RECOMMENDED APPOINTMENT FOR THIS SERVICE
Choose Standard for a straightforward review or follow-up. Choose Long for a new workplace injury, an initial Certificate of Capacity, multiple concerns or a detailed return-to-work assessment. More time may be required depending on complexity.
If you have been injured at work, or developed an illness because of your work, our general practitioners can assess your condition, advise on treatment, consider your ability to work and help document your recovery.
Please tell your practitioner that your injury or illness is work-related and that you wish to proceed with a workers compensation claim. This helps us arrange the appropriate clinical documentation and billing pathway.
Medical services that are payable under workers compensation should be billed through the workers compensation arrangements rather than claimed from Medicare. Your eligibility and account responsibility depend on the insurer's decision and coverage.
Bring your claim number and insurer's name to your appointment. Where the service is covered and insurer billing arrangements are confirmed, DC Medical Centre will bill the insurer directly.
For accepted, payable treatment, you would generally have no consultation gap fee. A claim number does not by itself establish that every service is approved or payable.
You can still arrange an assessment. Until insurer details and payment arrangements are confirmed, you will be billed directly using the applicable NSW SIRA medical practitioner rates, rather than our standard Medicare consultation fees.
If a claim is subsequently accepted, you can seek reimbursement from the insurer for eligible expenses, subject to its decision. Keep your invoice and receipt.
If an insurer declines the claim or declines liability for a treatment, the patient may be responsible for unpaid accounts. The practice will explain its payment process when you book or attend.
01 — Notify your employer
Tell your employer about the injury or work-related illness as soon as possible, including when and how it happened. Your employer is generally required to notify its insurer within 48 hours of becoming aware of it.
02 — Attend your GP appointment
Explain that the condition is work-related and that you intend to make a workers compensation claim. Your practitioner will assess you and determine whether a Certificate of Capacity is appropriate.
03 — Obtain the insurer details
After your appointment, reception can help you identify the information required for billing and your claim. Ask your employer or insurer for your claim number and insurer name, then provide both to reception.
04 — Continue treatment and reviews
Keep your certificates current, attend follow-up appointments and follow treatment and return-to-work advice. Some treatment requires insurer approval before it proceeds.
Ask your employer for the insurer's name and contact details. You can also contact icare on 13 77 22 for icare-related enquiries.
If you do not know who the workers compensation insurer is, the NSW Independent Review Office (IRO) can help on 13 94 76.
For more information about reporting an injury, see SIRA's steps after a workplace injury →.
A NSW Workers Compensation Certificate of Capacity records your diagnosis, treatment needs, functional restrictions and capacity to work. It helps the insurer, employer and treating team plan appropriate duties, time away from work and recovery.
You must be clinically assessed. Your treating doctor considers your injury, work duties, symptoms, examination findings and ability to perform your usual or modified tasks. A certificate cannot simply be issued on request without a suitable assessment.
The first certificate is generally completed by your nominated treating doctor. It identifies whether you can do your usual duties, some suitable work, or currently have no work capacity.
A certificate generally covers no more than 28 days; longer periods require specific clinical justification. A further clinical assessment may be needed before renewing it. Arrange review before your current certificate ends.
For ongoing care, the treating doctor should review progress and work capacity. SIRA-approved physiotherapists or psychologists may issue certain second or subsequent certificates within their scope. Read SIRA Certificate of Capacity requirements →
WorkCover-related medical practitioner services in NSW are subject to SIRA's applicable fees order. The amount depends on the service delivered, not simply the appointment length selected when booking.
Consultations and treatment that are payable under workers compensation should be billed through that system, rather than claimed through Medicare. Your practitioner and reception can discuss the appropriate billing pathway.
When your insurer and claim details are confirmed and the service is covered, DC Medical Centre can bill your insurer directly, normally leaving no out-of-pocket cost for the payable consultation. A claim number alone does not guarantee coverage.
You may still attend for assessment, but you will be invoiced at the applicable SIRA rates while insurer arrangements are unresolved. Keep your invoice and receipt and ask your insurer about reimbursement if your claim is accepted.
If the insurer declines liability or refuses to cover a particular service, you may be responsible for the account. Speak with reception about billing and contact the insurer or the Independent Review Office if you dispute the decision.
Choose Standard (15 minutes) for a straightforward existing claim review, or Long (30 minutes) for an initial injury assessment, complex concerns or Certificate of Capacity discussion. Your practitioner may recommend additional time.
Report the injury to your employer as soon as possible. The employer generally must notify its insurer within 48 hours; the insurer can then provide a claim number. Ask your employer for its insurer details and give the claim number to our reception team when available.
It is the NSW workers compensation medical certificate describing your injury, treatment, functional limitations and current ability to work. It helps guide rehabilitation, appropriate duties and insurer decisions.
Your practitioner must complete an appropriate clinical assessment before certifying work capacity. An in-person review may be required, especially for a new injury or when an examination is needed.
The usual maximum is 28 days. A longer period requires specific clinical reasons. Arrange review before expiry if you need ongoing certification or support.
Yes. If clinically appropriate, the doctor can document capacity for some work and describe restrictions, suitable duties, hours and days rather than certifying no capacity at all.
Your nominated treating doctor can issue and review certificates. For relevant conditions, a SIRA-approved treating physiotherapist or psychologist may issue some subsequent certificates using the designated form.
Eligible treatment may be covered, but some services need prior insurer approval. Ask the insurer and your practitioner about authorisation before arranging non-urgent investigations or treatment.
Book a prompt medical review so your care and capacity can be reassessed. If symptoms are severe or life-threatening, call Triple Zero (000) or attend an emergency department.
Book a Standard consultation for a straightforward follow-up or a Long consultation for a new injury, Certificate of Capacity or more detailed work-capacity assessment. Bring your insurer name and claim number if you have them.
