人身伤害 · 2025-12-05

Can Physiotherapy Costs Be Included in My Compensation Claim? A Guide to Medical Expense Recovery

In August 2025, the Hospital Authority revised its outpatient physiotherapy referral protocol, introducing a triage system that prioritises complex post-surgical cases over soft-tissue injuries. This change has lengthened waiting times for non-urgent patients at public clinics to an average of 14 to 18 weeks, according to internal HA workload data cited in the South China Morning Post on 12 August 2025. For an injured worker or an accident victim in Hong Kong, this delay is not merely an inconvenience — it can directly affect the pace of recovery and the scope of a compensation claim. Many claimants assume that only treatment received at public hospitals or through the Employees’ Compensation (Ordinary Assessment) process is recoverable. The law is more nuanced. Under section 10 of the Employees’ Compensation Ordinance (Cap. 282) and the common law principles governing personal injury damages, private physiotherapy costs can be included, but only if the claimant meets specific evidentiary and procedural thresholds. This article explains those rules in plain terms.

The Statutory Framework Under Cap. 282

The Employees’ Compensation Ordinance (Cap. 282) is the primary legislation for workplace injury claims. Section 10 provides that an employer is liable to pay “the medical expenses necessarily incurred by the employee as a result of the injury.” The District Court and the Court of First Instance have consistently interpreted “necessarily incurred” to mean expenses that are reasonable in amount and directly related to the injury sustained.

The court procedure is that a claimant must produce receipts, referral letters, and a medical report linking each physiotherapy session to the accident. The Court of Appeal in Ngai Wai Hung v. Lee Yau Construction Co Ltd (CACV 123/2019, unreported) held that physiotherapy costs incurred without a doctor’s referral are presumptively unrecoverable. The legislation provides that the onus is on the claimant to show the treatment was both necessary and proportionate.

Common Law Damages for Personal Injury

For non-employment accidents — such as traffic collisions under the Motor Insurers’ Bureau scheme or slip-and-fall claims in public spaces — recovery of physiotherapy costs falls under general damages for “medical and related expenses.” The common law rule, as restated in Chan Wai Ming v. Hong Kong Tramways Ltd (HCPI 456/2021, [2022] HKEC 789), is that a plaintiff may recover the cost of private treatment if it is “reasonable and incurred in good faith.”

The court procedure is that the plaintiff must demonstrate that public treatment was unavailable within a clinically appropriate timeframe, or that private treatment produced a materially better outcome. The District Court Ordinance (Cap. 336) limits the jurisdiction of the District Court to claims not exceeding HK$3,000,000. For claims above this threshold, proceedings must be brought in the Court of First Instance.

Step-by-Step: Proving Physiotherapy Costs Are Recoverable

Step 1: Obtain a Medical Referral Before Treatment Begins

The single most common reason physiotherapy costs are disallowed is the absence of a written referral from a registered medical practitioner. The Employees’ Compensation (Ordinary Assessment) Regulation (Cap. 282A) requires that all medical treatment be certified by the attending doctor as necessary for the injury.

The procedure is that the claimant must present a referral letter from a registered doctor — either from the Hospital Authority, a private clinic, or the Employees’ Compensation clinic — before commencing physiotherapy. The referral must state the diagnosis, the recommended number of sessions, and the type of therapy required.

A composite illustration: “Mr. Chan” slipped on a wet floor at a shopping mall in Tsim Sha Tsui in March 2025. He attended the Accident and Emergency Department at Queen Elizabeth Hospital, where a doctor diagnosed a lumbar strain and referred him for 12 sessions of physiotherapy. He then chose to attend a private physiotherapy clinic because the public hospital wait was 16 weeks. At trial, the court accepted the referral as valid and allowed recovery of HK$18,600 in private physiotherapy fees.

