Autologous Chondrocyte Implant
There is sufficient scientific evidence of improved outcomes when this procedure is appropriate. Please contact WorkCover for recommended fees.
Blinded Opioid Infusion
This procedure is to determine if opioid therapy will provide therapeutic benefit for chronic pain patients. This procedure should only be performed in a day surgery/hospital setting by specialists who have adequate training in the procedure. For recommended fees, please phone WorkCover.
Bone Exogen Machine
This treatment (also known as Exogenic Sonic Accelerate Fracture System, Pulsed Ultrasound) ultrasonic device is used to treat fractures by stimulating bone growth activity. This treatment would only be appropriate where the natural healing time has been exceeded and where worker compliance with the self-administered daily treatment is expected to be very high. Approval for this treatment should be sought from the claims manager prior to commencement.
Botox for chronic pain
There is no scientific evidence on the medium or long term risks or benefits of the use of Botulinum toxin in the management of musculo-skeletal based chronic pain (also known as Botulinumtoxin). Currently, WorkCover does not support the use of this treatment.
Chondroitin for arthritis
Glucosamine and chondroitin (also known as shark cartilage, athro aid, osteoze) are over-the-counter tablets and capsules, often derived from shark cartilage and marketed for the temporary relief of arthritis.
Reimbursement of costs is appropriate if the use of glucosamine or chondroitin has been recommended by an approved medical expert, for arthritic pain caused by or aggravated by a compensable injury.
C-Leg
A C-leg, (computerised trans-formal prosthesis) is an artificial limb that is aided with computerised components rather than mechanical devices. When recommended, claims managers must forward all requests to WorkCover for approval.
Diagnostic Ultrasound
See Real Time Ultrasound Imaging (RTUI).
Dietician services and supplements
Dieticians are not recognised medical experts under the Act. Dieticians can only be reimbursed where the service is delivered as a component of a rehabilitation programme or rehabilitation and return to work plan, or if the worker's treating medical practitioner conducts a dietary program. Dietary supplements should meet the following criteria:
- supplement is listed in the most recent edition of MIMS or
- approved by Health and Rehabilitation Operations Unit, and
- is part of a weight management program
Both dietary services and supplements require claims manager approval.
Disc replacement surgery
After extensive reviews, WorkCover supports the use of disc replacement surgery in compensation patients. When recommended by the operative surgeon, claims managers must forward all requests to WorkCover for review and or approval.
Exercise balls (Swiss ball, Smartball)
Payment for exercise consultations which use large inflatable balls, is only to be made as part of existing gymnasium/exercise items within the medical and non-medical expert service and fee schedules. The unsupervised home use of these balls is not endorsed by WorkCover.
Gabapentin (Neurontin) and Pregabalin (Lyrica)
Gabapentin is not available on the Pharmeceutical Benefits Scheme for the treatment of chronic pain. It will be approved in the following circumstances:
- Chronic pain of at least three months duration
- Inadequate response to other treatments prescribed previously. (These would include at least two of the following: Tricyclic antidepressants; Carbamazepine, Sodium Valproate and Phenytoin.)
Where Gabapentin is given, with a noticable benefit to the injured worker, providers should ensure that the dose is reduced for a trial period every six months to ensure that it remains beneficial to the claimant as treatment progresses.
Glucosamine for arthritis
Glucosamine and Chondroitin (also known as Shark Cartilage, Athro Aid, Osteoze) are over the counter tablets and capsules, often derived from shark cartilage and marketed for the temporary relief of arthritis. Reimbursement of costs is appropriate if the treatment is recommended by an approved medical expert, for arthritic pain caused by or aggravated by a compensable injury.