Do I need to keep getting medical certificates?

Health Law, Litigation & Dispute Resolution

Comcare/EML accepted my workers compensation claim but does my doctor need to keep giving me medical certificates?

You were required to provide a medical certificate when you first submitted your workers compensation claim, but are you required to continue getting these certificates? The answer is yes! These medical certificates are really important throughout your whole claim. They continue to have benefits even after your claim is first accepted.

It is best to think of medical certificates as a communication tool for all the people involved in your claim – yourself, your treaters, case manager and rehabilitation provider. They must be completed by a legally qualified medical practitioner. This can be a General Practitioner or a specialist, such as a surgeon or psychiatrist. The certificates keep everyone aware of your clinical progress, treatment recommendations and current work capacity (including any work restrictions you might have). These medical certificates must be provided if you are wanting to continue claiming income support. They are also really helpful if you are claiming for treatment costs.

Sometimes medical certificates are accidently not completed correctly. For example, sometimes important information may be missing. This can cause the insurer to ask for more information from you and your treaters, which may cause delays in you received your compensation payments. We recommend double checking your medical certificates before submitting them to the insurer, making sure that they include, amongst other things:

1. A clear description of your current capacity for work: It is really important that certificates clearly outline your current capacity for work. The certificates might say that you are currently fit for work, or fit for work with modified duties, or not fit for work just yet. These capacity details are important as they can facilitate a discussion between yourself and your doctors about your injury and return to work goals. They also indicate to your rehabilitation provider your current capacity, an expected timeline for your return to work and any adjustments that your employer will need to make to facilitate your safe return. They also assist your case manager in making decisions regarding any incapacity amounts you may be entitled to.

2. Any treatment that your doctor recommends that you receive: It is common for medical certificates to include treatment recommendations. This can be helpful for your claims manager when assessing your request for payment of any medical treatment. The claims manager is required to determine whether the treatment is reasonable, and having this recorded on a medical certificate can be really helpful.

3. The certificate is about your accepted injury: Sounds obvious, but sometimes certificates list new events, or can say that the injury has been aggravated. If this is the case, your doctor should say whether your condition is still the same condition that you are receiving workers compensation for.

If you notice any clear errors or missing information in your medical certificates, it is best to raise this with your doctor as soon as possible. If completed accurately and regularly, medical certificates will be a fantastic tool in progressing your workers compensation claim, supporting in your safe recovery and promoting your gradual return back to work.

At Elringtons, we specialise in Comcare and EML claim, helping workers across all stages of the claims process. If you ever need help throughout your claims process, feel free to contact us if you would like to discuss your workers compensation matter and next steps.