Section 39 Requests Need a Branching Evidence Map, Not One Checklist

An aid can be medical treatment, rehabilitation support or something outside both routes. AI can expose the branches and assemble the evidence, but a human must select the statutory path, decide entitlement and preserve the reasons for that choice.

The item name does not tell you which SRC Act provision applies. A wheelchair, hearing aid, vehicle modification or ergonomic product can arrive with overlapping clinical, functional and return-to-work explanations. Putting every request through one aids-and-appliances checklist hides the legal question that comes first.

Use AI to build a branch gate. It should separate a possible section 16 medical-treatment request from a possible section 39 rehabilitation-support request, expose any other route that needs attention, and stop when the evidence does not resolve the classification. The relevant authority, acting through an authorised human, chooses the route and determines the claim.

Once section 39 is the human-approved route, replace the flat checklist with a branching evidence map. The evidence for a home alteration is not the evidence for a vehicle modification. The amount questions for a hired aid differ from those for a structural change. One common spine can feed those branches, but it cannot replace them.

Which statutory branch applies first?

The current in-force Safety, Rehabilitation and Compensation Act 1988 is Compilation No. 82, with a compilation date of 1 July 2026. Its subsection 4(1) definition of medical treatment includes the supply, replacement or repair of an artificial limb or other artificial substitute, or of a medical, surgical or other similar aid or appliance. Section 16 then addresses reasonable medical treatment obtained in relation to an injury and the appropriate amount of compensation. The SRC Act keeps those routes distinct for a reason.

Comcare's current medical-treatment guidance reduces the section 16 analysis to four sequential questions for claims managers: whether the service is medical treatment, whether it relates to the compensable injury, whether it was reasonable to obtain in the circumstances, and what amount is appropriate. A practitioner's recommendation does not automatically turn an object or activity into medical treatment.

Section 39 serves a different function. Comcare's section 39 guidance says items for treating the injury are not payable under section 39 and may instead be considered under the medical-treatment provisions. It describes a section 39 aid or appliance as an item that assists with basic personal or work functions or supports a return to work.

That does not create a safe keyword rule. "Pain relief" does not conclusively mean section 16. "Independence" does not conclusively mean section 39. Record what the requested item is intended to do, which statutory characteristics the evidence supports, and what remains ambiguous.

Nor are sections 16 and 39 the only possible destinations. Comcare's section 39 guidance notes that section 37 may be relevant to aids or alterations connected with a rehabilitation program, and employers will generally bear workplace-adjustment costs. A general household item may not fit the claimed route at all. The branch gate should therefore include OTHER ROUTE OR HUMAN ADVICE REQUIRED, not force a binary answer.

For a self-insured licensee, role labels matter. Although section 16 names Comcare, subsections 4(10) and 4(10A) substitute the licensed authority or corporation for provisions outside the listed exclusions. Section 39 directly names the relevant authority, defined for an employee of a licensee as the licensee. For an employee of a licensed corporation, the rehabilitation authority is the principal officer, and Comcare's guidance says that authority can assess whether the employee is not capable of undertaking a program. Neither a case manager nor AI can invent that assessment or decision authority.

This prompt performs route triage only. A human delegate must read the source records, confirm the applicable route and document any referral to another function.

Build a route-only map for the de-identified request on [CLAIM_NUMBER].

Requested item or work: [REQUESTED_ITEM]
Accepted injury information: [INJURY_SUMMARY]
Stated purpose: [PURPOSE_EXTRACT]
Rehabilitation status evidence: [REHABILITATION_STATUS_EXTRACT]
Sources: [SOURCE_DOCUMENT_IDS]

Test these candidate branches separately:
1. section 16 medical treatment
2. section 39 alteration, modification, aid or appliance
3. another route, including section 37, an employer-provided workplace adjustment, or advice required

For each branch, show supporting source text, contrary text, missing facts and the statutory question a human must answer. Do not choose a branch, determine entitlement, infer impairment, treat a recommendation as approval or draft reasons. Mark the result ROUTE REVIEW REQUIRED.

What must a section 39 map prove?

Section 39 is not triggered merely because a useful item has been requested. Under subsection 39(1), the employee must have an injury resulting in impairment and must be undertaking or have completed a rehabilitation program, or have been assessed as not capable of undertaking one. The costs must be payable by the employee. The alteration, modification, aid or appliance must be reasonably required, having regard to the impairment and, where appropriate, the rehabilitation-program requirements.

The available categories are exact. They are an alteration to the employee's place of residence or place of work, a modification to a vehicle or article used by the employee, and an aid or appliance for the employee's use, including repair or replacement of an aid or appliance. Do not widen those words to include any purchase that could make daily life easier.

Build a common evidence spine before opening the relevant category branch:

• accepted injury and the identified impairment, each with a source anchor
• rehabilitation status and the human-made assessment or program record supporting it
• the exact requested work or item, intended function and person who recommended it
• the cost payable by the employee, quotes and any contribution from another source
• the functional difficulty said to be addressed, supported by the employee's account and appropriate professional evidence
• alternatives considered, likely duration, hire options and any earlier section 39 payment for the same need

Then apply only the branch that fits:

These branches reflect the matters in subsection 39(2). That subsection directs attention, where relevant, to the likely period of need; access and movement at home or work; vehicle access, driving, movement and safety; alternative transport; hire; and, where a place of residence or vehicle that received a compensated alteration or modification is later disposed of, any resulting increase in its value. Comcare's guidance also identifies alternatives and comparative cost as relevant considerations. The human decision-maker decides which matters carry weight and what amount is reasonable.

