Accepted claims · Provisional liability · Five Dock & Gladesville

How WorkCover physio works, Five Dock

You do not pay for treatment on an accepted workers compensation claim. Your insurer pays us directly, at the rates SIRA sets.

Most people who ring us have been injured at work in the last week and have no idea what happens next. The short version: you tell your employer, you see a doctor and get a certificate of capacity, your employer notifies their insurer, and the insurer opens a claim. You can start physiotherapy before any of that is finished.

Under NSW workers compensation an insurer can begin paying for treatment on provisional liability within seven days of being notified, before they have decided the claim itself. That is the mechanism that lets you be treated early rather than waiting weeks for a decision.

The sequence

What has to happen, and in what order

None of this is your job to get right on your own. If you are partway through it and stuck, ring us and we will tell you which step is missing.

Tell your employer

In writing if you can, and as soon as you are able. Your employer has to notify their insurer within 48 hours of becoming aware of the injury. The date you reported it matters later, so keep a copy.

Get a certificate of capacity

From your GP or the hospital. This is the document that says what you can and cannot do at work, and it is what your employer and insurer act on. It is renewed through your recovery, not written once.

The insurer opens a claim

You are given a claim number and a case manager. Quote that number when you book with us and we can invoice your insurer directly rather than asking you for anything.

Treatment starts

For the first eight sessions your GP's referral is enough. Beyond that the insurer approves further treatment against a management plan we write and send them.

Money

Who pays, and what it costs you

On an accepted claim, nothing

We invoice your insurer at the rates SIRA publishes for physiotherapy and exercise physiology. There is no gap for you to pay and no rebate for you to claim back. You do not need private health insurance and it does not touch your extras.

Before the claim is decided

Provisional liability lets an insurer pay for treatment while they are still deciding. If your employer has notified them and you have a certificate of capacity, ring us and we will check where the claim is up to before your first appointment.

If the claim is declined

You can dispute it, and there is a process for that with time limits attached. We can keep treating you privately in the meantime, and the clinical notes we write are the same ones that support a dispute. Our article on appealing a WorkCover decision sets out the steps.

Common questions

Questions we get asked

Do I need a referral to start physio on WorkCover?
Yes. Your GP writes a referral for the first eight sessions. After that the insurer approves further treatment against the management plan we send them.
Can I start before my claim is accepted?
Usually. Under provisional liability an insurer can pay for treatment within seven days of being notified, before the claim is decided. Ring us with your claim number and we will check.
Do I have to use the physio my employer or insurer suggests?
No. In NSW you choose your own physiotherapist. Your employer and insurer can suggest one, and you are not obliged to go there.
What does it cost me?
Nothing on an accepted claim. We bill your insurer directly at SIRA rates.
How long can I be treated for?
There is no fixed limit. Treatment continues while it is producing measurable improvement and the insurer approves it against the plan. That plan is reviewed and resubmitted as you progress.

Not sure where your claim is up to?

Book a free 30 minute call. Tell us what has happened so far and we will tell you what is missing and what to do next.

Plan managed and self managed welcome · No referral needed · Five Dock & Gladesville