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How to get psychology approved under Workers Compensation in NSW
At a glance: Insurer pre-approval is not always required before the first psychology session. Under current NSW Workers Compensation rules, specified consultations with a SIRA-approved psychologist can proceed without pre-approval depending on when treatment starts and whether the injury has already been treated by a psychologist or counsellor. An AHTR is used when the current rules require a treatment request or when further treatment is needed.
The approval process is one of the most common sources of confusion and frustration for injured workers. The steps themselves are straightforward, but the paperwork and the waiting can feel opaque when you're already dealing with the injury itself. This guide walks through how it usually works in NSW, so you know what to expect and where things sit.
How the current pathway works
A referral from your nominated treating doctor is required before psychological treatment commences under NSW Workers Compensation. Your nominated treating doctor also remains important for documenting the injury, assessing work capacity and issuing the relevant Certificate of Capacity.
For SIRA-approved psychologists, current rules allow up to four consultations without insurer pre-approval where treatment begins within three months of injury and the injury has not previously been treated by a psychologist or counsellor. Where treatment begins more than three months after injury and the injury has not previously been treated by a psychologist or counsellor, up to three consultations may be available without prior approval. Other rules apply where there has been previous psychological treatment.
In most cases where treatment begins within three months, an AHTR is completed if more than four consultations are required. If treatment begins more than three months after the injury, SIRA says an AHTR should be completed after the first consultation. The insurer uses the information to consider ongoing treatment.
Treatment is reviewed against progress, function and recovery goals. Further treatment is requested through the scheme where clinically indicated and where the current approval requirements apply.
What "reasonable and necessary" means
From 1 October 2026, medical and related treatment under NSW Workers Compensation is assessed under the reasonable and necessary test. Treatment should primarily treat the compensable injury, be clinically justified and represent value for money. When an AHTR is required, it gives the insurer information about the presentation, progress, barriers, goals and proposed treatment so the request can be considered.
If approval is delayed
If an AHTR or another treatment request is awaiting a response, the next step depends on the timing and circumstances of treatment. The Workers Compensation Guidelines contain specific situations in which consultations can proceed without pre-approval. Your psychologist can check the applicable rule with the insurer. If treatment is declined, the insurer should provide a decision and there are review or dispute pathways that may be available.
Frequently asked questions
Insurer pre-approval is not always required before the first psychology session. Under current NSW Workers Compensation rules, a SIRA-approved psychologist may provide up to four consultations without pre-approval in specified circumstances when treatment begins within three months of injury and the injury has not previously been treated by a psychologist or counsellor. AHTR requirements depend on timing, prior treatment and whether further sessions are needed.
An Allied Health Treatment Request (AHTR) outlines the worker's clinical presentation, progress, goals and treatment request. For SIRA-approved allied health practitioners, when it must be submitted depends on when treatment begins and how many consultations are required.
When an AHTR is required, the insurer reviews the treatment request under the Workers Compensation rules. Some consultations can proceed without pre-approval in defined circumstances, so the practical pathway depends on when treatment starts and whether the injury has already been treated by a psychologist or counsellor.
Scheme information reviewed: 1 October 2026.
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If you'd like help understanding the approval process for your situation, call or email directly. All enquiries are handled personally.
For details of our Workers Compensation psychological treatment service, visit our WorkCover psychologist services in NSW.
General information only, written for a NSW audience, not personal or clinical advice. Eligibility and funding depend on your individual claim and insurer approval, so confirm your own situation with your treating doctor.