Workers compensation treatment requests: what changed on 1 October 2026?

A treatment request made now may be assessed differently from one submitted before October. Keep the request date and the insurer’s response with your claim records.

Current law and transitional protection

Section 60 of the Workers Compensation Act 1987 uses the “reasonable and necessary” test. Regulation clause 8P requires a primary purpose of treating the claimed injury, clinical justification, cost effectiveness and value for money.

SIRA confirms commencement for new treatment or service claims from 1 October 2026. Schedule 6 Part 19R clause 21 preserves the former rules for specified existing claims: requests made but not finally determined before commencement, or approved requests where treatment had not started or had not finished. Dust disease claims are excluded from this reform.

Workers Compensation Act 1987, s 60 · Schedule 6 Part 19R cl 21 · Workers Compensation Regulation 2016, cl 8P · Schedule 6 Part 19R cl 7 · SIRA — Workers Compensation Reform FAQs

What to organise before asking for advice

Prepare a short timeline showing when treatment was recommended, when approval was requested and when the insurer responded. Include the proposed treatment plan, supporting medical explanation and any written refusal. These documents help identify both the relevant rule and the actual reason for a dispute.

A useful question for your next appointment

Ask your treating practitioner to explain the proposed treatment’s purpose and expected benefit. If the insurer requests more information, keep the request alongside the practitioner’s response. A well-organised file makes it easier to see what remains unresolved.

If you are uncertain which rules apply, bring the documents to a consultation with Stephen Young Lawyers. The date of your injury alone should not be used as a shortcut for deciding which treatment rules apply.