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Treater or workplace rehab provider: who does what, and who pays

The two provider types are easy to confuse. Here is the difference in one page, and how each is funded under the scheme.

Injured workers often meet several providers early on and it is not always obvious who does what. The clearest way to think about it: an allied health treater treats the injury, and a workplace rehabilitation provider coordinates your return to work. They are different roles, often working at the same time.

The treater

Your treater is the hands-on clinician: a physiotherapist, exercise physiologist, osteopath or similar. They assess and treat your injury, set treatment goals, and report on your functional capacity. To be funded they need AHPRA registration and current SIRA approval. In the early period after an injury, some allied health treatment can start without pre-approval, and where a request is made within three months of injury and no prior practitioner of the same profession has been engaged, the insurer generally has a set number of working days to decide before the request is taken as approved.

The workplace rehab provider

The WRP is the coordinator. They assess your capacity in the context of your job, work with your employer on suitable duties, and build and monitor your return to work plan. They are SIRA approved organisations, separate from your treating clinician.

Who pays

For an accepted claim, the insurer (icare for most NSW employers, or a self-insurer or specialised insurer for some) pays approved providers directly under the scheme fee arrangements. You should not be paying an approved provider out of pocket for reasonably necessary, approved treatment related to your injury. If you are being asked to, that is worth querying with your case manager.

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