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Letters

In reply: Work-related stress: care and compensation

Ian D Steven and Michael Shanahan
MJA 2002 177 (7): 398

In reply: What Carroll says is correct, but Section 3.6 of the general explanatory notes of the Medicare benefits schedule book also states that "The only exception to this is where a person has entered into a reimbursement arrangement with a compensation insurer. In such cases a Medicare benefit is not payable".1

While it may be arguable as to what actually constitutes a reimbursement arrangement, the situation is further clarified by Section 13.2.1 of the same schedule, which states:

"Medicare benefits are not payable in respect of a professional service in the following circumstance:

(b) where the medical expenses for the services are in relation to a compensable injury or illness for which the patient's insurer or compensation payer has accepted liability. However, if medical expenses relate to a compensable injury or illness and the insurer or compensation payer is disputing liability, Medicare benefits are payable until liability is accepted".

  1. Medicare benefits schedule book. General explanatory notes. Section 3.6. Canberra: Department of Health and Aged Care, 1 November 2001.

(Received 18 Jul 2002, accepted 1 Aug 2002)

WorkCover Corporation, Adelaide, SA.

Ian D Steven, Medical Consultant.

Repatriation Hospital, Daw Park, SA.

Michael Shanahan, Occupational Physician and Rheumatologist, and NHMRC Research Scholar.

Correspondence: Dr Ian D Steven, WorkCover Corporation, Adelaide, SA. IstevenATworkcover.com

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©The Medical Journal of Australia 2002 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377