Understanding Section 67 of the NSW Workers Compensation Act

What Section 67 Covers

Section 67 of the Workers Compensation Act 1987 (NSW) sets out the legal framework for the provision of medical and related expenses to workers who sustain a work‑related injury or disease. It mandates that eligible claimants receive reasonable and necessary treatment, and it outlines the responsibilities of employers, insurers, and medical providers in delivering those services.

Eligibility and Definition of a Claim

To trigger Section 67, a worker must demonstrate that the injury or condition arose out of and in the course of their employment. This includes acute injuries, gradual occupational diseases, and psychological injuries where a direct work‑related cause is established. The claim must be lodged with the employer's workers‑compensation insurer within the statutory time limits, typically within six months of the injury becoming known.

Employer and Insurer Obligations

Under Section 67, the employer's insurer is required to:

• Provide a list of approved medical practitioners and allied health professionals.
• Approve and fund all reasonable and necessary treatment recommended by those practitioners.
• Ensure that treatment does not exceed what is required for the worker's recovery or safe return to work.

If the insurer refuses a treatment request, the decision can be reviewed by the Workers Compensation Commission, which may order the insurer to fund the treatment if it deems it appropriate.

Process for Accessing Medical Treatment

When a worker seeks treatment, the usual steps are:

This process aims to balance timely access to care with cost‑effectiveness for the insurer.

Key Considerations for Workers

Workers should be aware that:

• Only treatment deemed "reasonable and necessary" under Section 67 will be funded.
• Choosing a practitioner not on the approved list may result in out‑of‑pocket costs.
• They have the right to request a second opinion or a review if they disagree with the treatment plan.

Understanding these rights helps avoid delays and unexpected expenses.

Impact on Employers and Business Operations

Employers benefit from Section 67 because it clarifies the scope of their financial liability and provides a structured pathway for managing claims. By ensuring that workers receive appropriate care, employers can reduce the duration of absence and support faster return‑to‑work outcomes, which in turn minimizes productivity loss.

Comparative Overview of Section 67 Features