Summary
NSW SIRA-regulated workers compensation treatment is gated on the Allied Health Treatment Request (AHTR) form. The AHTR replaced the previous Allied Health Recovery Request (AHRR) in June 2024. The first AHTR establishes goals and a treatment plan; subsequent AHTRs must demonstrate measurable progress to unlock further sessions. This guide details what to put on each AHTR and the supporting documentation that backs it up.
The AHTR form
The Allied Health Treatment Request (AHTR) is the primary documentation for SIRA approval of allied health treatment under the NSW Workers Compensation Scheme. Each AHTR must include:
- Worker identification and claim details.
- Diagnosis and current presentation.
- SMART goals.
- Treatment proposed (sessions, frequency, duration).
- Outcomes from prior treatment (for second and subsequent requests).
- Predicted outcomes from the requested treatment.
The icare nominal insurer and self-insurers all use the AHTR; some specialised insurers may use slight variants. A single AHTR can request up to a maximum of 8 consultations.
Approval timeframes
SIRA's guidelines for AHTR decision-making:
- The insurer must make a decision within 21 days of receiving an AHTR.
- For a SIRA-approved allied health practitioner requesting treatment within 3 months of the injury where no prior allied health practitioner from the same profession has been engaged, a decision must be made within 5 working days — otherwise the request is automatically approved.
Documentation supporting the AHTR
The AHTR is the summary; the underlying clinical record is what an audit examines. The supporting record should include:
- Initial assessment with baseline measurements (PSFS, ODI, DASS-21, etc.).
- Each session note documenting the session focus, intervention delivered, and worker response.
- Outcome measure re-administration at intervals appropriate to the instrument.
- Communications with the nominated treating doctor, employer, and SIRA-approved rehabilitation provider.
SMART goals
SIRA explicitly requires SMART goals — Specific, Measurable, Achievable, Relevant, Time-bound. A goal worded as "reduce shoulder pain" fails on Specific and Measurable. A goal worded as "Return to full pre-injury work tasks (lifting up to 20kg, overhead reaching) by 8 weeks" passes on all five. SIRA decision-makers do not approve goals — they assess whether the proposed services are 'reasonably necessary' against the goals you have set.
What audit teams look for
- Match between AHTR-stated goals and the goals in clinical session notes.
- Match between AHTR-stated treatment delivered and the session notes.
- Outcome measures actually re-administered (not just claimed).
- Notification of injury changes or recovery plateau when they occur.
- Communication with the employer about graduated return-to-work duties.
Common failure modes
- Goals copied verbatim across multiple workers.
- AHTR claims sessions delivered but session notes are missing for some dates.
- "Treatment as planned" in every session note — no individualisation.
- Outcome measure named but no record of administration or scoring.
- Requesting more than 8 consultations on a single AHTR.
Related reading
How we review this guide
Library guides reference original Australian source authorities — not secondary commentary — and are updated when source material changes. Each guide cites the regulator, item descriptor, or governing standard it draws from so you can verify it directly.
- Sources checked
- • Original Australian source authorities and peer-reviewed guidance
- Review cadence
- Reviewed annually and whenever a cited source authority publishes a material change. Last reviewed .
- Not advice
- Reference content for Australian practitioners and education staff. Not legal, clinical, or billing advice — verify against your governing body and current source documents.
Keywords: sira workers compensation documentation, ahtr allied health treatment request, nsw workers comp progress report, icare nsw documentation, sira clinical framework
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