Police (Medical and Other Benefits for Former Officers)

The Insurance Commission assesses all claims in accordance with The Workers Compensation and Injury Management Act 1981 and The Police (Medical and Other Expenses for Former Officers) Act 2008. All decisions in regards to acceptance of liability and ongoing payments, as part of this scheme are made solely by the Insurance Commission of Western Australia based on the information contained in the claim form and the supporting medical evidence provided. Further information may be provided by WA Police where relevant.

The Scheme covers reasonable medical expenses that are directly related to a work injury or disease. Medical evidence which contains a clear link between the injury and required treatment needs to be provided to the Insurance Commission for a claim to be accepted. You will also be required to provide ongoing medical certificates to support ongoing payment of treatment incurred.

The total amount payable for medical and other expenses is limited in accordance with the Workers’ Compensation and Injury Management Act 1981; Schedule 1, Clause 17. This is an amount prescribed by WorkCover WA and is reviewed annually at the beginning of each financial year.

Access to additional levels of cover may be available, if relevant criteria are met. Your Insurance Commission Claims Officer can provide you with further information if you require access to further treatment costs over the Prescribed Amount.

Reasonable medical and other expenses for a work related injury can be claimed in accordance with WorkCover WA rates, fees and payments, this may include:

Reasonable travel costs to travel to medical appointments can also be claimed at the rate prescribed by WorkCover WA, indexed annually.

Consideration will be given for other types of treatment if you provide supporting medical evidence and a referral from an appropriate medical practitioner or specialist confirming the expected benefits of the treatment.

You are not entitled to claim benefits under this scheme if you have previously received compensation for medical and other expenses related to the same injury or disease. This includes compensation received through a common law action, motor vehicle third party insurance, an act of grace payment and criminal injury compensation.

To make a claim , you must have sustained a work related injury or disease while serving as a police officer or APLO as defined under the Police (Medical and Other Expenses for Former Officers) Act 2008.

Complete Part 1 of the Claim Form and submit it to the WA Police Force as soon as possible.

You will also need to submit a Police (Medical and Other Expenses for Former Officers) Scheme Medical Certificate from your treating medical practitioner.

Part 2 of the Form will be completed by the WA Police Force and submitted to the Insurance Commission, together with any other relevant medical information for assessment of the claim.

The Insurance Commission will advise you in writing if your claim is accepted. We will also provide you with a treatment number by SMS. You can provide this number to your treating practitioner or allied health provider and they can claim the cost of your consult through HICAPS, or they can invoice us directly. Reasonable travel costs to and from medical appointments can be claimed by completing a Reimbursement of Travel Expenses Form. All reimbursements will be paid directly into your bank account.

NOTE: You are not obliged to pay the cost of your treatment up front. You should discuss this with your treatment provider and give them your claim number and treatment number.  Not all providers will charge the prescribed rate. It is therefore recommended that the provider invoices us directly to ensure you are not out of pocket.

You will be required to submit regular medical certificates or reports to ensure support for your ongoing need for treatment.

Under Section 64 of the Workers’ Compensation and Injury Management Act 1981, we may also require you to attend a medical review by a WorkCover WA Approved Medical Specialist to provide an independent assessment of your injury and treatment program.

All claims are reviewed in accordance with the provisions of the Workers’ Compensation and Injury Management Act 1981 and Police (Medical and Other Benefits for Former Officers) Act 2008 and we will endeavour to make fair and transparent decisions in accordance with the above legislations, If you disagree with a claim decision you have access to a dispute resolution process.

In the first instance you should contact us to discuss your concerns or issues, and you may participate in our Internal Dispute Resolution Process. If the matter cannot be resolved by the internal review you may refer the matter to the WorkCover WA’s Conciliation and Arbitration Service for advice and/or determination.

If you have any questions about the Scheme or your entitlements as a former officer please contact the WA Police Force Health and Safety Division, the Medically Retired WA Police Officers’ Association or the WA Police Union.

The contact details for the WA Police Force are:

Address:

Police Separation and Transition, Western Australia Police Force

9th Floor Westralia Square

141 St Georges Terrace

PERTH WA 6000

If you have an existing claim and want to discuss the claim and/or payment of accounts, please contact your Insurance Commission Claims Officer directly.

• Frequently Asked Questions
• Claim Form
• Medical Certificate
• Reimbursement of Expenses Form