Quick answer: what section 60 means in practice
Section 60 usually requires the insurer to pay for reasonably necessary treatment linked to your work injury. Most disputes are won or lost on evidence quality: whether your treating team clearly explains necessity, causation, and what happens if care is delayed.
What section 60 usually covers
- GP and specialist consultations
- Physiotherapy, psychology, and allied health treatment plans
- Scans, diagnostics, medicines, and some equipment
- Hospital treatment and surgery where clinically justified
- Travel costs for approved treatment in eligible circumstances
If you are already dealing with a refusal, start with the dedicated guides for treatment denials and surgery denials. If the insurer says your treatment window has expired, review section 59A time limits.
Why insurers refuse section 60 requests
- The insurer argues treatment is not reasonably necessary right now.
- The clinical notes do not clearly connect treatment to work injury causation.
- Reports are old, generic, or inconsistent across providers.
- An IME report is given more weight than your treating practitioner evidence.
- The insurer says there is a better or cheaper treatment pathway.
If an IME report is driving the refusal, use this IME response strategy before the narrative hardens.
First 7 days after a refusal: practical plan
Day 1: Request written reasons and keep the denial notice.
Day 2–3: Ask your treating doctor for an updated report that addresses necessity, causation, and urgency.
Day 3–5: Attach objective support (imaging, specialist letters, treatment history, response to prior treatment).
Day 5–7: Decide whether to escalate to formal dispute pathways if the insurer will not reverse quickly.
If the refusal sits alongside payment pressure or liability disputes, map your options using claim denied steps, section 78 notice strategy, and the PIC disputes guide.
Evidence checklist that improves approval odds
- Current certificate of capacity aligned to the proposed treatment
- Provider letter explaining why this treatment is reasonably necessary now
- Clear causation statement linking current symptoms to the accepted injury
- Prior treatment outcomes (what worked, what failed, what remains impaired)
- Functional impact detail: work tasks, daily activities, and risk if care is delayed
Which guide to open first: refusal route map
- Non-surgical treatment refusal: treatment denied guide.
- Surgery refusal: surgery denied guide.
- Insurer says treatment is out of time: section 59A time-limit guide.
- IME report is driving refusal: unfair IME strategy.
- Formal notice / liability dispute / legal escalation: section 78 notice guide, claim denied steps, then PIC disputes process.
If more than one path applies, structure your file around one timeline and one evidence bundle so each pathway reuses the same facts cleanly.