Will my operation be done in Canberra?

We cannot promise that on a web page, and be wary of anyone who does. What we can do is assess you, look at your imaging, give you a surgical opinion or a second one, write the reporting your payer asks for, and run the rehabilitation afterwards, in person across Canberra and by telehealth. Where an operation is performed, if one is recommended, is worked out with you and turns on your insurer's or claims manager's approval.

Do I need approval before surgery?

In the Comcare scheme, seek it in advance wherever possible. The claims manager assesses the request and writes back with what has been approved and for how long. In the ACT private scheme nothing has to be approved in advance under the statute; the cost is claimed afterwards by written notice. Even so, never book on the assumption something is covered. Naming the treatment in your personal injury plan before it happens is what removes the argument later.

My insurer wants me to see its own specialist. Is that the same thing?

No. An assessment your insurer books is part of how it decides your claim rather than part of your care, and we do not take that work. In the ACT private scheme, where the insurer or employer requests a specialist assessment the written notice has to state the reasons, including a brief description of what led to the request, why that specialist is the appropriate one, and which of aetiology, diagnosis, prognosis or recommended treatment is to be assessed. The Comcare scheme has its own examination power. Where your own nominated treating doctor requests a specialist assessment, that notice regime does not apply at all.

Can a specialist opinion be done by telehealth?

Often, yes, for the consultation, review of your imaging and the discussion that follows. A physical examination happens in person, and so does any appointment where a certificate is part of it, because that is a doctor's document in both schemes. We tell you which parts of your assessment need you in the room before you are booked.

Am I going to be out of pocket?

Do not assume it either way, and do not accept a blanket promise. The ACT private scheme has no fee schedule: the employer is liable for the cost of treatment reasonably received, at an amount appropriate having regard to charges customarily made for similar treatment where the treatment is received. Comcare publishes upper-limit fees benchmarked to the AMA list, and its claims managers are expressly not bound by them. We confirm what has been approved before you are booked, and we tell you where a gap is likely rather than after it appears.

Workers Compensation Orthopaedic Surgeon Canberra

Work injury that might need surgery? Our specialists give surgical opinions, second opinions and the reports your payer asks for, in person across Canberra and by telehealth. Where an operation would happen is settled with you and turns on your payer's approval.

Clinician assessing a worker's shoulder movement during a musculoskeletal examination

What this page covers, and what it does not

This page is about the parts of orthopaedic care that happen outside an operating theatre: the consultation, the surgical opinion, a second opinion, review of your imaging, reporting to your insurer or claims manager, and the rehabilitation afterwards. If an operation is recommended, where it is performed is worked out with you and turns on your payer's approval. We do not name a hospital here and we do not claim one.

What We Do

The Opinion, the Evidence Behind It, and What Comes After

Three things a specialist adds to a claim, with the operating question answered honestly rather than assumed.

Surgical Opinions and Second Opinions

Assessment, review of your imaging and a clear recommendation: conservative management, injection or surgery. A second opinion is legitimate treatment in both Canberra schemes and is worth having before a decision that cannot be undone. Appointments run in person across the capital, with telehealth for the parts that do not need an examination.

Reports the Payer Actually Reads

Comcare treats reports about treatment or progress as separate from medical treatment. They are paid under their own provision when the claims manager asks for information. Examinations, tests and analyses carried out at a doctor's request, imaging and pathology among them, are compensable in their own limb, and so is the report on them. Knowing which bucket a document sits in is half of getting it paid.

Approval Sorted in Advance

Comcare asks you to seek approval for medical treatment in advance wherever possible, and the claims manager then issues a written determination showing the level of services approved and for how long. The ACT private scheme requires no prior approval in the statute; you claim the cost by written notice stating the amount and reasonable details of the expenses. Having the treatment named in your personal injury plan first is still what keeps it uncontested.

No panel

Neither scheme approves, registers or panels a treating specialist beyond AHPRA registration.

Its own limb

Comcare funds examinations, tests and analyses requested by a doctor, and the report on them, separately from treatment itself.

The insurer's own

An assessment your insurer arranges is the payer's process rather than treatment, and it is not something we offer you.

What Is Funded

Both Schemes Fund the Whole Pathway

In the ACT private scheme, medical or surgical treatment by a doctor, treatment and maintenance as a patient at a hospital, and the nursing, medicines, surgical supplies and curative apparatus that go with it are each listed heads of compensable treatment, payable at the customary-charges standard.

Comcare says much the same in its own words. The services a legally qualified medical practitioner provides include medical procedures including surgery, and hospital treatment covers operative treatment, nursing services, day procedures, room charges, meals and anaesthesia in a public or private hospital. Room upgrades and extras such as television hire sit outside it. What differs between the schemes is when approval is asked for, and what the payment is measured against.

Which of those applies to you follows your employer. If that is not settled yet, start with our which-scheme guide, and our Canberra doctors handle the referral and the certificate around the specialist appointment.

1 November

comcare.gov.au medical rates; checked 20 August 2026

When the specialist fee benchmark is indexed

Comcare benchmarks upper-limit fees for specialists and surgeons to the AMA List of Medical Services and Fees, which is indexed annually on 1 November. Claims managers can determine a different amount for a particular claim.

