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Frequently asked questions for medical practitioners (GPs and specialists)
- Who is covered by Comcare?
- What income support can patients get when they have been injured at work?
- How long can my patient get income support if they are off work as a result of a workplace injury or illness?
- What other financial support can my patient access?
- Can my patient get paid out for their claim?
- Permanent impairment
- Who is responsible for assisting my patients to return to work?
- What constitutes a case conference?
Who is covered by Comcare?
Comcare is an insurer of workers compensation and provides coverage for employees of Commonwealth Government, employers and the ACT Government.
What income support can patients get when they have been injured at work?
An injured employee (your patient) may be entitled to receive income support, known as incapacity payments, while they are unable to work or are on a rehabilitation program, if they have a work-related condition that has been accepted by Comcare.
Incapacity payments are not a pension. They compensate an injured employee for loss of income while on a rehabilitation program or until they recover from their work-related injury or illness. Find out more information about incapacity payments.
How long can my patient get income support if they are off work as a result of a workplace injury or illness?
If your patient has an accepted compensation claim they may need a short period of compensation leave. If this is the case, compensation would be payable at a rate equal to 100 per cent of their normal weekly earnings (NWE), less any amount they are actually earning, for periods of compensation leave up to a total of 45 weeks.
If your patient needs compensation leave for longer than 45 weeks, then compensation is calculated based on the percentage of normal weekly hours the employee worked during the week. This is subject to statutory limits.
What other financial support can my patient access?
Reasonable and appropriate medical costs
Comcare may reimburse reasonable medical, hospital, pharmaceutical and other treatment costs where there is an accepted claim for a work-related injury or illness.
If physical therapies are undertaken with allied health professionals Comcare will not usually pay for such treatments from two or more medical providers at the same time.
Comcare may reimburse travel related costs to attend medical treatment in the following cases:
- the condition reasonably requires use of an ambulance or public transport (including a taxi)
- a private motor vehicle is used for travel to attend medical treatment and the necessary distance travelled for any one-off treatment session is more than 50 kilometres for the round-trip.
Aids and appliances
Comcare may approve the provision, repair or replacement of an aid or appliance that an injured employee reasonably requires as a result of a compensable condition.
Comcare will also consider liability for essential home, workplace (outside the boundaries of the employer's duty of care) and car modifications that are required as a result of a compensable condition.
Find out more information about aids, appliances and modifications.
Household and attendant care services
A serious work-related injury or illness may make it difficult for your patient to cope with home duties. Comcare may approve services of a domestic nature to assist your patient to properly run and maintain their home.
Comcare would not normally pay for services if it is reasonable to expect other members of the patient’s family to carry them out, even if these family members did not normally undertake the tasks before the work-related injury or illness.
More information about application for Household, Attendant care and/or child care services [PDF,138.2KB].
Can my patient get paid out for their claim?
Commutation of a claim, that is, an agreement to commute liability for workers compensation to a lump sum amount is not available under the Safety, Rehabilitation and Compensation Act (SRC Act) 1988.
If your patient has a work related injury or illness that results in a permanent impairment (PI) they may wish to claim a PI lump sum benefit. Under the SRC Act, 'impairment' is defined as the loss, loss of use, or the damage or malfunction of any part of the body or of any bodily system or function, or part of such system or function.
You, as the GP or a specialist are able to assess whether an employee has sustained any impairment(s) as a result of the work-related injury or illness.
For more information see information for injured workers—permanent impairment (PI).
Who is responsible for assisting my patients to return to work?
You, the employee, the workplace rehabilitation provider (WRP), treatment providers and supervisors all play a role in assisting employees return to work. Under the SRC Act the employer is responsible for managing the return to work of their injured or ill employees.
You as the GP or specialist, play an important role in providing information relating to an employee’s capacity. The certificate of capacity has been developed with a focus on what the employee with a workplace injury or disease can do, rather than what they can’t do.
Comcare's preferred medical certificate is the certificate of capacity that, when fully completed, fulfills the legal requirements under the Safety, Rehabilitation and Compensation Act 1988 (the SRC Act). We recommend using this form, but it is not mandatory. A copy of the certificate of capacity and information on how to complete it can be found here Better practice - Certificate of Capacity.
What constitutes a case conference?
A return to work (RTW) case conference connects you, your patient, their employer, other treatment providers and the insurer at the right time to best support return to work outcomes.
RTW case conferencing provides the opportunity to:
- discuss the requirements for RTW
- consider the employee's capacity for work
- discuss what supports may be required to support the employee to RTW—e.g. flexible work arrangements, workplace adjustments, alternative duties, equipment supports
- agree on actions that focus on and support the employee's RTW.
You will be required to document the case conference in your clinical notes and are eligible to bill Comcare, as per AMA rates, for participating in the case conference. For billing purposes a RTW case conference only needs to involve you, your patient and a minimum of one other person, usually an employer representative.
For more information regarding RTW case conferencing visit return to work case conferencing.