4.4 Termination of medical & like benefits
There are particular circumstances outside of the 52 week Medical and Like Entitlement Review (MLER) process where compensation for medical and like services will no longer be paid. This may be following the time limit associated with provisional payments, and/or when it is determined that medical and like services are no longer reasonable or necessary.
Updating records
When medical and like benefits have been stopped, system records must be updated to prevent further medical and like payments to that worker (e.g. PP screens).
Notification requirements
Give the worker a minimum of 28 days' notice that payment for their medical and like service will be ceasing.
The notice must inform the worker of their appeal rights.
If the Agent is aware of service providers who have been providing regular services to the worker, inform the provider/s of the intention to cease medical and like benefits for the worker.
Note: Informing the service provider/s will reduce the risk The probability of the worker not returning to work is known as the risk or risk factor. For example: if a worker is likely to return to work, the claim is categorised as low risk. of disputes about ongoing responsibility for paying medical and like costs.