The Former Officers' Medical Benefits Scheme was established to provide former police officers and Aboriginal police liaison officers (APLO) with support for medical expenses related to a physical or psychological injury that occurred while serving with the WA Police Force. The Scheme is governed by legislation (Police (Medical and Other Expenses for Former Officers) Act 2008) that prescribes entitlements, and this is different to the medical expenses provided by the WA Police Force for serving officers.
The Insurance Commission manages claims on behalf of the WA Police Force.
The Scheme covers reasonable medical expenses that are directly related to a work injury or illness. A clear link between the relevant injury and treatment needs to exist for a claim to be paid.
There is a cap on the expenses that can be claimed. The cap is a prescribed amount set by WorkCover WA, indexed annually. Access to additional levels of cover may be available, if relevant criteria are met.
Reasonable medical and other expenses for a work related injury can be claimed in accordance with WorkCover WA rates, fees and payments for:
Allied Health Provider Fees:
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.
Consideration will be given for other types of treatment and usually require a referral from an appropriate medical practitioner or specialist confirming the expected benefits of the treatment.
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.
To make a claim, for reasonable medical and other expenses, incurred or likely to be incurred on or after 1 July 2007, 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.
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.
We will advise you in writing if your claim is accepted. You can provide this letter to your treating practitioner in order for them to invoice us directly. Reasonable travel costs to and from medical appointments can be claimed by completing a Reimbursement of Travel Expenses Form.
NOTE: Not all providers will charge an individual the prescribed rate. It is therefore recommended that the provider invoices us directly to ensure you are not out of pocket.
You may be required to submit further information including a current medical specialist report to ensure your treatment program complies with Scheme entitlements.
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 Police (Medical and Other Expenses for Former Officers) Act 2008 and we endeavour to provide the best possible outcome. 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, we may review your claim in consultation with the WA Police Force. If the matter cannot be resolved by the initial informal discussion, and further information (e.g. new medical or factual evidence) that may allow a decision to be reconsidered you may refer the matter to the WorkCover WA’s Conciliation Service 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:
Health and Safety Division
Western Australia Police Force
Level 13 Westralia Square
141 St Georges Terrace
PERTH WA 6000
+61 (8) 6229 5615
If you have an existing claim and want to discuss the claim and/or payment of accounts, please contact RiskCover.