All about WorkCover home help
If you have an accepted WorkCover claim, it’s possible that the WorkCover insurer will pay for help around the home if required.
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When will the WorkCover insurer pay for home help?
The WorkCover insurer will pay for home help services if you need help due to an incapacity relating to a work related injury, illness or condition.
The WorkCover insurer will consider paying for home help services in instances where a person requires help to replace labour in the home in instances where you can no longer perform certain household talks.
For example, if prior to the injury you used to clean the bathroom including doing the floors and you are now no longer able to do so as a consequence of your injury, then this is something that the WorkCover insurer may consider paying for.
The insurer will take into account whether there are others in your household who may be able to perform the task.
Who pays the cost of home help services?
The WorkCover insurer.
That being said, the WorkCover insurer’s have set fees that they will pay for home services. So if a provider bills you over and above what the insurer is prepared to pay, then you will be required to pay the extra amount.
Your employer is not required to contribute towards the cost of home services.
How do I request the insurer pay for home help services?
The first thing you should do is call or email your claims manager and let them know that you’d like home help services provided.
You will usually require support from a medical practitioner or health provider such as a physiotherapist, osteopath or chiropractor.
You may be lucky and the insurer could have sufficient medical material on file to approve home help services.
More often than not though, you will need to obtain a letter from your doctor or other health practitioner confirming that you require home help (and what those services are) provided to you, the period of time you need the services provided for (this might not be known) and how the need for those services is connected to your work related injury, illness or condition.
The insurer may also organise an occupational therapist to perform an assessment at your home to determine your household help needs. The occupational therapist which the insurer will then use to make a decision in relation to your request.
You should also obtain a quote from a services provider or two if you can.
What if the insurer refuses to pay for home help?
If the insurer refuses to pay for home help and you have an accepted WorkCover claim, you can ask them to perform an internal review.
You can do this by simply emailing or calling your claims manager.
If you are to ask for an internal review, we would recommend that you have further medical material in support.
The better option in our opinion in most instances if the insurer will not pay for home help is to pursue the matter to conciliation, rather than an internal review.
Again, we would recommend that you obtain supportive medical material if you are to pursue the matter to conciliation.
What if the insurer agrees to pay for home help but at a lower rate than I require?
The answer above applies. You can ask for the insurer to perform an internal review or in addition to this and perhaps as an alternative to, you can pursue the matter to conciliation.
What household tasks can the home help services provide?
Below is a list of some of the household tasks that the insurer will consider paying for. This list is not exhaustive:
- Cleaning benches
- Cleaning sinks
- Wiping floors
- Dusting windowsills skirting boards
- Dusting furniture
- Vacuum and sweep
- Change bedlinen and make bed
- Clean bathroom
- Clean toilet
- Load and unload washing machine
- Ironing and folding clothing
- Lawnmowing including lawn edging of lawns
- Clearing gutters
- Light pruning of trees
Who is able to provide household help services?
The WorkCover insurer will only pay for providers who are registered and approved by WorkSafe. These providers are required to have a registered business with liability insurance.
How long should it take for the insurer to approve a request
The WorkCover insurer let you know whether your application has been accepted or rejected within ten working days of receiving the request.
If further information is required for them to make a decision (such as a letter from your GP), they should let you know this within ten working days of receiving your request.
If the insurer does need further information to make a decision in relation to your request, they should let you know whether it has been approved or rejected within ten working days of receiving the further information.
Paying for home help services
Typically what happens is the provider will bill the WorkCover insurer directly, quoting your claim number.
In some instances, you may be required to pay the provider and then seek reimbursement from the insurer.