Allied health providers
The role of an allied health provider
Allied health providers play a vital role in helping workers stay at or return to work after an injury. Allied health providers:
- treat and manage the clinical care of the injury/illness
- make a significant contribution to improving health and return to work outcomes, under the direction of the treating medical practitioner.
Before you can provide any medical treatment, the worker must have a current medical certificate or have been referred by a registered medical practitioner.
All statutory claims involve working with the treating medical practitioner, the worker, rehabilitation coordinator or employer, allied health providers and all other stakeholders. Organising treatment remains the responsibility of the treating medical practitioner. WorkCover relies on the medical information you provide us to develop a tailored rehabilitation program to help the worker get back to work after an injury.
Allied health providers and return to work
As an allied health provider, the best way to support a worker's return to work is by focusing on what functions they can do, rather than what they can't. If we know what they can do, we can develop a suitable duties plan, if necessary find a host employer, and get the worker back to work and on the road to recovery.
Follow these principles to help your worker return to work as quickly and safely as possible.
- Assess the worker's condition and communicate to them the importance of staying active and, if possible, at work to restore function and decrease disability or long periods of time off work.
Research shows that when a person is off work for long periods of time, the less likely they are to return.
- Provide relevant medical treatment, identify any risks that may hinder their recovery or return to work, and set realistic treatment goals that focus on what the worker can do, not what they can't.
- Encourage, where appropriate, the worker to self-manage.
- Provide information, advice and feedback (verbal/written) to the employer and WorkCover. Information should be clear and detail the worker's injury, treatment approach and a positive and realistic return to work expectation.
- Identify suitable duties and possible workplace adjustments.
The information you give us helps us manage the worker's injury and rehabilitation program. You should provide us with:
- the results of initial assessment, what treatment is planned
- the goals of treatment (including return to work goal)
- expected recovery timeframe and pathway and how much treatment is anticipated
- results of simple screening and outcome measures.
What we pay
To receive payments for services, you need to be registered with WorkCover as an allied health provider. We only approve treatment by a registered or non-registered approved provider as per the table of costs. The table of costs specify the item codes that can be charged and who is qualified to provide them. The Act uses the term 'registered' to refer to those professions covered by a health registration board. The Australian Health Practitioner Regulation Agency website provides a list of registered professions we recognise. If we do not accept a claim, the patient is responsible for any costs.
Registered providers include:
- medical practitioners
- occupational therapists
- speech pathologists
- Chinese medicine practitioners for acupuncture only.
Other or non-board registered providers include:
- exercise physiologists
- rehabilitation counsellors
- social workers
- diversional therapists
- job placement providers
- vocational services providers.
Non-approved providers, which we will not consider for payment of services, include:
- massage therapists
- natural therapists
- pilates instructors
- personal trainers
- acupuncturists who are not Chinese medicine practitioners
- dance or music therapists.
This list is not exhaustive. If you are in doubt about a provider, please call WorkCover on 1300 362 128. If work is referred for services not covered by WorkCover, the worker will be responsible for the associated costs.
Frequently asked questions
- Do I have to reveal all details of the consultation?
- We appreciate the nature of the doctor/patient relationship. You may limit the information provided, but basic information that we need includes what the patient said about work related events, examination findings, diagnosis and proposed treatment and rehabilitation options.
- Why would I contact WorkCover?
- to find out if a claim is accepted
- to see if we will pay for a treatment or rehabilitation not usually covered by Medicare
- to provide a verbal response to a request for a written report
- to discuss a specific issue relating to a claim or patient.
- Can I charge WorkCover for contact?
- In some circumstances you can charge WorkCover for contact however there are exclusions that you need to be aware of (for example, WorkCover will not pay for contact that is of general administrative nature). Please see the Supplementary Allied Health Table of Costs for the relevant item codes and exclusions.
- What is a provider management plan?
- The provider management plan is a form used by allied health providers to advise our customer advisor of a worker's progress and ongoing rehabilitation needs.
- What does registered mean?
- The Act uses the term 'registered' to refer to those professions covered by a health registration board. All other registered professions recognised by WorkCover Queensland can be found on the Australian Health Practitioner Regulation Agency website
- What is a non-registered provider?
- A provider not registered with a health registration board. Non-registered providers are covered by the Table of costs. These costs outline the conditions and fees payable for delivery of specific rehabilitation services by certain non-registered providers. These services include return to work activities, physical conditioning, dietary assessment, diversional therapy, domestic assistance and home nursing. The document outlines the qualifications required by providers wishing to offer these services.
- How do I register with WorkCover Queensland as a provider?
- You need to register via our website.
- How will I receive a referral?
- There are three ways you may receive a referral:
1. from WorkCover, the referral form will specify exact services to be delivered and costs approved
2. in some cases the employer's rehabilitation and return to work coordinator may refer for a specific service without our approval from the treating medical practitioner
3. from the treating medical practitioner.
Allied health services require treating medical practitioner support and may require the insurer's prior approval. The Table of Costs outlines the items that require prior approval. You need to contact the insurer to obtain approval and to negotiate if the hours referred for are not sufficient.
- What if I have questions about the referral?
- Contact the referrer. If we are not the referrer, and the claim has been accepted by us, you will need to contact us for approval of services.
- I am a social worker or rehabilitation counsellor. Can I provide psychological treatment services?
- We will not pay for psychological treatment services provided by non-registered providers under most circumstances. Exceptions include treatment services provided by social workers in isolated areas where either a psychologist or psychiatrist is not available. This exception is not automatic and will need to be approved by us. Social workers and rehabilitation counsellors can offer services to help the worker prepare for return to work and can help in the return to work process. In most cases, the focus of the intervention would be on developing specific strategies or resolving problems directly associated with return to work. Rehabilitation counsellors may also assess vocational potential, assist with the generation of new work options (if necessary) and assist the worker in job development skills. There may also be a need for services if a return to work is not possible. Prior approval from WorkCover is required for any services. The worker must have a current medical certificate for payment to be made on any service.
- I am a counsellor. Can I provide counselling services?
- We can only pay for psychological treatment services provided by psychologists, psychiatrists, and general practitioners. We are not able to pay for any services provided by a counsellor unless they have qualifications and experience as a rehabilitation counsellor.
- What happens if I provide a service without approval from WorkCover Queensland?
- All services provided under the Table of costs need to be approved by us before the service is provided. This includes follow on services provided after the approved number of sessions has been exceeded.
- How are claims closed?
- Claims can be closed in two ways:
1. Legal closure—based on a legislative requirement:
* when a damages action is settled (s119)
* when weekly payments of compensation stop (s144(a))
* when payment of medical treatment, hospitalisation and expenses stop (s144(b))
* no further compensation for an injury after receiving a lump sum offer (s190(2))
* when there is a conviction of fraud (s537).
2. Administrative closure—based on an administrative decision:
* on review it becomes apparent that the person was not a 'worker' or there was not an 'event'
* when a work-related incapacity stops.
- Claims can be closed in two ways:
- What happens when a claim is closed?
- Once a claim is closed, the worker is not entitled to any further compensation benefits and we will not pay for any further treatment after this date.
- Last updated
- 26 November 2014