Keep a negative-branch log beside the map. It should record the routes tested and why each was retained, ruled out or left unresolved. That makes the routing choice reconstructable and stops a convenient checklist from quietly defining the law. It is the same source-anchor discipline that keeps statement summaries tied to their source IDs.

This prompt builds the evidence map only after a human has approved section 39 as the working route. A human must verify every source, resolve each gap and make the determination.

Create a section 39 branching evidence map for de-identified claim [CLAIM_NUMBER]. The human-approved workflow branch is [RESIDENCE_OR_WORK_ALTERATION / VEHICLE_OR_ARTICLE_MODIFICATION / AID_OR_APPLIANCE / AID_OR_APPLIANCE_REPAIR_OR_REPLACEMENT]. The last is an internal sub-branch of paragraph 39(1)(e).

Use only [SOURCE_DOCUMENT_IDS]. Create:
- a common spine for injury, impairment, rehabilitation status, cost payable by the employee, purpose, functional need and source anchors
- a category-specific branch applying only the relevant section 39(2) matters
- an alternatives branch covering suitable lower-cost options, hire, repair, warranty and other funding evidence where relevant
- a negative-branch log for section 16, section 37, employer responsibility and any unresolved route
- an exception list identifying contradictions, missing dates, unsupported assumptions and stale quotes

Quote short source phrases with document, page or paragraph anchors. Do not find impairment, approve rehabilitation status, select a statutory route, decide what is reasonably required, calculate compensation or draft a determination. Label every conclusion HUMAN DECISION REQUIRED.

Fictional worked example

This scenario is fictional and de-identified. [CLAIMANT_NAME] requests [REQUESTED_ITEM], described in one treating note as helping with pain and in an occupational assessment as assisting transfers and daily independence. The file records an accepted injury, but the extract supplied to the model does not identify the impairment finding, operative rehabilitation status, exact product specification or who would bear the cost.

A flat checklist might mark "medical recommendation present" and move straight to price. The branch gate instead retains possible section 16 and section 39 routes, then identifies the missing role and threshold records. If a human approves section 39 as the working route, the evidence map opens the aid-or-appliance branch and asks about function, suitability, duration, hire, repair, warranty, alternatives and source-anchored cost. The completeness of that evidence pack matters for the same reason it does when normal weekly earnings evidence is assembled: the decision-maker must be able to reconstruct the basis of the decision.

The model does not resolve whether pain relief or functional support is the dominant statutory character. It does not infer impairment from diagnosis. It does not treat the occupational assessment as a determination. The relevant authority reviews the full evidence and records the route, entitlement and amount decisions.

Comcare's claimant application page tells Comcare-managed claimants to obtain approval before purchase and distinguishes employees of self-insured licensees, whose claim is managed by their organisation or third-party provider. A licensee should therefore use its own controlled intake path, delegations and correspondence, rather than copying Comcare's customer form as though it were the licensee's procedure.

Do this Monday

1. Add the branch gate. Put section 16, section 39 and other-route review before every aids, appliances and modifications checklist.
2. Lock the role fields. Record the relevant authority, rehabilitation authority, authorised decision-maker and applicable delegation. Do not let AI populate legal authority from a job title.
3. Create the common spine. Require source anchors for injury, impairment, rehabilitation status, requested function, cost payer and recommendation.
4. Build three statutory branches. Add a repair-or-replacement evidence sub-branch within aids and appliances.
5. Retain rejected paths. Save the negative-branch log and unresolved questions with the claim record.
6. Test with fictional files. Use contradictory and incomplete scenarios before applying the workflow to de-identified operational material, then require human review of every output.

Bottom line

Section 39 does not begin with a shopping list. It begins with the statutory route, threshold and category. AI can expose competing routes, assemble a source-anchored evidence map and show which branch is incomplete. It cannot decide whether an item is medical treatment, find impairment, approve rehabilitation status or determine what compensation is reasonable.

This article is general information and education only. It is not legal advice, and it is not advice about any individual claim. Decisions under the Safety, Rehabilitation and Compensation Act 1988 are made by human decision-makers on the individual merits of each claim, and claimants have reconsideration and review rights in respect of determinations. Seek advice specific to your scheme and circumstances.

References

1. Federal Register of Legislation, Safety, Rehabilitation and Compensation Act 1988, Compilation No. 82, compilation date 1 July 2026. https://www.legislation.gov.au/C2004A03668/latest/text
2. Comcare, Scheme guidance - Compensation for certain alterations, modifications or aids and appliances. https://www.comcare.gov.au/scheme-legislation/src-act/guidance/compensation-for-alterations-modifications-aids
3. Comcare, Scheme guidance - Definition of medical treatment. https://www.comcare.gov.au/scheme-legislation/src-act/guidance/definition-medical-treatment
4. Comcare, Aids, appliances and modifications. https://www.comcare.gov.au/claims/supports-benefits/aids-applications