Independent medical examiners
Independent medical examiners are registered medical practitioners who provide impartial medical assessments in the NSW workers compensation system.
In brief
A referral to an independent medical examiner occurs when medical information is inadequate, unavailable or inconsistent, and the referrer has been unable to resolve the problem directly with the practitioners involved.
As an independent medical examiner, it is not your role to provide advice to workers about their condition, treatment or workers compensation claim. Instead your role is to examine the worker and provide independent commentary on the worker's injury and/or treatment.
Your report may include advice on accepting a claim, the insurer's ongoing liability, the worker's level of capacity for employment, ongoing treatment and the degree of permanent impairment (where applicable).
If you believe another type of treatment might assist the worker, it is recommended you mention it in your report and you may contact the worker's nominated treating doctor to discuss treatment options.
The report must be forwarded to the person who requested it and the worker's nominated treating doctor.
Publications you might need
- Workers compensation guidelines
- Workers compensation guide for medical practitioners
- Workers compensation medical dispute assessment guidelines 2019
Fees and invoicing
Payments for independent medical examinations must be in accordance with the gazetted fees in the relevant fees order below current at the time of assessment:
Current health-related fees
These are the current health related fees and rates orders.
- Accredited Exercise Physiology fees order No 3 (effective 17 April 2020)
- Hearing Aid fees and practice requirements (effective 1 January 2021)
- Independent Consultant fees order No 3 (effective 17 April 2020)
- Injury Management Consultant fees order No 2 (effective 17 April 2020)
- Massage Therapy fees order (effective 1 January 2021)
- Medical Examinations and Reports fees order No.2 (effective 17 April 2020)
- Medical Practitioners fees order (effective 1 January 2021)
- Orthopaedic Surgeon fees order (effective 1 January 2021)
- Physiotherapy, Chiropractic and Osteopathy fees and practice requirements (effective 1 January 2021)
- Psychology and Counselling fees and practice requirements (effective 1 January 2021)
- Surgeon fees order (effective 1 January 2021)
- Private Hospital Maximum rates fee order (2020) (effective 1 April 2020)
- SIRA rates for General Practitioners 2021 (effective 1 January 2021)
- SIRA telehealth item numbers for medical practitioners 2021
- 2020 Public Hospital Fees Schedule (effective 1 July 2020)
- Workers compensation (ambulance service fees) order 2020 (effective 11 September 2020)
- Workers compensation (public hospital rates) order 2020 (effective 1 July 2020)
Historical health-related fees
These are the historical health related fees and rates orders.
Fees and rates orders 2020
- Fees Order 2020 - Accredited Exercise Physiology
- Fees Order 2020 - Accredited Exercise Physiology No 2
- Fees Order 2020 - Hearing Aid
- Fees Order 2020 - Hearing Aid No 2 effective 17 April 2020
- Fees Order 2020 - Independent Consultant
- Fees Order 2020 - Independent Consultant No 2
- Fees Order 2020 - Injury Management Consultant
- Fees Order 2020 - Massage Therapy
- Fees Order 2020 - Medical Examinations and Reports
- Fees Order 2020 - Medical Practitioners
- Fees Order 2020 - Medical Practitioners No 2
- Fees Order 2020 - Medical Practitioners No 3 effective 17 April 2020
- Fees Order 2020 - Orthopaedic Surgeon
- Fees Order 2020 - Orthopaedic Surgeon No 2 effective 17 April 2020
- Fees Order 2020 - Physiotherapy, Chiropractic and Osteopathy
- Fees Order 2020 - Physiotherapy, Chiropractic and Osteopathy No 2
- Fees Order 2020 - Physiotherapy, Chiropractic and Osteopathy No 3 effective 17 April 2020
- Fees Order 2020 - Psychology and Counselling
- Fees Order 2020 - Psychology and Counselling No 2
- Fees Order 2020 - Psychology and Counselling No 3 effective 17 April 2020
- Fees Order 2020 - Surgeon Fees Order
- Fees Order 2020 - Surgeon Fees Order No 2 effective 17 April 2020
- SIRA rates for General Practitioners 2020
Fees and rates orders 2019
- Fees Order 2019 - Accredited Exercise Physiology
- Fees Order 2019 - Hearing Aid
- Fees Order 2019 -Private Hospital Fee Order
- Fees Order 2019 - Independent Consultant
- Fees Order 2019 - Injury Management Consultant
- Fees Order 2019 - Massage Therapy
- Fees Order 2019 - Medical Examinations and Reports, No. 2
- Fees Order 2019 - Medical Examinations and Reports
- Fees Order 2019 - Medical Practitioners
- SIRA 2019 workers compensation rates for general practitioners
- Fees Order 2019 - Orthopaedic Surgeon
- Fees Order 2019 - Physiotherapy, Chiropractic and Osteopathy
- Fees Order 2019 - Psychology and Counselling
- Fees Order 2019 - Surgeon Fees Order
- 2019 Private Hospital Fees Schedule
- 2019 Public Hospital Fees Schedule
- Workers compensation (public hospital rates) order 2019
Fees and rates orders 2018
- Ambulance fees schedule 2018
- Fees order 2018 - accredited exercise physiology
- Fees order 2018 - hearing aids
- Fees order 2018 - independent consultants
- Fees order 2018 - injury management consultants
- Fees order 2018 - massage therapy
- Fees order 2018 - medical examinations and reports
- Fees order 2018 - medical practitioner
- Fees order 2018 - orthopaedic surgeon
- Fees order 2018 - physiotherapy, chiropractic and osteopathy
- Fees order 2018 - psychology and counselling
- Fees order 2018 - surgeon
- Public hospital fees schedule 2018
- Private hospital fees schedule 2018
- SIRA rates for general practitioners 2018
- Workers compensation (private hospital rates) order 2018
- Workers compensation (public hospital rates) order 2018
- Workers compensation (ambulance services fees) order 2018
Fees and rates orders 2017
- Fees order 2017 - accredited exercise physiology
- Fees order 2017 - hearing aids
- Fees order 2017 - independent consultants
- Fees order 2017 - injury management consultants
- Fees order 2017 - massage therapy
- Fees order 2017 - medical examinations and reports
- Fees order 2017 - medical practitioner
- Fees order 2017 - orthopaedic surgeon
- Fees order 2017 - physiotherapy, chiropractic and osteopathy
- Fees order 2017 - psychology and counselling
- Fees order 2017 - surgeon
- SIRA rates for general practitioners 2017
- Workers compensation (ambulance services fees) order 2017
- Workers compensation (ambulance services fees) order 2017 no2
- Workers compensation (private hospital rates) order 2017
- Workers compensation (public hospital rates) order 2017
- Workers compensation (public hospital rates) order 2017 no2
- Workers compensation rates for general practitioners 2017
What your invoices will need to include
- worker's first and last name, and claim number
- payee details
- ABN
- name of the medical practitioner or service provider who provided the service
- SIRA workers compensation approval number or medical practitioner's Health Insurance Commission provider number (where applicable)
- date of service
- SIRA workers compensation payment classification code or AMA item number where applicable. Refer to the technical manual for further information:
- self and specialised insurers, or
- nominal insurer
- service cost for each SIRA workers compensation payment classification code or AMA item number and service duration (if applicable)
- date of invoice (must be on the day of or after last date of service listed on the invoice)
To prevent delays in payment, these details will need to be provided on all invoices.