4.1.4 THP reports

An Agent or employer will obtain clinical information about a worker’s injury or illness to determine liability or entitlements. A treating health practitioner (THP Treating Health Practitioner) report provides information about the effectiveness of the treatment or service and evaluates the worker’s progress towards rehabilitation and return to work goals.

Not all providers can be paid for a report. See 2.7.1 THP reports for more information.

Information requested in a THP report may be used to help:

  • determine liability for a claim
  • manage a worker’s rehabilitation and return to work
  • determine if a worker has an entitlement or continuing entitlement to weekly payments or the reasonable costs of medical and like services.

A THP report should be used as an alternative to an independent medical examination.

Primary contact service

WorkSafe can pay the reasonable costs of reports as a ‘medical service’ as defined in the legislation.

WorkSafe can pay the reasonable costs of reports from a THP who provides primary contact services (medical or allied health) or who is a Network Provider where authorised by the Agent.

WorkSafe has a detailed fee schedule for the reports. The Agent should confirm the fee with the THP before requesting the report.

Referred services

When the treating medical practitioner requests that a worker sees an allied health service (requested/referred service only), the treating medical practitioner is responsible for monitoring the outcomes of the service or treatment.

WorkSafe does not authorise the payment of reports from referred service providers.

A report about a requested/referred service must be provided by the treating medical practitioner and not by the requested/referred service provider.

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Request a THP report

THP reports may be requested by:

Agents may request a THP report from the following providers who must be registered or approved by WorkSafe to provide services to workers:

Reports should be sought from referring medical practitioners if the specific treating healthcare discipline is not on the above requesting list.

When WorkSafe can pay for a THP report

An Agent will only consider paying for a report when the:

  • Agent has requested a report by the specific THP
  • costs of the report are reasonable and in line with the relevant WorkSafe fee schedule for the THP discipline. If a WorkSafe fee schedule does not exist for the authorised THP discipline as detailed above, the Agent should discuss with the treating practitioner the fee for the provision of the report before requesting the report
  • Agent is satisfied that the information provided addresses the information requested.

Where an Agent requests further information from a THP to respond to a worker's medical and like request because the initial information provided with the request was insufficient it is not expected that a fee would be charged to provide information that should have been included in the initial request. The Agent will consider paying for the reasonable costs of providing additional information in accordance with the fee schedule for services including the provision of reports. The Agent will respond to a medical and like request when it has sufficient information to do so.

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