WorkCover Telehealth — What You Need to Know

SIRA's Telehealth Position

The State Insurance Regulatory Authority (SIRA) has formally endorsed telehealth as a valid mode of consultation delivery for both WorkCover and CTP claims in NSW. SIRA's position is that video consultation is the mandated standard — not telephone. This means a doctor can assess you, issue certificates, and manage your claim via video call, and insurers are required to accept certificates issued via telehealth.

When Telehealth Is Appropriate

Telehealth is appropriate for most WorkCover and CTP consultations. This includes initial assessments for soft tissue injuries, musculoskeletal presentations, and psychological conditions; follow-up certificate reviews; treatment plan discussions and referral coordination; and return-to-work planning. The majority of information a doctor needs to complete a Certificate of Capacity — history, symptoms, functional capacity, work restrictions — can be obtained via a structured video consultation.

When In-Person May Be Required

There are situations where telehealth is not clinically appropriate and an in-person consultation is needed. These include injuries requiring hands-on physical examination (e.g., joint instability testing, neurological examination of reflexes), post-surgical wound assessments, complex presentations where visual assessment via video is insufficient, and situations where the patient does not have access to a suitable device or internet connection.

Your Claims Doctor practitioner assesses telehealth appropriateness at the start of every consultation. If an in-person assessment is required, your doctor will advise you and arrange a referral.

SIRA Telehealth Requirements

• Consultation must be conducted via video (not telephone, unless video is unavailable — the reason must be documented).
• Patient must consent to telehealth (documented in clinical notes).
• Clinical appropriateness of telehealth must be assessed and documented.
• AMA item numbers must be suffixed with 'T' for telehealth (e.g., AA020T, AA030T).
• The video platform must be secure and compliant with Australian healthcare standards.

How Claims Doctor Complies

Every Claims Doctor consultation is conducted via secure, encrypted video using a SIRA-compliant platform. Patient consent is obtained and documented before every consultation. Clinical appropriateness is assessed at the start of the call. All invoices use the correct telehealth item codes. Clinical notes record the mode of consultation and any limitations.

Video vs Telephone

SIRA mandates video-first. Telephone consultations are only permitted when video is not available (e.g., the patient's internet connection fails during a scheduled video consultation). If a telephone consultation is conducted, the doctor must document why video was not possible. Claims Doctor conducts all consultations via video.