When pursuing a personal injury claim in New South Wales, there are several critical steps that must be followed to ensure your case progresses smoothly. One such step is completing your Medicare History Statement accurately and promptly. While it might seem like a routine administrative form, this document carries significant legal and financial implications in compensation matters — especially for those involved in motor vehicle accident claims, public liability claims, or workers compensation claims.
At BPC, our personal injury lawyers in Sydney have seen firsthand how errors or omissions in Medicare forms can lead to unnecessary complications, delays, or even financial setbacks. This article outlines why Medicare History Statements matter, what risks arise when they are not completed properly, and how our experienced team can support you through the process.
What is a Medicare History Statement?
A Medicare History Statement is a record of all medical services and treatments claimed through Medicare over a specific period. In the context of personal injury compensation claims, Services Australia requires this statement to determine whether Medicare has paid for any treatment related to the injuries the claim is about.
This statement enables Medicare to calculate any charges or reimbursements due under the Health and Other Services (Compensation) Act 1995 (Cth). If treatment has been covered by Medicare and is later compensated through a settlement or court-awarded damages, Medicare is entitled to be reimbursed from those compensation funds.
Why Accuracy Matters
Completing this statement accurately is not simply a formality. It is a legal obligation under federal legislation, and failing to do so can result in Medicare issuing what is known as a Deemed Notice of Charge.
If a Medicare History Statement is incomplete, inaccurate, or not submitted within the required timeframe, Services Australia may assume that all items listed in your Medicare record are related to your compensation claim — even if many of them are entirely unrelated. This can result in:
- Excessive deductions from your compensation payment;
- Delays in finalising your claim;
- The need for additional administrative steps to reverse the charge;
- In some cases, the freezing of settlement funds until the matter is resolved.
This deemed charge operates on the assumption that you have received a benefit for all Medicare items in question and that these were related to your injury — regardless of whether that is the case.
The Impact of a Deemed Notice of Charge
When a Deemed Notice of Charge is issued, you may be required to refund the entire amount of medical expenses listed, unless and until you can prove that certain items are unrelated to your injury. This involves completing further documentation, including a “Medicare History Notification Form”, and potentially engaging in protracted correspondence with Medicare to reverse the deemed charge.
For injured clients already dealing with medical appointments, legal proceedings and personal recovery, this additional red tape can be stressful and avoidable — especially when the issue stems from an initial form that was not filled in with care.
How You Can Get It Right
If you are making a compensation claim in NSW — whether for a car accident, workplace injury, or a public incident — you will likely be asked to provide a copy of your Medicare History Statement as part of the claim process.
Here are some key steps to ensure accuracy:
- Request the Statement Early: Apply for your Medicare History Statement as soon as your claim begins. This allows sufficient time to review and address any discrepancies.
- Review the Item Numbers: Go through each item and confirm whether the treatment relates to your injury.
- Seek Assistance: If you’re unsure whether a medical item is related to your claim, speak to the treating doctor or contact our office. We can guide you through the process and help annotate the statement accurately.
- Don’t Guess: If in doubt, don’t make assumptions. A single incorrect entry can trigger a deemed charge or create the appearance of misleading information.
We Are Here to Help
At BPC, our team is here to assist you in completing your Medicare documentation correctly. We understand how complex and confusing these forms can be, particularly when you are in the midst of physical recovery and legal proceedings. We will work with you to:
- Identify which items are relevant to your injury;
- Liaise with Medicare if clarification or correction is needed;
- Ensure your compensation is not unfairly reduced by unrelated Medicare charges.
We routinely handle claims involving motor accidents, workers compensation, public liability and medical negligence claims and we understand the practical and procedural requirements necessary to protect your rights and your compensation.
Need Help With a Personal Injury Claim?
If you have suffered an injury and are making a claim for compensation in NSW, it is essential that all supporting documents — including your Medicare History Statement — are completed accurately. Mistakes or omissions can result in significant delays and may affect the final amount you receive.
If you need help filling out your Medicare forms or would like legal advice about your rights in a compensation claim, contact our experienced personal injury lawyers in Sydney today. We offer a free initial consultation and can guide you through every stage of the claim process.
BPC Lawyers – Sydney’s trusted personal injury lawyers
Let us help you take the stress out of your claim. Our legal team combines experience, professionalism, and compassion to ensure your rights are protected. If you’ve been injured and need advice, call us today or visit our website to arrange a free case evaluation.