While medical and other endorsement should be provided for the claim, the decision to approve a particular item and its cost will remain with Comcare. Always ensure that consideration for any alteration, modification, aid or appliance is made in conjunction, where relevant, with general RTWP requirements.
Approval for claims under section 39 should always be clearly indicated in a letter to the employee and/or Case Manager before alterations or modifications commence, or aids and appliances are purchased. The letter should outline individual alterations, modifications, aids and appliances which have been approved.
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Example 1 |
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“Compensation has been approved for payment of the following alterations to your residence: |
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installation of ramp access to your front and back doors |
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widening of all doorways |
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lowering of kitchen cupboards by 1 metre |
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Payment will be made for services carried out by <service provider> at a cost of .” |
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Example 2 |
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“Compensation has been approved for payment for hire of: |
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dressing stick |
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special telephone |
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from . |
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Payment will be made for hiring fee.” |
Where some or all items are not payable, the employee and/or Case Manager should be clearly advised why the item/s have been rejected. Comprehensive reasons for the decision should be outlined in the letter together with the legislative basis for the rejection.
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Example |
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An employee's request for installation of ramps to his residence has been rejected as he has previously been provided with compensation to install ramps in a former property which has since been sold. |
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A higher amount was received for the sale, having regard to ease of accessibility to the former residence. |
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Since section 39 (2) (f) indicates that: |
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“where the employee has previously received compensation under this section in respect of an alteration of his or her place of residence ... and has later disposed of that place of residence ... (and) ... the value of that place of residence ... was increased as a result of the alteration ...” |
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compensation is not payable under section 39. |
Accounts should normally be sent directly from the provider of the services to Comcare.