2.6.2 Medical expenses only
A claim for medical and like expenses only (MEO Medical expenses only) is:
- a claim for medical expenses only
- the worker’s entitlement to weekly payments has ceased but continues to be entitled to limited medical and like expenses. This could include a worker who has reached retirement age and is no longer entitled to weekly payments
- a full RTW Return to Work has been achieved
- liability has been accepted on an under excess time loss claim
- the worker has died but there are medical expenses claimed for injury prior to death
- no further weekly payments are to be made but there are ongoing medical expenses.
Objective
The main objective is to ensure effective and timely determination on liability and payment of expenses. Most claims for medical expenses only require limited or no intervention.
Monitor for a change in risk
If there is a change in circumstances, the claim should be transferred to the appropriate segment for ongoing claims management.
This may include:
- weekly payments are to be made or
- circumstances change which may result in weekly payments being made
For example:
- a worker has a further period of certified time lost after a full RTW
- the worker's employment is terminated
- a worker requires surgery.
Claim summary
A summary of the claim does not need to be developed for MEO claims but Agents may use their discretion if expenses are higher than expected.