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Workcover Medical Expenses

If you have had an injury at work, in accordance with section 60 of the Workers Compensation Act 1987, the worker’s compensation insurer is required to pay all “reasonably necessary” medical expenses.

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Claiming medical expenses can include the below:

1. Medical and related treatment includes:

  • Treatment by medical practitioners, physiotherapist, chiropractors, osteopaths, psychologists, counsellors, exercise psychologists, remedial massage therapists and other allied health practitioners.
  • Provision of artificial aids.
  • Domestic assistance services.
  • Nursing, medical and medicine supplies (provided outside of hospital treatment).

2. Hospital treatment

Hospital treatment includes treatment at public and private hospitals and/or rehabilitation centres.

3. Ambulance service includes emergency, non-emergency and inter hospital transfers provided by the Ambulance Service of NSW.

4. Work place rehabilitation services include:

  • Return to work in case management.
  • Vocational, functional and work place assessments.
  • Job analysis and modification.
  • Identification of suitable employment.
  • Worker retraining and placement in suitable employment.

5. Travel expenses can be claimed. To claim for payment for travel to attend medical, hospital and rehabilitation appointments, the worker will need to keep:

  • A record of the mileage if the worker used his or her car; and/or
  • Receipts for public transport.

The maximum amount payable for private car travel associated with attending medical expenses is currently $0.55 per kilometre.

Would you like assistance with your claim?

Complete our free, no obligation confidential case assessment form and we’ll get back to you within 24 hours.

Alternatively, we are available to talk by phone and email. Please contact our experienced accredited specialist personal injury lawyers to find out how we can help.

No Win No Fee

You won’t be required to pay any fees until we win your case.

Industry Experts

We’re industry experts with over 20 years of experience.

Maximum Compensation

Our team of expert injury lawyers will help you get maximum compensation.