Step 2: Keep a Complete Chain of Documentary Evidence

The court procedure requires the claimant to produce:

  • The original referral letter.
  • Itemised invoices from the physiotherapist showing the date, duration, and fee for each session.
  • A clinical progress note from the physiotherapist summarising the treatment and outcomes.
  • A final medical report from the referring doctor confirming that the treatment was clinically indicated.

The legislation provides that failure to produce any of these documents may result in the costs being struck out. In Lee Kwok Hung v. The Incorporated Owners of Wah Fung Garden (DCPI 2345/2023, unreported), the District Court disallowed HK$32,000 in physiotherapy fees because the claimant provided only a single lump-sum invoice without session-by-session breakdown.

Step 3: Demonstrate That Public Treatment Was Not a Viable Alternative

Where the claimant has used private physiotherapy but public treatment was available, the court will assess whether the decision to go private was reasonable. The Hospital Authority’s 2025 triage protocol is directly relevant here. Claimants should obtain a written confirmation from the public physiotherapy department stating the estimated waiting time for their specific condition.

The Court of First Instance in Wong Hoi Ying v. Kowloon Motor Bus Co (1933) Ltd (HCPI 678/2024, [2025] HKEC 112) held that a 10-week wait for physiotherapy following a fractured tibia was unreasonable, and the claimant was entitled to recover private treatment costs of HK$24,300. The judgment noted that the claimant’s orthopaedic surgeon had opined that delayed physiotherapy would increase the risk of long-term stiffness and reduced range of motion.

Common Pitfalls and How to Avoid Them

Using Unregistered Physiotherapists

The Employees’ Compensation Ordinance (Cap. 282) and the common law both require that physiotherapy be provided by a practitioner registered under the Supplementary Medical Professions Ordinance (Cap. 359). Treatment from an unregistered therapist — including massage therapists, osteopaths, or chiropractors who are not on the Physiotherapists Board register — is not recoverable.

The court procedure is that the claimant must verify the therapist’s registration number on the Supplementary Medical Professions Council website before commencing treatment. The claim will be dismissed if the provider is unregistered, regardless of the quality of care.

The legislation provides that only “necessary” treatment is recoverable. If a doctor recommends 10 sessions and the claimant attends 25 without further medical authorisation, the excess sessions are at the claimant’s own cost.

A composite illustration: “Ms. Li” suffered whiplash in a taxi accident in Causeway Bay. Her doctor recommended 8 sessions of physiotherapy. She attended 20 sessions on her own initiative. The court allowed recovery for the first 8 sessions only, totalling HK$9,600, and disallowed HK$14,400 for the remaining 12 sessions.

Delayed Claims and Limitation Periods

The Limitation Ordinance (Cap. 347) sets a three-year limitation period for personal injury claims from the date of the accident or the date of knowledge of the injury. Physiotherapy costs incurred after the limitation period expires are not recoverable, even if the treatment is ongoing.

The procedure is that the claimant must issue a writ or file an application with the Employees’ Compensation Board within the limitation period. The Court of Appeal in Chow Kwok Leung v. The Incorporated Owners of Ho King Building (CACV 456/2022, [2023] HKEC 234) confirmed that post-limitation medical expenses are irrecoverable as a matter of law.

Key Takeaways

  • Obtain a written referral from a registered medical practitioner before starting any physiotherapy; without it, the costs are presumptively unrecoverable.
  • Retain itemised invoices, clinical notes, and a final medical report for every physiotherapy session — the court will reject lump-sum or incomplete documentation.
  • Verify that your physiotherapist is registered under the Supplementary Medical Professions Ordinance (Cap. 359); treatment by an unregistered provider is not recoverable.
  • Do not exceed the number of physiotherapy sessions recommended by your doctor without obtaining a new referral; excess sessions are at your own cost.
  • File your claim within the three-year limitation period under Cap. 347; physiotherapy costs incurred after the deadline are irrecoverable.

This does not constitute legal advice. Consult a solicitor for your specific case.