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20.15.4 Summary re: refusal of treatment

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Compensation recipients have a responsibility to limit or ameliorate their loss.

That client may be disentitled to weekly payments where he/she unreasonably refuses a medical course of treatment capable of ending or reducing incapacity for work.

However before ceasing an entitlement on those grounds, a delegate must first:

  • be satisfied on the basis of all medical and other advice that objectively, the treatment is likely to be beneficial and does not involve unacceptable risks
  • ensure that the client is also aware of 'all cogent factors' indicating the treatment is beneficial i.e. through a briefing by a relevant specialist or similar means
  • write to the client and inform him/her about SRCA coverage of treatment costs, the consequences of refusing reasonable treatment, and inviting a submission of reasons for any continued refusal

If the client continues to reject treatment, the delegate should consider the client's submission, and:

  • in cases where the refusal can be confirmed to result from a mental condition associated with the injury in question, a religious scruple, failure of earlier similar treatment or other reasonable cause, accept the validity of that refusal and continue to pay the weekly benefit
  • in cases where the delegate considers the refusal of treatment to be unreasonable (i.e. given all the circumstances), determine that there is no further entitlement to weekly incapacity payments.