Graeme M.
04:22 29 Oct 25
Matthew Garling and his team have been excellent in dealing with my case. I am very happy with the result and the process to guide me through everything over the last two years. Most importantly... happy with the payout. Highly recommend if you’re thinking of claiming for an injury caused by another party.read more
Melanie F.
00:20 18 Oct 25
3 years ago, I got injured at work and at first I was denied getting any help from a certain insurance company so I looked up lawyers that could possibly help me getting what I was entitled to and I... am so glad Garling and co took on that responsibility to help me,I still have some way to go but Kerry Byrnes and her team have gone above and beyond for me I am so grateful I had her in my corner,I highly recommend Garling and co I don’t know where I would be now if not for guidance and understanding THANKYOU Kerry and team I am 1 happy customerread more
steve J.
00:38 29 Sep 25
Brilliant Service and I am always kept well informed. Definitely recommend this law firm to anyone seeking compensation lawyers. I really appreciate and thank Matthew and his wonderful team for their... incredible and sincere hard work they have put in for my case in the last couple of years. My family and I are blessed and very satisfied with our outcome. God Bless you Matthew Garling and your team.read more
Mark W.
10:50 17 Sep 25
Garling and Co. are an exceptional outfit. Matthew Garling is a talented lawyer and supported and surrounded by a great team of people including Allison Luck and others. What made Matthew... particularly impressive with my case were his ability to communicate complex legal processes and simplify options for the next steps, his genuine interest in the law, and his passion to seek appropriate compensation on my behalf. He was not ready to settle my case until I was ready to settle the case. I am very grateful to have had Garling and Co. 'in my corner' and would not hesitate to recommend this business to others.read more
Elyce
22:22 06 Sep 25
I never imagined this chapter would close, but it finally has.I cannot thank Joelle enough for the incredible support she gave me during one of the most challenging times in my life.Her... professionalism and genuine care throughout my claim process exceeded all my expectations.Whenever I contacted Garling and Co to speak with Joelle, I was assisted by Lynn. She was always polite, clear, and concise, and consistently showed empathy whenever I called or emailed.read more
Anonymous 1.
22:02 04 Sep 25
I was referred to Garling & Co Lawyers, after previously retaining another law firm who failed to progress my matter for a period verging on three years.This was extremely frustrating and damaging,... causing me a lot of unnecessary stress and unreasonable delays. After my first conference with Matthew, he understood the challenges that I had faced and that I wanted to resolve my matter with the defendant reasonably and in a timely manner.My matter was resolved at mediation and during the process, Matthew and Dallas Morgan (barrister), professionally communicated the procedure to me and they negotiated a reasonable settlement, that I was comfortable in accepting.Thank you to Matthew and Allison for being patient with me during the most challenging time of my life. I can now move on with my life and heal. Had I not retained Garling & Co Lawyers, I highly doubt my matter would ever have been resolved.read more
Sammy R.
01:07 04 Sep 25
Garling and Co have been the best lawyers. Kerry and Matthew have worked and been working on my case for a long time now. They have worked so hard and fought for my case every step of the way. They... are highly experienced in what they do, and are compassionate at the same time. I highly recommend this firm. My life changed in an instant when I was hit by a car, I will be forever grateful for the help they've given me. 10/10read more
Donelle L.
20:37 11 Aug 25
So very happy with the service Garling has provided with both of my claims from the start to the end cannot thank them enough Mathew and the team are the best
Rachel J
01:46 09 Aug 25
The level of service that Garling & Co provides is truely unmatched.Thank you to both Matthew and Allison for your professionalism & dedication throughout my journey of being a client.Matthew... provided me with genuine, factual and straightforward advice throughout the process and this made things easy to understand and put any uncertainty I had to rest. A complicated process ran smoothly and I always felt supported, knew where things were at and that I was in good hands.The communication at Garling & Co is exceptional. Every question I had, whether by email or phone was responded to in a timely manner and at every stage I was confident Matthew would be guiding me through the next steps - which he did, until my case was finalised.Thank you for upholding clients dignity and respect, these are values people like me need in such critical times of their lives. As a client, it is clear these values shine through. You provided me with a safe space where I was able to focus on my day to day challenges caused by my injuries, while you took care of the legal aspect on my behalf.Lastly, I’m grateful for your commitment to the work that you do and the care that you provide to people who find themselves in unfortunate circumstances beyond their control. And thank you so much for the very positive outcome that I received.read more
Ros P.
07:12 29 Jun 25
Staff polite, clear and concise. Explained well in a logistical manner. Overall a great service.

Find out more about Workers Compensation

Frequently Asked Questions

1. What is “reasonably necessary” medical treatment?

The insurer is required to pay “reasonably necessary” medical expenses. In determining what treatment is reasonably necessary, the insurer should have regard to:

  • The appropriateness of the treatment.
  • The availability of alternative treatment.
  • The cost of the treatment.
  • The actual potential effectiveness of the treatment.
  • The acceptance by medical experts of the treatment as being appropriate and likely to be effect.

The term has also been defined to mean “any necessity for relevant treatment which results from the injury where its purpose and potential effect is to alleviate the consequence of injury”.

Often this test is confused to mean that the treatment must be reasonable and necessary. This is incorrect. That is a much more demanding test.

If the treatment is such that its potential effect is to alleviate the consequence of injury, then it will be “reasonably necessary”

2. Is pre-approval necessary?

Section 60 (2A) of the Workers Compensation Act states that the insurer is not liable to pay for the cost of medical treatment without prior approval of the insurer.

However, there are several exceptions where no prior approval is required and they include the following:

