Medical reports

A medical report describes your claimed injury or illness and is provided by a medical practitioner or a treating allied health professional.

Your claims manager may ask for a medical report to help with the management of your claim, recovery or return to work.

Payment of the medical report fee

Your claims manager will arrange payment for the medical report they request to help manage or determine your claim.

To avoid unnecessary expense, we recommend you talk with your claims manager before you obtain a report.

In some circumstances, reports are received that were not requested. The report may have been arranged by someone other than your claims manager, such as you or your representative.

Your claims manager uses their discretion when deciding whether to pay for a report they did not request. They may consider whether:

• the cost of the report is reasonable
• the report provides relevant new information which helps manage your claim or determine benefits.

If your claims manager decides not to pay for this report, the cost of the report remains the responsibility of the person or organisation who requested it.

If this happens, your claims manager will:

• contact you or your representative
• provide reasons why the report will not be paid for.

A decision by your claims manager not to pay for a report is an administrative decision and not a determination under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act). This decision cannot be reconsidered.