW workers compensation system provides this support to help you recover and return to work as soon as possible. The scheme covers all workers in NSW, including full-time, part-time and casual.
The compensation you can receive depends on the extent of your injury or illness and its effect on your ability to work now and into the future. You may be eligible for weekly payments to replace a percentage of your lost income. Read more about weekly payment calculations.
If your condition is more serious, you might be eligible for a lump sum payment for permanent impairment in addition to weekly payments.
However, many workers don’t realise there’s another workers compensation payment they may be eligible for – reimbursement for a range of expenses incurred as a result of their workplace injury.
What expenses does workers compensation cover?
If you are injured in the workplace, you may need to pay some expenses as a result. The good news is that you can include reimbursement for these expenses in your claim. Here are just some of the expenses you could claim, depending on your circumstances:
- Medical and treatment fees: Claim for fees paid to doctors, specialists, physiotherapists, psychologists, dentists and other health professionals. You can also claim medication costs.
- Hospital fees: Claim for public or private hospital fees and accredited rehabilitation clinics.
- Ambulance fees: Claim for ambulance trips, whether they’re emergency, non-emergency or transfers from one hospital to another.
- Workplace rehabilitation services: Claim for services to help you get back to work, including training for a different role or modifications to your current work environment.
- Home and vehicle modifications: Claim for modifications to support your independent living after a permanent disability.
- Travel expenses: Claim for the cost of traveling to and from medical appointments and rehabilitation facilities.
- Home care: Claim for support for daily activities, such as cleaning, laundry and gardening (up to 6 hours per week for 3 months unless you have at least 15% permanent impairment).
- Other expenses: Claim for other expenses related to your injury, including artificial aids, nursing care and medical supplies.
How to show what expenses to claim for
Before you submit your claim form, you need to gather and submit evidence of your expenses.
Medical expenses
Any medical expenses you claim must be related to your workplace injury or illness and be considered ‘reasonably necessary’.
The medication must be prescribed by a doctor or health professional and supplied by a registered pharmacist. Keep the tax receipt to claim reimbursement.
You should get the insurer’s approval for most treatments before you pay for them. The insurer doesn’t need to reimburse you for treatment or services that it didn’t approve first.
However, some treatments don’t need pre-approval, such as:
- any initial treatment within 48 hours of the injury
- consultations with your nominated treating doctor about the injury
- treatment provided by your treating doctor within one month of the injury
- treatment for the injury provided by an emergency department in a public hospital.
You can claim medical expenses for:
- two years after weekly payments cease either if you have 10% or more permanent impairment or from the day you made the claim if you didn’t receive weekly payments
- five years after weekly payments cease either if you have 11–20% permanent impairment or from the day you made the claim if you didn’t receive weekly payments.
These time limits don’t apply to some exempt workers.
If you have more than 20% permanent impairment, you may be eligible for medical, hospital and rehabilitation expenses for your lifetime. This may also apply if you’re nearing retirement age.
Travel expenses
You can claim expenses for travel to and from appointments, hospital visits and other travel relating to your workplace injury. Keep all your public transport receipts to prove your claim.
If you’re using a private vehicle, you can claim up to $0.55 per kilometre. Keep records of the kilometres you drive.
Homecare expenses
You may be eligible to claim homecare expenses if you were performing those domestic tasks yourself before your injury or illness.
A medical practitioner needs to assess your functioning to decide what assistance you need. Keep receipts for all your homecare expenses.
Does a claim automatically cover all expenses?
If your workers compensation claim is accepted, you can access some reimbursable treatment options automatically without approval from the insurer:
- ambulance
- initial treatment within the first 48 hours
- emergency treatment in a public hospital
- consultations with your nominated treating doctor
- some diagnostic investigations within a time period (e.g. x-rays within two weeks; ultrasounds and MRIs within three months)
- some pharmaceutical items prescribed by your GP or specialist
- up to eight consultations for physiotherapy, osteopathy or chiropractic treatment, or psychological treatment or counselling, starting within three months of the injury.
For other treatments, you need the insurer’s approval if you want to get reimbursed for the expense. They need evidence that the expense is reasonably necessary and relates to your work injury.
Never assume that the insurer will pay for your medical treatment, as you may end up out of pocket if they decline your expense claim.
Getting approval for treatment
Usually, to get approval, your doctor or treatment provider needs to send a written request to the insurer, who has 21 days to decide whether to approve the treatment.
Always keep thorough records of your expenses for medical treatment, related travel and any other costs relating to your injury claim. This will make the approval process smoother.
Once approved, your healthcare professional will usually invoice the insurer for the cost; however, sometimes you might have to pay upfront and request reimbursement later.
Submit the request for reimbursement to the insurer within six months of your appointment. The insurer has 30 days to reimburse you.
How can Main Lawyers Help?
If you’ve been injured at work, unexpected costs like hospital bills, travel to medical appointments, and home care can quickly add financial stress. These are expenses that may be covered under workers compensation in NSW—but many workers don’t know what they can claim.
At Main Lawyers, an experienced worker’s compensation lawyer in NSW can help you claim everything you’re entitled to, including reimbursement for approved medical treatment, rehabilitation, and out-of-pocket expenses.
Get in touch today for a free consultation and find out how we can support your claim from start to finish.