2 weeks

Workers Compensation Act 1951 (ACT); checked 20 August 2026

Notice for a payer-requested specialist assessment

Where the worker, their lawyer, the employer, the insurer or the default insurance fund manager asks for a specialist assessment, written notice generally runs two weeks ahead and has to state the reasons. That regime does not apply where the worker's own nominated treating doctor requests the assessment.

On demand

Workers Compensation Act 1951 (ACT); checked 20 August 2026

When a hospital bill has to be paid

Where the employer is liable for medical treatment received from a hospital it must pay the amount on demand: to the proprietor of a private hospital, or to the person authorised in writing by the governing entity of any other hospital. Hospital costs are settled between the payer and the hospital rather than through the worker.

The Pathway

From Referral to Recovery

The orthopaedic pathway in both schemes, and the points where it commonly stalls.

Referral from your treating doctor

One ACT rule is worth knowing here. The written-notice regime that governs specialist assessments does not apply where your own nominated treating doctor requests the assessment. That regime exists for assessments requested by you, your lawyer, your employer, the insurer or the default insurance fund manager.

Consultation and examination

In the Comcare scheme the examination itself, with any imaging or pathology your doctor orders, sits in its own funding limb, and the same limb pays for the report written on it. In the ACT private scheme these sit inside the general medical-treatment definition at the customary-charges standard.

The opinion

Conservative management, injection or surgery, with the reasoning written down rather than implied, because that reasoning is what a payer weighs. If surgery is recommended, where it is performed is decided with you and depends on your payer's approval.

Approval and payment

In the Comcare scheme, approval comes first and then a determination naming the services and the period, with upper-limit fees benchmarked to the AMA List of Medical Services and Fees. In the ACT private scheme there is no prior approval in the Act, and the employer is liable for the cost of treatment reasonably received.

Rehabilitation afterwards

Physiotherapy from the same clinical record, and psychology where a long recovery has taken a toll. Both are funded in both schemes. Continuity here is what turns a good operation into a good outcome.

Across Canberra

Consultations and Reviews Across the Capital

Specialist appointments run in person across Canberra and by telehealth. Here is what each district looks like for the people who work in it.

Belconnen

Westfield Belconnen, the Fresh Food Markets and the CIT campus keep a large retail and services workforce on foot through the town centre every day.

Gungahlin

The Marketplace and the surrounding shops employ a substantial retail workforce, while the suburbs still being built around it keep construction trades busy — and a large share of residents commute down Flemington Road to APS offices in the city.

Inner North

The Inner North runs from Civic's office towers up the Northbourne Avenue light rail corridor through Braddon, Turner and Lyneham to Dickson and Watson. It holds the ANU campus in Acton, government offices in the city and Dickson, and the hospitality strips of Lonsdale Street and the Dickson shops — one of the densest mixes of office, university and hospitality work in Canberra.

Inner South

Fyshwick's warehouses, trade suppliers and workshops round it out — office, hospitality and light-industrial workforces within a few kilometres of each other.

Woden Valley

Westfield Woden and the town centre's ongoing redevelopment, including the CIT campus, add a steady retail, construction and services workforce.

Weston Creek

Most working residents commute to Woden, Civic or the Parliamentary Triangle, while the district itself employs people in local retail, schools, childcare and health clinics.

Tuggeranong

South.Point and the surrounding town centre carry a large retail workforce, and Kambah, the ACT's largest suburb, sits at the valley's northern end.

Molonglo Valley

Molonglo Valley is Canberra's newest district, taking shape between Weston Creek and the Molonglo River — Coombs, Wright, Denman Prospect and Whitlam are still growing street by street. That makes construction its most visible industry, with a resident population that skews young and largely commutes to Civic, Woden and the Parliamentary Triangle for office work.

Travelling in from the surrounding region? Tell us where you are coming from and we will work the appointment around it. Call (02) 7238 7379 or book an appointment online.

FAQs

Orthopaedic Questions from Canberra Workers

Keep Reading

Around the Specialist Appointment

Our other Canberra services

Workers compensation GPs in Canberrawhat goes in the certificate, and the clocks that run off it.
Workers compensation physiotherapists in Canberratreatment you can start without a referral, with the funding handled behind it.
Workers compensation claims in Canberrawho pays your claim, and the deadlines that follow.
Workers compensation doctors in Canberracertificates in both schemes, and what a treating doctor actually carries.
Workers compensation psychologists in Canberrapsychological injury treatment, in person in Canberra and by telehealth.

Canberra guides

Workers compensation in Canberra and the ACTthe Canberra hub, covering both schemes end to end.
Which workers compensation scheme am I under?Comcare, ACTPS or the ACT private scheme, sorted in one question.
ACT Government (ACTPS) workers compensationthe federal statute, self-insured, with claims run by EML rather than WorkSafe ACT.
Comcare workers compensationhow the federal scheme works, from certificate to tribunal.
Comcare psychologistdoctor-arranged psychology billed direct to Comcare at scheme rates.

Get an Orthopaedic Opinion on Your Claim

Consultations, second opinions and imaging review for Comcare, ACTPS and ACT private-sector claims, in person across Canberra and by telehealth.

Call (02) 7238 7379

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