Many people recover from their injuries and get back to normal activities without treatment or rehabilitation, while others need rehabilitation such as physiotherapy to assist their recovery.
Rehabilitation aims to return you to how you were before the accident, if this is not possible rehabilitation focuses on you obtaining new skills or new ways of doing things.
It is widely recognised that if rehabilitation is needed, it should be provided as soon as possible after the injury. Ask your Doctor / medical practitioner whether they think you need rehabilitation services.
What does the CTP insurer fund?
If the insurer has accepted liability for your claim or agreed to fund rehabilitation without admitting liability, the insurer will pay rehabilitation expenses provided they:
- are reasonable and appropriate;
- relate to the injuries from the accident; and
- are validated e.g. by providing receipts to the insurer.
How to organise rehabilitation or treatment
1. The insurer can contact you
Information provided on the claim form medical certificate will let the insurer know if rehabilitation is needed. The insurer may contact you to discuss your rehabilitation.
2. You can contact the insurer
If you, your doctor or treatment provider think you need rehabilitation you can:
- call or write to the insurer and request they fund the rehabilitation service. (If you have a solicitor you can ask them to do this for you or you can contact the insurer yourself); or
- ask your treatment provider to contact the insurer to request funding of your rehabilitation.
The insurer requires rehabilitation recommendations or requests in writing. This may be in the form of a treatment plan (e.g. used by physiotherapists or psychologists) or a letter from your GP or medical specialist.
Payment of rehabilitation / treatment expenses
Obtain approval from the insurer for payment of rehabilitation services before you attend. This will ensure that these services are paid for. The rehabilitation provider can then send accounts directly to the insurer for whatever has been approved.
If you have paid for rehabilitation and would like to be reimbursed, provide the insurer with a valid receipt. The insurer will then assess whether or not these services were reasonable and appropriate. Do not assume that the insurer will continue to meet the ongoing cost of a service if there has not been prior approval from the insurer.
Treatment by a public hospital or emergency services
Treatment of Queensland CTP claimants at a public hospital or by emergency services in Queensland is covered by the Hospital and Emergency Services levy which is included in the CTP insurance premium and you should not be billed.
Whiplash is one of the most frequently recorded injury among people with CTP claims in Qld. MAIC has supported the development of the Whiplash Injury Recovery – a self help guide for whiplash sufferers . This is designed to supplement care provided to you by a health professional.
Working after injury
Most people injured in motor vehicle crashes recover quickly and remain at work during the rehabilitation process. Continuing at work, even in a reduced capacity has important health and wellbeing benefits. Some people require more assistance to return to work due to the severity of their injury or the nature of their work. Early return to work and activity helps prevent long term disability and improves the likelihood that you will be able to continue at work.
If liability for the accident is denied
If the insurer denies liability, you are responsible for your own treatment and rehabilitation expenses. You may be reimbursed for these costs if it is determined later that the insurer is liable. In the meantime you may be able to claim some or all of the costs from Medicare or through private health insurance and/or other personal injury insurance. From 1 July 2016, if you have a National Injury Insurance Scheme Queensland (NIISQ) eligible injury (catastrophic injury) you may be able to access care and support through the NIISQ.
If you do not agree with the insurer’s rehabilitation decision, ask the insurer to refer the matter to their internal dispute resolution service.
For disputes which cannot be resolved by direct negotiation with the insurer, you can apply to the Motor Accident Insurance Commission to appoint a mediator to help resolve the dispute. Mediation is voluntary, there may be a cost and both parties must be willing to participate.
If a dispute cannot be settled by direct negotiation or mediation, you or the insurer may apply to the Court to decide what rehabilitation is reasonable and appropriate.
- Road to Recovery – Rehabilitation following a motor vehicle accident
This brochure provides more detailed information about rehabilitation in the Queensland CTP scheme.
- Whiplash Injury Recovery – a Self Help Guide
This booklet is designed to aid the recovery of people with a whiplash injury and to supplement care being provided by a health professional.
- The University of Queensland whiplash website
This website provides evidence based information about whiplash injury management.
If you have further queries on rehabilitation for your injury, talk to your doctor or rehabilitation provider, the insurer, your solicitor (if you are legally represented) or the Enquiry Line on 1300 302 568.