The following frequently asked questions will provide you with information to help you achieve your workers compensation requirements.
What is the difference between the Certificates of Capacity?
Certificates of Capacity are designed to focus on what your patient can do to remain in or return to work, improve communication that supports their recovery, and enable you to share your assessment of your patient’s progress and needs so the insurer can make informed decisions about a workers compensation claim.
The First Certificate outlines the type and extent of the injury, fitness to work, and any recommended restrictions on work duties.
The Progress Certificate keeps the employer and insurer updated on your patient’s progress, ongoing treatment requirements and capacity to return to work.
A Final Certificate is provided when the patient is fully fit and no longer requires treatment.
When is the next APIA training?Call our Advice and Assistance Service on 1300 794 744 to obtain more information about training dates.
Where can I get a copy of the WorkCover WA Guidelines?Publications for Approved Permanent Impairment Assessor can be downloaded from the
Health providers resources page.
If you need a hard copy, call our Advice and Assistance Service on 1300 794 744.
WorkCover WA specifies rates billable under the workers compensation system for medical and allied health treatment. These rates represent the amount that the insurer will reimburse the worker. If your rates are higher than those specified, the worker may be responsible to pay the ‘gap’. You should highlight this to the worker prior to their appointment..
To view these fees, see the Rates, fees and payments page.
Treatment codes can be accessed in the Resources Tab on the
Rates, Fees and Payments page. If codes for medical treatment are not shown, medical practitioners can use the code provided in either the Australian Medical Association’s (AMAs) List of Medical Services and book or on the Medicare Benefits Schedule Online website.
Please remember to include a clear description of the service provided on your invoice to the workers compensation insurer.
For more information, call our Advice and Assistance Service on 1300 794 744.
If a medical service does not have an applicable WorkCover WA fee, then you will need to discuss the payment of the service fee with the workers compensation insurer. The fee shown in the Australian Medical Association’s (AMAs)
List of Medical Services and Fees is the fee in most instances.
Please remember to include the service code and a clear description of the service provided on your invoice to the workers compensation insurer.
A worker is entitled to recover their costs for reasonable medical and related expenses. These fall under the heading of approved treatments and include such things as, visits to and treatments by your general practitioner and specialist, physiotherapist and occupational therapist.
If a worker requires treatment from a non-approved health provider for example a naturopath, they should check with their employer’s insurer to ensure that their cost will be reimbursed prior to commencing treatment.
WorkCover WA approves persons capable of providing workplace rehabilitation services and sets conditions of approval.
Further information is contained in the application package for approved workplace rehabilitation providers on the Health Providers page.
The account should be made out to the patient.
Where do I send accounts?If the claim status is unknown or deferred, send the account to the worker. If the claim has been accepted, send the account to the insurer. The employer is not liable for paying the treatment accounts.
How do I get paid for treatment if a claim has not been made?Your practice will have a billing policy. It may stipulate, for example, that the worker pays for service prior to treatment, or an invoice be issued to the patient for payment by a later date, or service can be bulk billed to Medicare.
