Practical review
What to check in this situation
- Record the practical or clinical reason for changing doctors and the date ongoing care will transfer.
- Transfer relevant records and explain the work injury, treatment and current duties accurately.
- Avoid a gap in Certificates of Capacity, medication or referral management.
Records that may help
Keep the change request, insurer response, record-transfer authority, first new consultation and updated Certificate of Capacity.
Next procedural step
If the insurer objects, ask for the written basis and separate care coordination from any dispute about capacity or treatment.
What you need to know
Changing doctors is permitted, but it is part of the claim record
Under the NSW injury management framework, the nominated treating doctor is the doctor nominated by the worker for the purposes of the injury management plan. The legislation uses the concept of a doctor nominated from time to time, and section 47 requires the injury management plan to include a procedure for changing that doctor.
SIRA tells workers who have a reason to change doctors to inform the insurer and/or employer. That is different from saying the insurer chooses the doctor. It is also different from deciding whether the insurer must pay for every consultation, referral or treatment request.
Why a worker may need a different doctor
Access or availability
The clinic may close, the doctor may leave, appointments may be unavailable, or the worker may move to another area.
Clinical relationship
A worker may need a doctor with whom they can communicate effectively and discuss symptoms, treatment and recovery at work.
Language or accessibility
Interpreter needs, disability access, cultural safety or communication barriers may make another doctor more suitable.
Claim coordination
The nominated doctor must be willing to participate in injury management, complete certificates and communicate about recovery at work where appropriate.
A practical change process
- 1
Check the injury management plan
Read the procedure for changing the nominated treating doctor and ask the insurer for a copy if you do not have it.
- 2
Arrange a clinically appropriate handover
Ask the previous clinic to transfer relevant records with your authority. Book the new appointment with enough time for an assessment before another certificate is required.
- 3
Give the new doctor the relevant history
Provide certificates, reports, imaging, medication details and the current injury management or recovery-at-work material. Do not ask the doctor to adopt an opinion they do not independently hold.
- 4
Notify the insurer and/or employer
Give the new doctor’s name and contact details and provide the current certificate through the usual claim channel. Keep proof of what was sent.
- 5
Clarify any disputed expense
If the insurer disputes payment for a consultation, referral or treatment, ask for the decision, legal basis and review information in writing.
Records that support continuity
The certificate of capacity is a primary communication document in the claim, but it is not the only medical evidence. A useful handover lets the new doctor see the history and explain the present clinical position in their own words.
Current and recent certificates of capacity
Relevant GP and specialist reports
Imaging and test results
Medication and treatment history
Injury management and recovery-at-work plans
Written duties and actual job demands
Relevant insurer decisions or treatment requests
Interpreter or accessibility requirements
What may need explanation after the change
A new doctor may reasonably reach a different view after examining the worker or reviewing later evidence. If hours, restrictions, diagnosis or treatment recommendations change materially, a contemporaneous clinical explanation can help the insurer understand whether symptoms changed, treatment failed, new findings emerged or the earlier certificate was incomplete.
A gap between certificates does not automatically determine entitlement, but it can create an evidentiary issue about incapacity during that period. Arrange appointments and provide documents promptly where possible. If a gap has already occurred, obtain advice about the available medical and factual evidence rather than asking a doctor to backdate a conclusion they cannot support.
The insurer may obtain other medical evidence or make a work capacity, treatment or liability decision. The new doctor does not decide the legal dispute, and the insurer cannot replace a proper statutory decision with an informal preference for the previous doctor.
Related claim issues
If the issue is a proposed reduction or stoppage of weekly payments, read the work capacity decision guide. A treating doctor’s certificate is important evidence, but the review pathway depends on the actual notice.
If the insurer disputes payment for care recommended by the new doctor, read the treatment expense dispute guide. The question is usually whether the treatment relates to the compensable injury and is reasonably necessary, together with any approval rule that applies.
Questions about changing doctors
Can I change my GP during a NSW workers compensation claim?
A nominated treating doctor is the doctor a worker nominates from time to time for the injury management plan. The plan must include a procedure for changing that doctor. If you change doctors, inform the insurer and/or employer and follow the procedure in the plan.
Do I need the insurer’s permission to change doctors?
There is no general rule that permanently fixes a worker to the first nominated doctor or makes an insurer’s preference decisive. However, the worker must inform the insurer and/or employer, and the injury management plan may set a change procedure. A separate question is whether the insurer accepts liability for particular treatment or expenses.
Can the insurer refuse to pay the new doctor’s treatment costs?
Changing the nominated doctor does not by itself decide whether an expense is payable. The treatment must still relate to the claim and satisfy the applicable compensation and approval rules. If payment is disputed, ask for the decision and reasons in writing.
What should I take to the first appointment with the new doctor?
Take recent certificates of capacity, relevant imaging and specialist reports, medication details, treatment plans, the injury management plan and important insurer decisions. The doctor still needs to form an independent clinical opinion after reviewing the history and examining you.
What if the new certificate differs from the old one?
A change can be clinically valid, but unexplained differences may create a work capacity or weekly payment issue. The new doctor should record the current findings and explain material changes in symptoms, treatment, function or restrictions where clinically appropriate.
Sources and review date
- SIRA - Your nominated treating doctor
- SIRA - NSW workers compensation certificate of capacity
- Workplace Injury Management and Workers Compensation Act 1998 (NSW)
- SIRA - Workers Compensation Guidelines
Reviewed 21 July 2026.
Need advice about a doctor change or related decision?
Send the injury management plan, recent certificates and any insurer decision. The applicable step depends on the documents and claim history.
This information is general in nature and is not legal or medical advice. You should obtain advice about your own circumstances.