The Former Officers' Medical Benefits Scheme was established to provide former police officers and Aboriginal police liaison officers (APLO) with support for reasonable medical and health expenses related to a physical or psychological injury that occurred while serving with the WA Police Force.
How the Scheme Works
The Insurance Commission assesses all claims in accordance with the Workers Compensation and Injury Management Act 2023 and the Police (Medical and Other Expenses for Former Officers) Act 2008, which prescribes entitlements and is different to the medical expenses provided by the WA Police Force for serving officers.
All decisions on the 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 and health expenses and reasonable miscellaneous expenses directly related to a work injury or disease. The Workers Compensation and Injury Management Act 2023 defines these expenses in section 71 and Part 2 Division 5.
Common expenses that are reasonable and are related to the injury or disease include the list below.
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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. Ongoing medical certificates to support ongoing payment of treatment expenses incurred must also be provided.
The total amount payable for medical and health expenses and miscellaneous expenses is limited in accordance with section 75 of the Workers Compensation and Injury Management Act 2023. 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 general limit amount.
Reasonable travel costs to travel to medical appointments can also be claimed at the rate prescribed by WorkCover WA, indexed annually.
Other types of treatment will be considered 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, health and miscellaneous 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.
Claims Process
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 Claim 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 reimbursed using the online portal. 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 uses their HICAPS system on the day of your consult or 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 180 of the Workers Compensation and Injury Management Act 2023 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.
Disputes
All claims are reviewed in accordance with the provisions of the Workers Compensation and Injury Management Act 2023 and Police (Medical and Other Benefits for Former Officers) Act 2008 . We will endeavour to make fair and transparent decisions in accordance with the above pieces of legislation. 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. 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 Workers Compensation Conciliation Service for advice and/or determination.
Contacts
If you have any questions about the Scheme or your entitlements as a former officer, please contact the WA Police Force Health, Welfare and Safety Division or the WA Police Union.
The contact details for the WA Police Force are:
Address:
Police Health, Welfare and Safety Division, Western Australia Police Force
9th Floor Westralia Square
141 St Georges Terrace
PERTH WA 6000
Email: | |
Phone: | +61 (8) 6229 5615 |
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 and Forms
Page Last Updated 12 Jul 2024