  • Any treatment provided within 48 hours of the injury.
  • Attending a nominating treating doctor for a consultation or to obtain a medical certificate.
  • The first consultation with a specialist medical practitioner on referral by the nominated treating doctor.
  • All plain x-rays performed on referral from a nominated treating doctor or specialist medical practitioner.
  • Any service provided in a public hospital on presentation to an emergency department.
  • In relation to physiotherapy, osteopathic or chiropractic treatment, the initial consultation and up to a further 7 treatment sessions provided the practitioner is registered and the injured worker has not previously received such treatment for the injury claimed.
  • Pharmacy items prescribed by the nominating treating doctor within the first 3 weeks’ post injury up to a maximum of $500.00.
  • For any psychological treatment or counselling, the initial consultation and up to a further 5 treatment or counselling sessions where the counsellor is WorkCover approved and the worker has not previously received such counselling.
  • Payment of up to 5 sessions of remedial massage however the remedial massage therapist must be WorkCover approved.
  • In relation to a hearing needs assessment, the initial hearing needs assessment as long as such assessment was referred by the nominated treating doctor or treating specialist.
  • The Workers Compensation Commission or a registrar orders the insurer to pay for treatment expenses.

When you request pre-approval from the insurer, the insurer has a period of 21 days to respond to your request. If the insurer does not respond within 21 days, you can make a complaint to the WorkCover independent Review Office (WIRO).

If the treatment has been pre-approved and receipts have been sent to the insurer for reimbursement, the insurer must reimburse you within seven days of receiving your expenses receipts.

3. For how long does the insurer pay my medical expenses?

The period the insurer is responsible for paying reasonably necessary medical treatment differs depending on your assessment of whole person impairment (WPI):

  • 10% WPI or less: payment of medical expenses will cease 2 years from the date of the claim was made or from the date that weekly payments cease (whichever occurs later).
  • 11% to 20% WPI: payment of medical expenses will cease 5 years from the date that the claim was made or from the date that weekly payments cease (whichever occurs later).
  • 21% or more WPI: payment of medical expenses are payable for the remainder of the injured workers life.

4. What do I do if the insurer declines my treatment?

The insurer may decline to pay for your medical expenses on the basis that it is not reasonably necessary, or that it is not related to your work injury. If the insurer declines to pay for your medical expenses they will need to provide written reasons in the form of a Section 74 Notice.

If the insurer declines treatment of medical expenses over the phone, make sure you ask them to provide a Section 74 Notice in writing outlining why they have declined your request. They must by law put the reasons for declining treatment in writing within 7 days.

It is important to obtain a Section 74 Notice as it is needed to challenge the decision of the insurer.

If the medical treatment dispute cannot be resolved and you consider the treatment to be reasonably necessary, you can make an application to the Workers Compensation Commission to appoint an independent Arbitrator to hear and determine the dispute.

You will need medical evidence to support the argument that the treatment is “reasonably necessary”, you lawyer will obtain this evidence on your behalf.

If you wish to challenge the decision of an insurer, you should contact an Accredited Specialist in Personal Injury Law like Garling & Co. We can help you with your medical expenses claim, simply get in touch with us through the below;

  1. Complete our FREE case assessment form HERE
  2. Email us at info@garlingandco.com.au
  3. Give us a call on (02) 8518 1120
More Faqs

Would you like assistance with your claim?

Complete our free, no obligation confidential case assessment form and we’ll get back to you within 24 hours.

Alternatively, we are available to talk through phone and email. Please contact our experienced workers compensation lawyers to find out how we can help.

No Win No Fee

You won’t be required to pay any fees until we win your case.

Industry Experts

We’re industry experts with over 20 years of experience.

Maximum Compensation

Our team of expert injury lawyers will help you get maximum compensation.

