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WORKERS REHABILITATION AND COMPENSATION ACT 1988 - SECT 75 Additional compensation for medical and other services

WORKERS REHABILITATION AND COMPENSATION ACT 1988 - SECT 75

Additional compensation for medical and other services

(1AA)  Subsection (1) applies to an employer of a worker if –
(a) the employer has accepted, or is to be taken under section 81AB to have accepted, liability to pay compensation in accordance with this Act for an injury to the worker; or
(b) the employer has been determined by the Tribunal or a court to be liable to pay compensation in accordance with this Act for an injury to the worker; or
(c) section 77AB applies to the worker.
(1)  If this subsection applies to an employer of a worker, the employer is, subject to this section, liable to pay as compensation to the worker or his dependants–
(a) the reasonable expenses necessarily incurred by the worker as a result of his injury for medical services, hospital services, nursing services, constant attendance services, rehabilitation services, household services, road accident rescue services and ambulance services; and
(b) if the worker dies as a result of the worker's injury –
(i) the reasonable expenses, not being more than the amount prescribed by regulations, of the worker's burial or cremation; and
(ii) the reasonable costs of counselling services provided to members of the family by counselling professionals, up to a total amount of all such costs that is not more than the amount prescribed by regulations.
(2)  If a worker was entitled to weekly payments in respect of an injury, the worker's entitlement to compensation under subsection (1)(a) for a service in relation to the injury ceases 52 weeks after the lawful termination of the weekly payments, unless the Tribunal makes a determination in relation to the service under subsection (2AB) .
(2AA)  If a worker is not entitled to weekly payments in respect of an injury in relation to which a claim for compensation has been made, the worker's entitlement to compensation under subsection (1)(a) for a service in relation to the injury ceases 52 weeks after the date the claim is made, unless the Tribunal makes a determination in relation to the service under subsection (2AB) .
(2AB)  If a worker's entitlement to compensation for an expense, referred to in subsection (1)(a) , for a service provided to the worker has ceased in accordance with subsection (2) or (2AA) , the Tribunal may order that, despite those subsections, the worker is entitled to compensation for –
(a) the expense; or
(b) expenses for services, specified in the determination, that are services referred to in subsection (1)(a) that have been or may be provided to a worker.
(2AC)  The Tribunal may only make a determination under subsection (2AB) in relation to a service provided, or to be provided, to a worker, if –
(a) the worker has returned to work and the worker requires surgery or cannot reasonably be expected to remain at work unless the service is provided; or
(b) the service consists of, or relates to, a modification, replacement or maintenance of a prosthesis of the worker; or
(c) the service is essential to ensure that the worker's health, or ability to undertake the necessary activities of daily life, does not significantly deteriorate.
(2A)  A person who provides any services in respect of a claim for compensation under this Act must not charge a fee that is in excess of –
(a) the prescribed fee; or
(b) if no fee is prescribed, the fee that the person would normally charge (taking into account any discount that would normally be applicable) for that service if that service were provided for a matter not connected with a claim for compensation.
Penalty:  Fine not exceeding 100 penalty units.
(3)  Where as a result of an injury suffered by a worker the question arises as to whether or not any constant attendance services or household services are required by the worker, the matter may be referred to the Tribunal by the worker, the employer of the worker, or the licensed insurer of the employer for determination as to–
(a) the necessity for such services;
(b) the period for which such services are to be provided; and
(c) the level of payments which it considers to be reasonable and appropriate for such services.
(4)  An employer who is required by subsection (1) to pay expenses for a service referred to in paragraph (a) of that subsection or for the burial or cremation of a worker shall, to the extent provided in this section, pay those expenses to the person or body of persons who performed the service or carried out the burial or cremation.
(5)  Notwithstanding subsection (4) , where an employer's liability to a person or body of persons under that subsection has already been discharged in whole or in part by a payment by the worker concerned or any other person, whether he is legally liable to make that payment or not, the employer shall, to the extent provided by this section, pay the amount by which the liability has been so discharged to the worker or, in the case of the worker's death, to his legal personal representatives or dependants, or to the other person by whom the liability was so discharged, as the case requires.
(6)  Where a worker or his legal personal representatives or dependants, by reason of any prior contract, agreement, or arrangement made by the worker, or by reason of his being a contributor or subscriber to any institution, fund, or scheme is or are entitled to any of the services referred to in subsection (1) (a) or to the worker's burial or cremation free of charge or at a reduced rate of charge, the payment by the employer in respect of the expenses of that service, burial, or cremation shall not thereby be reduced, but, after payment of the amount (if any) actually owing to the person or body of persons who provided the service or performed the burial or cremation, the balance of the expenses shall, to the extent provided by this section, be paid to the worker or, as the case requires, to his legal personal representatives or dependants.
(7)  The compensation payable under this section is in addition to all other compensation payable under this Act to a worker or his dependants, and the fact that a worker is, or his dependants are, entitled to compensation under this section does not restrict the compensation payable to him or them under any other provision of this Act.
(8)  The payment of the reasonable expenses of any service, repair or replacement, or burial or cremation expenses pursuant to this section, whether by agreement or upon the determination of the Tribunal, discharges the worker, his legal personal representatives, his dependants, and every other person from liability in respect of the expenses of that service, repair or replacement, or burial or cremation.
(9)  No action, claim, or demand shall be brought or allowed by or in favour of any person against a worker, or the legal personal representatives or dependants of a worker, for the payment or recovery of –
(a) any expenses that his employer is liable to pay pursuant to subsection (1) ; or
(b) the difference between the amount charged by a medical practitioner, in relation to medical treatment provided to or carried out on a worker for any injury in respect of which an employer is liable to pay compensation in accordance with this Act, and the amount of the fee mentioned in subsection (2) in respect of that treatment.
(10)  In this section –
counselling professionals means –
(a) medical practitioners, registered psychologists or social workers; or
(b) counsellors who are members of, or who have qualifications recognised by, the Australian Counselling Association;
counselling services means services provided to a person to assist the person to cope with the psychological impact of the death of a worker;
medical treatment , in relation to a worker, includes any attendance, examination, treatment, test or analysis provided to or carried out on the worker.