60Medical and like benefits

60 Medical and like benefits S. 60(1) amended by Nos 32/1988 s. 15(1)(a)–(d), 50/1989 s. 52(1) (as amended by No. 91/1989 s. 7(g)), 84/1994 ss 9(1), 36, 5/1999 s. 3, substituted by No. 84/2000 s. 19(1). (1) This section specifies amounts that the Commission is liable to pay as compensation in addition to any other compensation paid under this Act. S. 60(1A) inserted by No. 84/1994 s. 9(2), substituted by Nos 84/2000 s. 19(1), 95/2003 s. 30. (1A) The Commission is only liable to pay compensation under this section for the expenses and costs incurred in the following periods— (a) if the application for compensation is made within 3 years after the date of the transport accident, the period between the date of the accident and the date the application is granted; or (b) in any other case, the period of 2 years immediately before the application is made. Subsection (1A) applies in respect of all applications for compensation made on or after 1 January 2001—see section 181(2). S. 60(2) substituted by Nos 84/1994 s. 9(3), 84/2000 s. 19(1). (2) The Commission is liable to pay as compensation to a person who is injured or in respect of a person who dies as a result of a transport accident— S. 60(2)(a) amended by No. 71/2013 s. 16. (a) the reasonable costs of road accident rescue services, medical services, hospital services, nursing services, disability services, rehabilitation services, transportation costs, vocational rehabilitation services and ambulance services received in Australia because of the transport accident; and (b) the reasonable costs of attendant care services that would be otherwise payable under paragraph (a) if the injured person had received those services in Australia because of the transport accident, if the injured person receives those services while travelling overseas for a period of not more than 8 weeks in any year; and S. 60(2)(c) substituted by No. 94/2004 s. 15(1). (c) if the person, in the 30 days before the transport accident, was engaged in the care of a child and did not receive salary or wages in respect of that care, the reasonable costs incurred after the transport accident in employing, during the first 5 years after the death or injury, an authorised person to undertake in Australia care of the child, but payment is not to be made in respect of more than— (i) if, at the time of the accident, the person was in full-time paid employment for 35 hours or more per week, a total of 10 hours per week of child care services; (ii) if, at the time of the accident, the person was in paid employment for less than 35 hours per week, a total of x hours per week of child care services where "x" is— (A) if the result of the following calculation is less than 40— 10 + (35 – the number of hours per week of paid employment)— that number; or (B) in any other case, 40; (iii) in any other case a total of 40 hours per week of child care services; and S. 60(2)(ca) inserted by No. 60/2007 s. 14(1). (ca) if the person, at the time of the transport accident, was the primary care-giver in respect of a disabled or elderly member of the immediate family of the person and did not receive salary or wages in respect of that care, the reasonable costs incurred after the transport accident in employing, during the first 12 weeks after the death or injury, an authorised person to undertake in Australia the primary care of that disabled or elderly member of the immediate family of the person; and S. 60(2)(d) substituted by No. 94/2004 s. 15(1). (d) the reasonable costs incurred after the transport accident in employing an authorised person to provide in Australia home services and post acute support during the first 5 years after the death or injury, but payment is not to be made in respect of more than a total of 40 hours per week of such services or support. Paragraphs (c) and (d) only apply to a person who was injured in a transport accident that occurred on or after the date of commencement of section 15 of the **Transport Accident (Amendment) Act 2004**—see section 192. S. 60(2AAA) inserted by No. 49/2018 s. 12(1). (2AAA) If a person is— (a) entitled to compensation under subsection (2)(b); and (b) a worker based in Australia who is travelling for the purpose of the worker's employment— the person is entitled to compensation under subsection (2)(b) for a period of not more than 4 weeks in any year, in addition to the 8-week period set out in subsection (2)(b). S. 60(2AA) inserted by No. 94/2004 s. 15(2). (2AA) If a person is entitled to payments under both subsections (2)(c) and (2)(d), the payments are not to be made for more than a combined total of 40 hours per week of the services or support referred to in those subsections. S. 60(2AB) inserted by No. 94/2004 s. 15(2), substituted by No. 80/2010 s. 7. (2AB) For the purposes of subsection (2)(c), a person who is injured as a result of a transport accident and is— (a) a woman who was pregnant at the time of the transport accident; or (b) a domestic partner of a woman who was pregnant at the time of the transport accident— is deemed to have been engaged in the care of a child in the 30 days before the transport accident. S. 60(2AC) inserted by No. 94/2004 s. 15(2). (2AC) With respect to subsection (2)(d)— (a) the 5 year limit does not apply to a person who has a severe injury; and (b) in determining the reasonable cost of home services, the