Medical expense claims

We may be able to pay your medical bills if you have been injured by violence that happened in Queensland.

Claim medical treatment
Approved practitioners
Approved costs
How to claim
Payment process
Limitations
Timeframe
More information

Claim medical treatment

We may be able to pay for medical treatment for a physical or psychological injury that was directly caused by violence. We will only pay for costs billed to the patient (excluding costs covered by insurance, Medicare or other government agencies).

We may be able to pay for:

ambulance services
medical treatment received in a hospital
medical treatment by a health practitioner (e.g. consultations, diagnostics, prescriptions)
speech pathology.

Approved practitioners

You can choose your own health practitioner. This may be an:

Aboriginal and Torres Strait Islander health practitioner
Chinese medicine practitioner
chiropractor
dentist
medical practitioner (GP, specialist, psychiatrist)
midwife
nurse
occupational therapist
optometrist
osteopath
paramedic
pharmacist
physiotherapist
podiatrist
psychologist.

Your GP may be able to make a referral to a specialist or allied health practitioner if needed.

If the treatment is being provided in Australia, the treatment needs to be provided by:

a health practitioner who is registered under the Health Practitioner Regulation National Law
a speech pathologist who is eligible for practising membership of The Speech Pathology Association of Australia.

If the treatment is being provided overseas, the treatment needs to be provided by a health professional with an equivalent overseas registration.

Approved costs

If your claim is approved, we can pay for reasonable medical expenses and report fees to diagnose or treat injuries caused by violence. We can only pay out-of-pocket expenses (the gap).

Your health practitioner will need to provide a receipt, invoice or treatment plan. We will pay the rate outlined in the Victim Assist Queensland—Table of Costs or an equivalent overseas rate.

For Australian providers, the receipt or invoice must include:

what treatment was provided (including the corresponding table of costs item number)
the cost per session (or itemised treatment costs)
details of Medicare or insurance contributions.

For overseas providers, the receipt or invoice must include:

what treatment was provided
the cost per session (or itemised treatment costs)
details of any government or insurance contributions.

How to claim

To claim financial assistance for the first time, you need to:

report the violence
complete the application form and attach
- information about your injuries
- identity documents.

If you need to add a new expense to an application you have already submitted, use our expenses form.

Claiming ongoing medical treatment

If you need more than 12 sessions of medical treatment, your health practitioner will need to provide a comprehensive clinical report telling us what treatment you need.

We will assess the extra expenses and let you know if they can be paid for or not.

We may also request a progress report at regular intervals. This report will tell us how your recovery is going.

Claiming expenses for a pre-existing condition

If you had a health condition before the violence, but the violence made your condition worse, we may be able to pay new, additional medical expenses.

Example:

Jacob has had bad teeth for most of his adult life. He has many cavities and bad gums. Jacob was the victim of an assault. He was punched in the face and some of his teeth were knocked out. He needs to see a dentist to fix those teeth. The dentist also wants to fix the cavities and treat his gums.
Jacob could ask us to pay to fix the teeth that were knocked out, but we would not be able to pay to fix his pre-existing cavities and gum problems. Jacob’s dentist would need to provide information about the cost of fixing just the teeth that were knocked out.

Mei has had depression for the last 2 years. Before the act of violence, she saw a psychologist once a month and a psychiatrist once every 3 months. Mei was taking anti-depressant medication each morning.
Mei was assaulted. The assault made her depression worse and she also started having panic attacks. Her psychiatrist added Panic disorder to her diagnosis. She is currently seeing her psychiatrist once a week. The psychiatrist has also added a second medication.
She could ask us to pay for her extra psychiatric appointments and her extra medication costs. Her psychiatrist would need to complete a Comprehensive clinical report to confirm the new diagnosis, new medication and extra appointments.

Payment process

If your claim is approved, we will send you a ‘notice of decision’. This notice will list what we have agreed to pay for, who we will be paying and the conditions on the payment. Please don’t tell a service provider that we will pay for something before you get the notice of decision. The notice of decision will say if we will pay the cost or not.

Once you receive your notice of decision and your claim is approved, electronic payments will be deposited into your nominated bank account within 10 business days.

Common payment conditions

Paid expenses—We must reimburse the person who paid the cost. This may have been you or a family member, friend, or agency. If someone else paid the cost for you, we need to pay them back. Please provide their name, phone number or email and banking information.

Unpaid expenses—If the cost hasn’t been paid yet, please provide an invoice so we can pay the service provider directly. For medical or counselling expenses, we must deduct any Medicare and private health rebates first. It is important that the invoice is made out in your name. This is because you received the service or goods. The invoice should not be made out to Victim Assist.

Other conditions (if any) will be noted in your notice of decision.

Limitations

We cannot cover every expense you may incur because of violence. We cannot pay for:

appointments you missed or cancelled
medical costs for health conditions that were not directly caused by violence
pre-existing health conditions (unless the violence made the condition worse)
medical costs that are covered by a private insurer (if you have insurance)
medical costs that would usually be paid for by another government department, scheme or insurer (e.g. Queensland Health, Queensland Ambulance Services, Child Safety, Medicare, Pharmaceutical Benefits Scheme, National Disability Insurance Scheme, WorkCover)
costs for treatment that is not included under claim medical treatment or approved practitioners.

Timeframe

Due to the high number of claims already awaiting assessment, it may take a long time for us to assess your application and pay approved expenses.

If you have an urgent expense and meet the conditions for claiming urgent expenses, we may prioritise the assessment of these expenses. If we decide the expenses don’t meet these conditions, we’ll let you know. Non-urgent expenses will be queued for general assessment within normal timeframes.