Government agencies & regulatorsFree Verified
Australian Financial Complaints Authority (AFCA)
Free, independent complaints service for disputes with super funds and insurers, including TPD and income protection.
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What applies to me?
Your plain-English action plan
Step 1 · Your situation
Step 2 · Your state or scheme
Step 3 · Your next steps
My medical treatment has been denied.South Australia
In one sentence
If treatment your doctor recommends is refused, ask for written reasons — refusals can often be reviewed.
Your next steps
- 1Request the decision and reasons in writing.
- 2Ask your treating specialist for a supporting report.
- 3Lodge a review or dispute within the time limit.
- 4Contact a free legal service if the treatment is urgent.
- 5Contact ReturnToWorkSA (13 18 55) for free information about how the SA scheme applies to you.
- 6If you disagree with a decision — The South Australian Employment Tribunal (SAET) handles disputes, starting with conciliation.
- 7Watch the time limits — Disputes generally must be lodged within 1 month of the decision.
- 8Consider getting independent legal advice before signing anything or accepting a settlement.
How SA works
- Weekly payments
- Generally paid for up to 2 years (104 weeks) after the injury, with a step-down after 52 weeks. 'Seriously injured workers' (30% WPI or more) may receive payments until retirement age.
- Medical expenses
- Reasonable medical costs are generally covered for 12 months after weekly payments end, unless you are a seriously injured worker.
- Permanent impairment
- Lump sums for non-economic and economic loss are generally available at 5% WPI or more for physical injuries. Psychiatric injuries generally do not attract a lump sum except as a seriously injured worker.
- Free legal help
- Some legal costs may be covered under the Act. Unions, Legal Services Commission SA and community legal centres can help.
Questions you may have
Do I have to attend an IME?
Usually yes if the request is reasonable — refusing can affect your payments. You can ask about travel, timing and a support person.
Can I pay for treatment myself and claim later?
Sometimes, but there is a risk you will not be reimbursed. Get advice first, or use Medicare/private health and tell them it is a compensation matter.
What about psychological treatment?
Psychology and psychiatry are commonly covered for accepted psychological injuries, and sometimes for secondary conditions.
Support available to you
Community & free legal servicesFree Verified
Community Legal Centres Australia
Find a free community legal centre near you anywhere in Australia.
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Government agencies & regulatorsFree Verified
Fair Work Ombudsman
Information about workplace rights, dismissal and pay. Fair Work Commission deals with unfair dismissal and bullying applications.
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Government agencies & regulatorsFree Verified
ReturnToWorkSA
South Australia's return to work scheme — information about claims and support.
Covers: SA
Government agencies & regulatorsFree Verified
Services Australia – Disability, Sickness and Carers
Centrelink line for the Disability Support Pension, sickness-related payments and carers.
Covers: National
General information only. Rules change and depend on your circumstances. Check with your regulator or get independent legal, financial or medical advice about your situation.