Commission may have regard to the capacity of other members of the person's household to carry out such services. S. 60(2A) inserted by No. 84/2000 s. 19(1). (2A) The Commission is liable to pay as compensation in respect of a person who is injured or dies as a result of a transport accident— S. 60(2A)(a) amended by Nos 94/2004 s. 16(1), 60/2007 s. 14(2), 71/2013 s. 17(1). (a) where death or severe injury results from the transport accident, the reasonable costs incurred in Australia of family counselling services provided to any member of the immediate family of the person who is injured or dies by a medical practitioner, a registered psychologist or a person who is authorised under section 23 to provide a service for the purposes of this subsection not exceeding $15 000 in respect of that death or severe injury; and S. 60(2A)(b) amended by No. 71/2013 s. 18(1). (b) where death results from the transport accident, the reasonable costs incurred in Australia of a funeral, burial, cremation, monument or any other expense declared by Order of the Governor in Council to be a prescribed expense for the purposes of this section, where the total amount of the expenses does not exceed $14 135. S. 60(2B) inserted by No. 84/2000 s. 19(1), amended by No. 27/2001 s. 4(Sch. 2 item 4.11(a)(i)). (2B) In this section— *family member* amended by No. 27/2001 s. 4(Sch. 2 item 4.11 (a)(ii)), repealed by No. 60/2007 s. 14(3). *parent* inserted by No. 27/2001 s. 4(Sch. 2 item 4.11 (a)(iii)), amended by No. 94/2004 s. 3(3)(a). ***parent*** of a dependant child includes— (a) a person who has day to day care and control of the child and with whom the child is ordinarily resident; (b) a guardian of the child. *severe injury* repealed by No. 94/2004 s. 3(3)(b). S. 60(2BA) inserted by No. 94/2004 s. 17(1), amended by No. 71/2013 s. 19(1). (2BA) The Commission is liable to pay as compensation to an earner who is injured as a result of a transport accident the reasonable costs of travelling to and from work for up to 24 weeks after first returning to work after the accident if the earner is unable, because of the injuries received as a result of the accident, to undertake that travel in the way that he or she usually did before the accident, but the total payment made under this subsection to the earner as a result of the accident is not to exceed $1000. S. 60(2BB) inserted by No. 71/2013 s. 19(2). (2BB) For the purposes of subsection (2BA)— (a) the 24 weeks do not have to be consecutive; and (b) if more than one attempt to return to work is made after the accident, a claim may be made after any subsequent attempt to return to work. S. 60(2C) inserted by No. 84/2000 s. 19(1), amended by No. 27/2001 s. 4(Sch. 2 item 4.11(b)). (2C) If a parent of a dependent child injured and admitted to hospital as a result of a transport accident incurs reasonable travelling or accommodation expenses by reason of visiting the dependent child in the hospital, the Commission is, subject to this Act, liable to pay as compensation, payments in respect of those expenses. S. 60(2CA) inserted by No. 49/2018 s. 12(2). (2CA) If a parent of a dependent child injured and admitted to hospital as a result of a transport accident incurs a loss of wages by reason of visiting the dependent child in the hospital, the Commission is, subject to this Act, liable to pay as compensation, payments not exceeding $10 000. S. 60(2CB) inserted by No. 49/2018 s. 12(2). (2CB) The Commission is not liable to pay compensation under this section in respect of the first 5 days of loss of wages. S. 60(2CC) inserted by No. 49/2018 s. 12(2). (2CC) With respect to subsection (2CA), the Commission must not make a contribution in respect of a day that exceeds one-fifth of the current amount specified in section 44(3)(a). S. 60(2CD) inserted by No. 49/2018 s. 12(2). (2CD) If, by reason of subsection (2CB), the Commission is not liable to make a payment to a parent in respect of loss of wages, the Commission may make such a payment if it is satisfied that the parent would suffer acute financial hardship if a payment were not made. S. 60(2D) inserted by No. 84/2000 s. 19(1), amended by No. 27/2001 s. 4(Sch. 2 item 4.11(c) (i)(ii)), substituted by No. 60/2007 s. 14(4). (2D) Subsection (2E) applies if— (a) a person is injured and admitted as an in‑patient in a hospital as a result of a transport accident; and (b) the hospital is located at least 100 kilometres from the normal residence of members of the immediate family of the person referred to in paragraph (a); and S. 60(2D)(c) amended by No. 71/2013 s. 20(1). (c) members of the immediate family incur reasonable travelling or accommodation expenses by reason of visiting the person referred to in paragraph (a) in hospital. S. 60(2E) inserted by No. 60/2007 s. 14(4), amended by Nos 71/2013 s. 20(2), 49/2018 s. 12(3). (2E) The Commission is, subject to this Act, liable to pay as compensation to the members of the immediate family payments not exceeding $20 000 in total in respect of the expenses referred to in subsection (2D)(c). S. 60(2EA) inserted by No. 73/2016 s. 9. (2EA) Subsection (2EB) applies if— (a) a person dies as a result of a transport accident; and (b) a funeral, burial or cremation is held in Australia in respect of the person; and (c) the service is held at least 100 kilometres from the normal residence of the members of the immediate family