Graeme M.
04:22 29 Oct 25
Matthew Garling and his team have been excellent in dealing with my case. I am very happy with the result and the process to guide me through everything over the last two years. Most importantly... happy with the payout. Highly recommend if you’re thinking of claiming for an injury caused by another party.read more
Melanie F.
00:20 18 Oct 25
3 years ago, I got injured at work and at first I was denied getting any help from a certain insurance company so I looked up lawyers that could possibly help me getting what I was entitled to and I... am so glad Garling and co took on that responsibility to help me,I still have some way to go but Kerry Byrnes and her team have gone above and beyond for me I am so grateful I had her in my corner,I highly recommend Garling and co I don’t know where I would be now if not for guidance and understanding THANKYOU Kerry and team I am 1 happy customerread more
steve J.
00:38 29 Sep 25
Brilliant Service and I am always kept well informed. Definitely recommend this law firm to anyone seeking compensation lawyers. I really appreciate and thank Matthew and his wonderful team for their... incredible and sincere hard work they have put in for my case in the last couple of years. My family and I are blessed and very satisfied with our outcome. God Bless you Matthew Garling and your team.read more
Mark W.
10:50 17 Sep 25
Garling and Co. are an exceptional outfit. Matthew Garling is a talented lawyer and supported and surrounded by a great team of people including Allison Luck and others. What made Matthew... particularly impressive with my case were his ability to communicate complex legal processes and simplify options for the next steps, his genuine interest in the law, and his passion to seek appropriate compensation on my behalf. He was not ready to settle my case until I was ready to settle the case. I am very grateful to have had Garling and Co. 'in my corner' and would not hesitate to recommend this business to others.read more
Elyce
22:22 06 Sep 25
I never imagined this chapter would close, but it finally has.I cannot thank Joelle enough for the incredible support she gave me during one of the most challenging times in my life.Her... professionalism and genuine care throughout my claim process exceeded all my expectations.Whenever I contacted Garling and Co to speak with Joelle, I was assisted by Lynn. She was always polite, clear, and concise, and consistently showed empathy whenever I called or emailed.read more
Anonymous 1.
22:02 04 Sep 25
I was referred to Garling & Co Lawyers, after previously retaining another law firm who failed to progress my matter for a period verging on three years.This was extremely frustrating and damaging,... causing me a lot of unnecessary stress and unreasonable delays. After my first conference with Matthew, he understood the challenges that I had faced and that I wanted to resolve my matter with the defendant reasonably and in a timely manner.My matter was resolved at mediation and during the process, Matthew and Dallas Morgan (barrister), professionally communicated the procedure to me and they negotiated a reasonable settlement, that I was comfortable in accepting.Thank you to Matthew and Allison for being patient with me during the most challenging time of my life. I can now move on with my life and heal. Had I not retained Garling & Co Lawyers, I highly doubt my matter would ever have been resolved.read more
Sammy R.
01:07 04 Sep 25
Garling and Co have been the best lawyers. Kerry and Matthew have worked and been working on my case for a long time now. They have worked so hard and fought for my case every step of the way. They... are highly experienced in what they do, and are compassionate at the same time. I highly recommend this firm. My life changed in an instant when I was hit by a car, I will be forever grateful for the help they've given me. 10/10read more
Donelle L.
20:37 11 Aug 25
So very happy with the service Garling has provided with both of my claims from the start to the end cannot thank them enough Mathew and the team are the best
Rachel J
01:46 09 Aug 25
The level of service that Garling & Co provides is truely unmatched.Thank you to both Matthew and Allison for your professionalism & dedication throughout my journey of being a client.Matthew... provided me with genuine, factual and straightforward advice throughout the process and this made things easy to understand and put any uncertainty I had to rest. A complicated process ran smoothly and I always felt supported, knew where things were at and that I was in good hands.The communication at Garling & Co is exceptional. Every question I had, whether by email or phone was responded to in a timely manner and at every stage I was confident Matthew would be guiding me through the next steps - which he did, until my case was finalised.Thank you for upholding clients dignity and respect, these are values people like me need in such critical times of their lives. As a client, it is clear these values shine through. You provided me with a safe space where I was able to focus on my day to day challenges caused by my injuries, while you took care of the legal aspect on my behalf.Lastly, I’m grateful for your commitment to the work that you do and the care that you provide to people who find themselves in unfortunate circumstances beyond their control. And thank you so much for the very positive outcome that I received.read more
Ros P.
07:12 29 Jun 25
Staff polite, clear and concise. Explained well in a logistical manner. Overall a great service.
University of Technology, Sydney
Member of Law Society of New South Wales
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University of Sydney
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University of Technology, Sydney
Member of Law Society of New South Wales
Law Society of NSW Specialist Accreditation
University of Sydney
Legal Profession Admission Board of New South Wales
The law society of nsw professional standards scheme logo.
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