4.5.13 Exercise physiology

WorkSafe will pay the reasonable cost of exercise physiology services at the request of a medical practitioner where required as a result of a work-related An injury/disease is work related if it arose out of or in the course of employment and the scope of employment. injury or illness.

Policy

Refer to policy for Exercise Physiology including information about:

  • who can provide services
  • expectations for service delivery under the Clinical framework
  • referral requirements
  • what costs will be paid for.

  • what costs will not be paid for

  • reporting requirements of exercise physiologists

  • restricted consultations.

See: Cost of Services | Fee Schedule for Exercise Physiology Services

Allied Health Recovery Management Plan

If treatment by an Exercise Physiologist is going to continue beyond five (5) sessions, an Allied Health Recovery Management Plan (AHRMP) must be completed and submitted to the managing Agent.

Restricted consultations

Exercise Physiologists may apply to provide a restricted consultation for workers with the following injuries:

  • moderate to severe acquired brain injuries
  • crush injuries
  • extensive burns
  • spinal cord injuries
  • multiple orthopaedic fractures
  • loss of limb amputations.

Other complex injuries will be considered on merit.

A Restricted consultation application form must be completed by the Exercise Physiologist to apply for approval to use the restricted consultation item number within their fee schedule.

Restricted consultation application form

Restricted consultation application forms are submitted to the managing Agent and reviewed by a suitably qualified person (injury management) to ensure that the workers condition meets the restricted consultation diagnostic criteria.

Applications that do meet the criteria

If it is determined that the workers condition does meet the diagnostic criteria or may meet the ‘on merit’ criteria, the application is then forwarded to WorkSafe’s Clinical Panel for review and, if required, a Clinical Advisor will initiate a discussion with the treating exercise physiologist to determine whether the proposed treatment is clinically justified. Exercise physiologists should not bill the restricted item consultation item number until they have been advised in writing that their application has been accepted.

Applications that do not meet the criteria

If it is determined that the workers condition does not meet the diagnostic criteria the Agent will advise the treating Exercise Physiologist in writing that their application has been unsuccessful.

Appealing an Agent or WorkSafe decision

WorkSafe has instituted a process for Exercise Physiologists to appeal decisions made by Agents or WorkSafe for the use of restricted consultations. All appeals are considered by two members of WorkSafe Clinical Panel in consultation with the applicant, to determine the clinical justification of the treatment proposed. Appeals can be lodged by forwarding a copy of the original application, the reasons that a review is being requested and any other supporting documentation to:

WorkSafe Clinical Panel
PO Box 279
GEELONG VIC 3220
Fax: 9641 1927
email: clinical_panel@worksafe.vic.gov.au

Accessing the exercise physiology forms

The Allied Health Recovery Management Plan (AHRMP) and Restricted Consultation Application Forms are available:

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