Gym and pool memberships enable clients to access gym or pool facilities to carry out independent exercise-based rehabilitation programs that are developed and monitored by an allied health professional. The aim of a gym or pool membership is to empower the client to manage their injury through independent exercise without the need for regular treatment from their allied health provider.

The TAC can pay the reasonable cost of a gym or pool membership when it is required as a result of transport accident injuries and:

• The membership is recommended and monitored by a registered medical practitioner, physiotherapist, osteopath, chiropractor or accredited exercise physiologist.
• The prescribed exercise cannot be performed in the client’s usual settings, such as their home or workplace, and requires access to specialised facilities.
• The membership will assist the client in the transition from provider-based treatment to a self-managed program where appropriate.

Where a pre-existing condition has become aggravated as a result of a transport accident, the TAC will consider the extent to which the transport accident has exacerbated the pre-existing injury when making a decision about paying for the membership.

For accidents that occurred prior to 14 February 2018 a medical excess may apply.

The TAC may pay the reasonable cost of an initial 3-month gym or pool membership for eligible clients. The reasonable cost should reflect costs charged to the general public which may include the joining fee and membership fee. Subsequent memberships will only be approved where clinical justification is provided by a treating medical professional, physiotherapist, osteopath, chiropractor or exercise physiologist. Clients will be responsible for the cost if they wish to continue with a gym or pool membership beyond the TAC approved membership period.

The TAC may consider paying for memberships of a longer duration for clients with severe injury as part of their MyPlan.

The TAC will pay for travel to and from a gym or pool for eligible clients in line with the TAC Travel and accommodation policy. The facility must be in a practical location, within a reasonable distance from the client’s home or work.

The TAC won’t pay for:

• services that are not required for the treatment of transport accident-related injuries
• services that are not evidence based, reasonable, clinically justified and outcome focused.

This includes:

• Personal training.
• Memberships for general health, fitness or wellbeing purposes.
• Memberships for general health and fitness group classes, such as pilates, yoga and spin classes. The TAC may pay for group exercise when provided by a registered allied health practitioner when clinically justified as part of an approved treatment plan.
• Exercise clothing, footwear or swimming equipment.
• Swimming lessons.
• Hire of equipment for at-home gyms unless clinically justified and approved as part of a MyPlan for clients with severe injury and permanent disability.

Further information can be found at What we cannot pay for.

An initial gym or pool membership must be requested by a registered medical practitioner, physiotherapist, osteopath, chiropractor or accredited exercise physiologist on the TAC Gym and Pool Membership Request and Evaluation Form.

Gym and Pool memberships must be undertaken at one the following types of commercial facilities designed for public use:

• a gymnasium equipped for various modalities of exercise
• a swimming pool or aquatic centre.

The facilities must:

• hold current public liability insurance
• have a privacy policy
• employ staff who:
  • hold a minimum Certificate III / IV in Fitness or are accredited by AUSactive
  • hold a current first aid certificate.

To request a subsequent membership, supervising health professionals are expected to report on client progress using valid outcome measures on the Gym and Pool Membership Request and Evaluation Form. The TAC will use this information to consider if the membership continues to be reasonable, clinically justified and outcome focused.

The TAC uses the following principles to make socially and economically responsible decisions in line with the Transport Accident Act 1986:

1. Entitled

A TAC client is entitled to a gym or pool membership if the TAC has accepted liability for the accident-related injury that relates to the gym or pool membership.

2. Reasonable

When determining whether a gym or pool membership is a reasonable cost in the circumstances, the TAC considers whether:

• the exercise program can only be performed in a gym or pool facility
• is a reasonable cost.

3. Clinical justification

When deciding if a gym or pool membership is clinically justified, the TAC considers whether:

• The membership has been recommended by a medical practitioner, physiotherapist, osteopath, chiropractor or exercise physiologist.
• Clinical benefit is evidenced by improved scores on validated outcome measures.
• The membership promotes self-management, participation and return to work/health.
• The duration of the program is appropriate in relation to the client’s condition. These factors are assessed on a case-by-case basis. The TAC expects that most clients will not require a gym/swim service beyond the initial 3-month membership. Some clients with severe injury and permanent disability may require longer term memberships in order to maintain function and independence.
• The membership will support the client to transition from provider-led treatment to independent exercise and injury self-management. The TAC expects that the frequency of provider-led treatment will reduce as the client engages with a gym or pool membership.

4. Outcome focused

When deciding if a gym or pool membership is outcome focused, the TAC considers whether the membership is progressing or achieving individualised recovery or participation goals that are meaningful to the client.

For more information on TAC decision making see the How we make decisions page.