- Promoting health and safety
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- Healthy worker
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- Mental Health and Wellbeing - Participating and thriving in our workplaces
- Supporting ability at work
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- Rehabilitation assessment
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- Roles and responsibilities - claims
- Can I claim?
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- Medical treatment
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Frequently asked questions
If you have a question relating to your claim, you may be able to find the answer in this list of FAQs. If not, then please contact your Claims Manager directly or Comcare on 1300 366 979.
- What should I do if I need urgent treatment?
- Do I need a medical certificate from an allied health provider?
- What happens to my payments if I travel overseas?
- What if I take legal action against my employer or another third party?
- What changes should I let Comcare know of?
- How do I request a copy of my claim file?
- Does Comcare pay for medical reports?
- Documents protected from release
Before treatment is approved, Comcare requires that there is enough medical information on your file to relate the treatment to your compensable injury. If you are unable to get this information before undertaking the treatment, please call your Comcare Claims Manager directly or Comcare on 1300 366 979 to discuss your options.
You do not need a medical certificate from a doctor if you are only claiming for medical treatment by a registered chiropractor, osteopath, physiotherapist, masseur, occupational therapist, optometrist, psychologist or speech therapist. A certificate from the provider is sufficient.
If you wish to claim other benefits, such as incapacity payments or permanent impairment, you will need to provide appropriate medical evidence from a legally qualified medical practitioner.
If you are receiving fortnightly payments from Comcare and decide to travel overseas, you should let your Claims Manager know. Penalties apply in certain circumstances if you do not tell Comcare that you are leaving the country.
If you have lodged a claim with Comcare or have an accepted claim and you or a dependant take legal action against a third party, your employer (the Commonwealth) or another employee, you must advise Comcare of this action. There are penalties that apply if you do not do this within seven days of starting the action.
If you are paid damages as a result of your work-related injury or illness, you must let Comcare know within 28 days of receiving the damages payment. Penalties apply if you do not notify Comcare of the payment within that time.
Comcare is required to recover compensation that it had paid in relation to a work-related injury or illness from any damages you receive.
You should write to Comcare about any of the following changes in your circumstances, if you:
- change your address
- change your name
- change your EFT bank details (if you receive fortnightly payments from Comcare)
- engage in any employment (whether paid or unpaid)
- get a pension, allowance or benefit
Print and complete the Request to change bank account and/or personal details form.
All requests by claimants for documents under section 59 of the SRC Act 1988 should be made in writing and sent to email@example.com.
If you ask for one or two documents that are held on the claim file then you should get a response within five days. If you ask for the entire file and/or other material, or legal advice is needed, then you will get a response within 28 days.
Do I need to provide identification when requesting a copy of my claim file?
To prevent any breaches of the Privacy Act 1988, Comcare requires identification in the form of:
- the claimant’s claim number and/or signature; and
- some other form of identification which positively identifies the claimant as being who he/she claims to be.
This make sure there is no dispute:
- over the terms of the request; and
- that the person requesting the document is:
- the claimant to whom the documents relate; or
- the claimant's authorised representative.
What Comcare may provide under section 59 of the SRC Act 1988
A request for ‘any documents held by the authority, (e.g. Comcare), that relates to the claimant’s claim’, may also include records stored electronically.
Comcare also has a policy to provide a claimant with certain material held by Comcare which relates to operational issues but which is not necessarily held on the claimant’s file if:
- the claimant has specifically requested that material; or
- the claimant has referred to it in such a way as to make it clear that this is what they are requesting.
An example of this might be where a claimant requests documents on Comcare’s policy on aids and appliances. As a result, he/she might be provided with a copy of Comcare’s internal policy advice on section 39 of the SRC Act 1988.
However, Comcare’s view is that requests from claimants for longer documents, which are:
- not on the claimant’s file; or
- not related to the claimant’s claim; or
- publicly available through other sources and can be easily purchased or otherwise obtained,
do not have to be met.
If Comcare does not provide the publicly available material then the claimant will be advised where he/she can obtain that information.
Relationship between section 59 and the Freedom of Information Act 1982 (the FOI Act)
Claimants may make requests under either section 59 and/or the provisions of the FOI Act 1982.
The main differences between section 59 and the FOI Act 1982 are that:
- there is no requirement under the FOI Act 1982 for the person requesting the information to have a personal interest in it; and
- requesting documents and providing them under the FOI Act 1982 is a more formal process.
If the claimant makes a request for documents relating to their claim, without stipulating under what legislation the request is being made, then it will generally be actioned under the terms of section 59.
If a claimant makes a request under section 59, and a request under the FOI Act 1982, then the parts of the request which relate to section 59 will be actioned under that section and the remainder will be referred to the relevant Comcare FOI Contact officer. The claimant will be informed of this procedure.
Time frame for actioning section 59 requests
- if the request is for one or two documents that are held on the claim file then a response should normally be provided within 5 days;
- if the request is for the entire file and/or other material, or where legal advice needs to be sought, then a response should normally be provided within 28 days. If the information cannot be provided within 28 days then Comcare will advise the person who made the request.
Comcare can pay for a medical report it has requested to assist with the management or determination of a claim. In some circumstances ‘unsolicited reports’ are received by Comcare. An unsolicited report is a report obtained by someone other than Comcare, e.g. an employee or their representative.
Comcare may use its discretion to consider reimbursement of unsolicited reports in circumstances where the cost of the report is reasonable AND the report provides relevant new information that is required by Comcare to assist with the management of the claim or with determining benefits. If Comcare decides an unsolicited report is not payable, the cost of the report will remain the responsibility of the requesting party.
In this instance, Comcare will:
- contact the employee/their representative
- provide reasons why the report will not be paid for by Comcare.
A decision by Comcare to not pay for a report is an administrative decision and is not a determination under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act). The decision is therefore not reviewable under the SRC Act.
To avoid any unnecessary expense being incurred, before obtaining a report, employees (or their representative) should contact their Claims Manager to discuss whether a report is required.
There are some documents that could be protected from release under section 59. These include:
- information protected by Legal Professional Privilege;
- information on Comcare’s fraud investigations files; and/or
- medical reports containing information which, in Comcare’s opinion, if released, could cause the claimant or a third party harm.
Release of information to employers
Paragraphs 59(1)(b) and (c) of the SRC Act 1988 provide that employers (i.e. the Commonwealth or a licensed corporation) also have the right to request, and be provided with by Comcare, information relating to a claim.
This only extends to documents relating to the claim in question. Generally documents will not be provided to one department which relate to a separate claim involving another department, as, in most situations, those documents would not be relevant.
Where a claimant has advised Comcare that they do not want documents held on their file provided to a particular person in their agency, for example a manager or a supervisor, the documents will not be provided to that person.
The relevant documents can still be provided to the employer but it would be provided through an independent person such as the Human Resource Manager (or, if necessary, the Secretary, CEO etc) and the claimant’s objections regarding the release of the documents would be stated clearly to that person.
If you would like more information on this topic please contact us.