Attachment H
Dear
Claim Reference: <claim number>
Customer Claim Reference: <customer reference>
Date of injury: <date of injury>
Condition:
Your <doctor/other service provider> has provided a treatment plan detailing the amount of treatment you require from <name of provider> to therapeutically assist your condition.
I am therefore able to advise that liability has been extended for specific medical treatment for your accepted compensation claim. Compensation has been approved for payment of <amount and type of medical treatment> from <date to date>.
If you are dissatisfied with this determination, you can request a reconsideration. This will be carried out by an Officer not previously involved with this claim. An application must be made within 30 days of the date you receive the determination and you must set out in writing, the reasons why you disagree with the determination.
Please note that, once this course of treatment has expired, further such treatment will not automatically be payable. If your doctor feels you still require the treatment, he or she should provide a further treatment plan.
Your employer is responsible for actual payment of incapacity benefits which have been determined. Any reasonable medical expenses related to your condition will be paid by Comcare, to you or the provider of the services as appropriate.
If you wish to discuss this matter or need any help or advice concerning your claim, please call <Claims Manager> on <telephone number> or write to us quoting the claim reference number stated above.
Yours sincerely
Comcare