Reporting
Medical reports
We may ask you for a medical report to help decide or manage a claim. This is so we can learn more about your patient’s work-related injury and current work capacity.
In report requests, we'll ask about:
- the 'event' that caused the injury
- previous or similar injuries
- the worker's capacity
- your treatment recommendations
- details of the rehabilitation and return to work plan, including time frames
At times, we may ask if a permanent impairment is expected as a result of the work-related injury. We might also ask you to conduct an assessment, which you can find out more about in the guidelines.
Make sure you answer all the questions we ask in the report request. This helps our decision-making process, which in turn assists an injured worker’s access to treatment and a timely return to work.
Payment
Requested reports are paid for based on the item codes listed in the fee schedule. The amount can vary depending on what we ask for in the report and how quickly it's provided to us.
Please provide your report and invoice to us within 30 days of the examination. Getting us your report as quickly as possible means we can support your recommendations and help your patient faster.
Learn more about how to invoice us.
Privacy and freedom of information
Information you give us becomes part of the claim file, which may be requested and read by other people. This might include claims staff, our network of advisory doctors, specialists at the Medical Assessment Tribunals, or during legal proceedings.
We're also required to release information if it's asked for and required by law (e.g. a freedom of information request). These requests are usually from the worker or an employer.
Learn more about privacy and right to information.
Release of sensitive information
When information might be harmful to someone’s health or well-being, we release the information to a medical practitioner. After reviewing the supplied information, it's your decision to release, discuss or hold back the information.
We may request a Comprehensive Clinical Report (CCR) from you to make sure we have a full understanding of the diagnosis, treatment and prognosis at the start of the process.
A CCR can reduce the administrative requirements of the claim (e.g. removing the need for ongoing Work Capacity Certificate/s).
You must provide your CCR within 20 business days from the initial consultation.
The item codes that you can use for the CCR are:
- 100150 if received within 10 business days
- 100151 if received outside of 10 business days.
All comprehensive reports require insurer approval.
As part of an ongoing review of medical reports and how we can best partner with our medical and allied health providers, WorkCover made amendments to the CCR criteria (effective 1 December 2023) that removed previous criteria allowing for the provision of CCRs following an initial consult or surgery without prior approval.
WorkCover will commence consultation with relevant medical associations and key stakeholders to further review our current reporting templates and questionnaires.