Specialist Referrals for WorkCover & CTP Claims

When You Need a Specialist

Some injuries require assessment or treatment by a medical specialist beyond what a general practitioner can provide. Common reasons for specialist referral in WorkCover and CTP claims include surgical assessment for musculoskeletal injuries, psychiatric evaluation for psychological injury, neurological assessment for head injuries, and pain management for chronic conditions.

Your Claims Doctor practitioner assesses whether a specialist referral is clinically indicated during your consultation and arranges the referral as part of your care plan.

Specialists We Refer To

• Orthopaedic Surgeons: Shoulder, knee, hip, wrist, and spinal injuries requiring surgical assessment or arthroscopic intervention.
• Neurosurgeons: Spinal disc injuries, nerve compression, and spinal cord conditions.
• Psychiatrists: Work-related psychological injuries including depression, anxiety, PTSD, and adjustment disorders.
• Neurologists: Traumatic brain injury, concussion, nerve damage, and chronic headaches.
• Pain Specialists: Chronic pain management, complex regional pain syndrome, and nerve blocks.
• Hand Surgeons: Carpal tunnel, tendon injuries, and fractures of the hand and wrist.
• ENT Specialists: Hearing loss from workplace noise exposure.
• Dermatologists: Occupational skin conditions and contact dermatitis.

How Specialist Referrals Work Under WorkCover and CTP

When your Claims Doctor practitioner issues a referral, the specialist bills the consultation to your workers compensation or CTP insurer. You do not pay out of pocket with a valid claim. Your insurer may need to pre-approve certain specialist consultations — we handle this coordination and ensure the referral meets your insurer's requirements.

The referral letter includes your clinical history, diagnosis, current treatment, and the specific clinical question or assessment needed from the specialist. This ensures the specialist has the information they need from the first appointment.

Coordination of Care

Claims Doctor acts as your central point of medical coordination. Specialist reports are reviewed and integrated into your ongoing care plan. Your Certificate of Capacity is updated to reflect specialist recommendations. Treatment modifications are communicated to your employer and insurer.