Medical and other expenses - Section 77AA
Division 2 of Part VI (sections 74 to 77AA) of the Workers Rehabilitation and Compensation Act deals with claims for medical and other treatment, rehabilitation, travelling and accommodation and similar expenses in cases where the employer has a general obligation to pay workers compensation benefits.
A worker who incurs any medical or other expense relating to a work-caused injury should submit the account for that expense to the employer for payment.
When an employer receives such an account they must within 28 days, either:
- pay the expense (either by paying the service provider directly or reimbursing the worker if the account has been paid); or
- dispute the expense
If the employer decides to dispute, they must deliver a notice to the worker that the expense is disputed and giving the reasons for the dispute. They must also provide the worker with material including medical reports which they rely upon to dispute the expense.
The employer must also notify the person who provided the service that the account is disputed and the reasons for the dispute.
If an employer disputes an expense, the worker may refer the dispute to the Tribunal under section 77AA within 60 days of receiving of the employer's notice of dispute.
If a referral is made to the Tribunal there will be a conciliation process to try to settle the dispute by agreement.
If agreement cannot be reached the Tribunal will resolve the dispute after hearing evidence from both sides.
If the dispute goes as far as a hearing the employer has the onus of satisfying the Tribunal that it should not pay the expense.