of the person referred to in paragraph (a); and (d) members of the immediate family incur reasonable travelling or accommodation expenses in Australia by reason of attending the service referred to in paragraph (b). S. 60(2EB) inserted by No. 73/2016 s. 9. (2EB) The Commission is, subject to this Act, liable to pay as compensation to the members of the immediate family payments not exceeding $5000 in total in respect of the expenses referred to in subsection (2EA)(d). S. 60(2F) inserted by No. 71/2013 s. 21(1). (2F) For the purposes of subsection (2)(a), the Commission is not liable to pay as compensation the reasonable costs of medical services that are the provision of a document obtained for medico-legal purposes, or related to medico-legal purposes unless the document— (a) is requested jointly by the Commission and the person who is injured; and (b) is provided jointly to the Commission and the person who is injured; and (c) is provided by a registered health practitioner within the meaning of the Health Practitioner Regulation National Law. S. 60(2G) inserted by No. 71/2013 s. 21(1). (2G) For the purposes of subsection (2F), a document obtained for medico-legal purposes includes a document obtained for any of the following purposes— (a) for the purposes of determining the degree of impairment under section 46A, 47(7) or 47(7A); (b) for the purposes of Part 6 or Division 1 of Part 10; (c) responding to a decision of the Commission under Parts 3 and 4 or in contemplation of such a decision; (d) for the purposes of an application under section 77 for a review of a decision, or in contemplation of such an application. S. 60(2H) inserted by No. 71/2013 s. 21(1). (2H) For the purposes of subsection (2F), a document is not obtained for medico-legal purposes if the document is obtained from a person's treating medical practitioner. S. 60(2I) inserted by No. 71/2013 s. 21(1). (2I) In this section— ***document*** includes but is not limited to a medical report; ***treating medical practitioner***, in relation to a person who is injured in a transport accident, is a person who has provided medical services to the injured person before being requested to provide a document. S. 60(3) inserted by No. 32/1988 s. 15(2), substituted by Nos 84/2000 s. 20(1), 94/2004 s. 18. (3) If a person, as a result of his or her transport accident injury, reasonably requires a motor vehicle used by him or her in Australia to be modified, the Commission is liable— (a) to pay the reasonable costs of modifying the vehicle; or (b) if the vehicle is not capable of being modified, to contribute a reasonable amount to the purchase cost of a suitably modified motor vehicle selected by the Commission. S. 60(3A) inserted by No. 94/2004 s. 18. (3A) If a person, as a result of his or her transport accident injury, reasonably requires access to a motor vehicle, and he or she does not have access to a motor vehicle, the Commission is liable to contribute a reasonable amount to the purchase cost of a suitable motor vehicle selected by the Commission. S. 60(3B) inserted by No. 94/2004 s. 18. (3B) Without limiting the factors the Commission may consider in determining what is a reasonable amount for the purposes of subsections (3)(b) and (3A), the Commission must have regard to any of the following factors that are applicable— (a) the market value now of the motor vehicle used by the person at the time of the accident; (b) if that vehicle is no longer used by the person, the market value of the vehicle at the time of the accident; (c) whether the person or, in the case of a minor, his or her parent or guardian, owned, leased or rented the vehicle; (d) how often the person was using motor vehicles at the time of the accident; (e) how often the person will, or is likely to, use a motor vehicle in future; (f) the market value of any other motor vehicle that the person uses. S. 60(4) inserted by No. 84/2000 s. 20(1), substituted by No. 94/2004 s. 19. (4) If a person, as a result of his or her transport accident injury, reasonably requires that a home in which he or she resides in Australia be modified, the Commission is liable— (a) to pay the reasonable costs of modifying the home; or (b) if for any reason the home cannot be reasonably modified, to contribute a reasonable amount— (i) to the purchase costs of a semi detachable portable unit; or (ii) to the costs of relocating the person to another home that is suitable for the person or that is capable of being reasonably modified. S. 60(4A) inserted by No. 94/2004 s. 19. (4A) Without limiting the factors the Commission may consider in determining the reasonable costs or amount for the purposes of subsection (4), the Commission must have regard to the following factors— (a) whether the home in which the person resides is structurally suitable for modification; (b) the nature of the person's injuries as a result of the accident; (c) how those injuries restrict, or are likely to restrict, the person's ability— (i) to enter and leave the home in which the person resides; and (ii) to move about the home for necessary purposes; (d) the extent of the modifications that will be needed to address those restrictions or likely restrictions; (e) any complex, unique or unusual circumstances associated with those modifications; (f) whether the cost of those modifications is likely to exceed the value of the home in which the person