Medical Expenses
Workers who are receiving an award of weekly compensation benefits, may also be entitled to have the reasonable, medical, hospital, ambulance and other related costs for the treatment of their dust disease paid by the Dust Diseases Board.
The Dust Diseases Board will not pay for medical expenses or treatment that are not directly related to your dust disease. The Dust Diseases Board can not reimburse you for any medical treatment or medicines that you received while you are visiting or living in another country.
Medical Expenses the DDB will pay for
Medical expenses are described in the Workers' Compensation Act 1987 and can include the following:
- Ambulance services to transport a worker to a doctor or hospital.
- Treatment for your dust diseases at a hospital, nursing home, palliative care or rehabilitation centre (either public or private and with Government accreditation).
- Therapeutic treatments at the direction of your doctor such as exercise, massage, herbal remedies and aromatherapy.
- Wheelchairs and other mobility aids such as walking frames and motorized scooters.
- Therapeutic apparatus such as reclining chairs, beds, pressure relief cushions, commodes and shower chairs.
- Home care including nursing care, cleaning and lawn & garden maintenance.
- Respite care (out of home) or rehabilitation centre admissions at a designated health care facility (either public or private with Government accreditation).
- Pharmaceuticals, domiciliary oxygen and nebulisers as prescribed by your treating doctor for the treatment of a dust disease.
- Reasonable travelling costs to and from treatment of your dust disease.
It is important that you contact the Health Care Services Team between 9am and 5pm on (02) 8223 6600 or 1800 550 027 before you incur any of these expenses. The Dust Diseases Board must make sure that the medical expenses incurred are related to your dust disease (and not some other illness) before it can make payment for these costs.
In the event of an emergency where a severely ill person requires an ambulance and hospital admission it is not necessary to first contact the Health Care Services team before making arrangements for care.
Medical Expenses the DDB will not pay for
The Dust Diseases Board can not assist you with the payment of the following items:
- Payment of the Federal Government Accommodation Bond to enter a nursing home
- Electricity*, gas and phone bills
- Renovations or painting of your house
- The termination or care of your pets
- Pest control
- Items of clothing
- Dental treatments
- Dentures
- Cataract surgery, spectacles and other sight aids
- Hearing Aids
*some electricity companies provide a pensioner and life support rebates to households that have medical equipment onsite that uses electricity. Please contact your electricity company to ask if you are eligible for any rebates.
What limits apply to medical expenses?
The Workers' Compensation Act 1987 states the maximum amounts that the Dust Diseases Board can spend on medical and hospital costs for each worker as:
- $50,000 limit for medical expenses
- $50,000 limit for hospital expenses
- $10,000 limit for ambulance expenses
- $1,200 limit for occupational rehabilitation expenses
The Dust Diseases Board may, in exceptional circumstances, approve the payment of medical, hospital or ambulance expenses that are greater than the limits listed above if the additional treatment required is necessary as a result of your dust disease for which you are being treated.
Who organises medical equipment and payment of expenses?
The Dust Diseases Board Health Care Services Team will make arrangements for the hire of equipment and various types of care. To help process your request you must provide a written recommendation from your health care professional stating what treatment or equipment is required and why they are required to treat your dust disease.
The Health Care Services Team is responsible for verifying that any treatments and equipment you request are required as a result of your dust disease. For this reason, it may be necessary at times for us to contact your doctor or other health care professional to obtain additional information to support your claim for medical expenses.
Who receives the payment for hospital and medical expenses?
The Dust Diseases Board will make payments directly to the company, hospital or doctor that is providing the treatment or equipment. We will send a letter to the company, hospital or doctor stating what treatment and equipment the Dust Diseases Board will pay for and asking that invoices be sent directly to the Dust Diseases Board.
If you have already paid for your treatment or equipment you may forward your invoice to the Health Care Servces Team requesting that you be reimbursed. To assist us in processing your claim as quickly as possible please attach to the invoice a written recommendation from your health care professional confirming that the expenses were incurred as a result of your dust disease.
Who is not entitled to medical expenses?
Anyone who has been certified by the Medical Authority as having been exposed to a dust but are not disabled by a dust disease (ie 0% disability) are not entitled to payment of hospital and medical expenses.
Can I receive assistance for travel to medical appointments?
If the Dust Diseases Board directs you to attend a medical examination you may be entitled to the cost of any fares or travelling expenses reasonably incurred by you while travelling to attend your medical examination. If you are still employed, the amount of any wages that you did not get paid by your employer as a result of taking time off work to attend your medical examination.
You must complete an "Application for Travel Expenses" form that can be obtained by contacting the Medical Services Section on (02) 8223 6600 or 1800 550 027.
Can my partner receive assistance for travelling with me to atttend a medical appointment?
No.
However the Dust Diseases Board does understand that sometimes you may be too ill to attend the medical appointments or hospital treatments on your own and will need for your partner, another family member or a friend to escort you to your appointment. In these situations please contact the Health Care Services Team who will assess if you are eligible to be reimbursed for any fares, travelling expenses, reasonable accommodation and meal expenses incurred by the person escorting you. You must provide a letter from your treating doctor who must state the medical reasons why you were unable to travel on your own.
Can I receive assistance from the DDB for home modifications if I have a dust disease?
The Dust Diseases Board can only pay for minor home modifications required to assist you manage your dust disease. Approved home modifications include:
- hand rails for ease of access to bath and shower facilities
- access ramps to your house if you use a wheelchair or scooter
The Health Care Services Team will arrange for any minor home modifications to take place upon receiving a recommendation from your doctor and an report from an occupational therapist stating why the modifications are necessary.