resides. S. 60(4B) inserted by No. 94/2004 s. 19. (4B) If a person moves from a home that has modifications to which the Commission made a contribution, in assessing whether to make a payment in respect of modifications to the person's new home, the Commission must have regard to the appropriateness of that home for modification, having regard to all relevant circumstances, with respect to the modifications that are needed. S. 60(5) inserted by No. 84/2000 s. 20(1), amended by No. 60/2007 s. 14(5). (5) The Commission must not make a payment or contribution under subsection (3) or (4) which exceeds $10 000 or a greater amount as may be prescribed, unless the person enters into an agreement with the Commission in relation to the ownership of, and maintenance of modifications to, the motor vehicle, home or semi-detachable portable unit. S. 60(6) inserted by No. 84/2000 s. 20(1), amended by No. 94/2004 s. 20. (6) Without limiting what may be included in an agreement under subsection (5), the agreement must include provisions in respect of— (a) subsequent modifications; (b) changes of ownership; (c) the frequency of modifications and changes of ownership. S. 60(7) inserted by No. 95/2003 s. 25(2). (7) Nothing in this section renders the Commission liable to pay as compensation the cost of the provision to, or for, a person who is injured as a result of a transport accident of any of the following things unless the provision of a particular thing to the person is a medical service, or a hospital service, provided as a result of the injury— (a) accommodation (including accommodation-related costs such as rent, bonds, rates, accommodation costs levied in accordance with Commonwealth legislation, capital contributions and costs associated with the buying or selling of property, but not including the costs and contributions referred to in subsection (4)); (b) food or household or personal items; (c) power, water or any other service provided by a utility; (d) room temperature controls; (e) any other thing specified by the regulations for the purposes of this subsection. S. 60(8) inserted by No. 95/2003 s. 25(2). (8) Subsection (7) does not apply in the case of a person who is under 18 years of age and who, as a result of his or her injury, is unable to reside at the place that he or she resided at before he or she was injured. S. 60(9) inserted by No. 95/2003 s. 25(2). (9) Subsection (7) also does not apply to a person— (a) who receives a hospital service as a result of a transport accident; and (b) who is then discharged from hospital; and S. 60(9)(c) substituted by No. 60/2007 s. 14(6). (c) who then resides in supported accommodation— during the first 18 months after the person is first discharged from hospital. S. 60(10) inserted by No. 95/2003 s. 25(2). (10) For the purposes of subsection (9)— (a) a person can only be "first" discharged once from hospital in relation to a particular transport accident; and (b) it does not matter if, during the relevant period, the person changes accommodation, or does not live continuously in accommodation of the sort listed in subsection (9)(c) (although in this latter case subsection (9) only applies to the person while he or she is living in accommodation of that sort); and (c) the 18 month period referred to in subsection (9) is to be extended by the addition of any period during which a person is in a hospital receiving a hospital service after he or she is first discharged from hospital. Subsections (7) to (10) only apply to applications for payment made after the date of commencement of section 25 of the **Accident Compensation and Transport Accident Acts (Amendment) Act 2003—**see section 181(1). Also, those subsections do not apply to people who had been injured in a transport accident before that date until the expiry of 18 months after that date**—**see section 181(3). S. 60(11) inserted by No. 94/2004 s. 21. (11) Subsection (7) also does not apply to a person while the person is receiving respite care as a result of the injury. S. 60(11A) inserted by No. 60/2007 s. 14(7), amended by No. 71/2013 s. 22(1). (11A) Despite subsection (7), the Governor in Council may, by Order published in the Government Gazette, fix limits in respect of contributions to be made by a person towards the cost of supported accommodation, which contributions must not exceed $32.50 per day. S. 60(11B) inserted by No. 60/2007 s. 14(7). (11B) An Order made under subsection (11A)— (a) may fix limits that vary according to the type of supported accommodation in which a person is residing; (b) takes effect on the date that the Order is published in the Government Gazette, or on a later date specified in the Order. S. 60(12) inserted by No. 94/2004 s. 22. (12) The Commission must not make a payment under subsection (2) of more than $5000 for any equipment or item of the sort described in paragraph (g), (h) or (i) of the definition of ***medical service*** in section 3(1) unless the injured person enters into an agreement with the Commission in relation to the equipment or item. S. 60(13) inserted by No. 94/2004 s. 22. (13) Without limiting what may be included in an agreement under subsection (12), the agreement must include provisions in respect of— (a) the ownership, operation and maintenance of the equipment or item; and (b) changes of ownership of the equipment or item. S. 60A inserted by No. 94/2004 s. 23.