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I've made a claim for compensation for an injury sustained at work, which has been declined...what do I need to do?

I’ve made a claim for compensation for an injury sustained at work, which has been declined…what do I need to do?

Published on June 30, 2021

First published by BlueStar – AFPA Magazine, June 2021 Edition.

Once you receive a determination from Comcare you have 30 days to submit a Reconsideration Request Form to Comcare. The form is available on the Comcare website. You must include reasons for requesting the reconsideration, and any supporting documents.

Reconsideration requests are generally made on the following grounds:

  • Insufficient investigation of the claim
  • Comcare did not consider relevant information
  • You did not have the opportunity to respond to adverse information
  • You have new information to provide at review

In the request it for reconsideration it may be necessary to submit your own independent medical report.

If you intend to submit further documents which you are unable to obtain within the 30 day period, you should lodge the Reconsideration Request Form and in your covering letter request further time to obtain the outstanding documents.

Comcare will then consider your request for reconsideration and issue a Reviewable decision. The Reviewable decision may confirm the initial determination or replace it with a new decision.

I am still not satisfied with the Reviewable Decision – What do I do next?

Once you have received the Reviewable Decision from Comcare you have 60 days to file an Application for Review of Decision Form in the Administrative Appeals Tribunal (AAT). This form is available on the AAT website.

If you have not already done so you may wish to engage a lawyer to advise and appear for you in the AAT.

The AAT will list your matter for a telephone conference. If you are represented by a lawyer, you will not need to attend the telephone conference.

During the telephone conference the AAT Conference Registrar may make orders for the production of documents under Summons, filing of witness statements and service of other evidence. It is unusual practice for there to be more than one telephone conference.

In a later telephone conference the AAT Conference Registrar may list the matter for a Conciliation Conference (if appropriate) prior to listing the matter for hearing before a Member of the AAT. The hearing will be at the AAT venue closest to your residential address.

A Conciliation Conference is an informal meeting to discuss resolution of your claim with Comcare’s legal representative. You will need to attend the Conciliation Conference. If you have instructed a solicitor to act for you, that lawyer and a barrister may also attend. A Registrar of the AAT will attend. Any discussions between the parties are confidential.

You will attend conferences with your solicitor and barrister to prepare you for the hearing.

You will need to attend every day of the AAT Hearing and you will likely be required to give evidence and be cross examined by Comcare’s Barrister.

The AAT member will give a decision. The decision may be given orally at the time of the hearing or it may be a written decision. Unfortunately there is no prescribed time limit for written decisions to be made.

If you receive a decision in your favour from the AAT you will be entitled to claim part of your costs from Comcare. These costs are known as Party/Party costs. In most cases there will be a gap between the Solicitor/Client costs and the Party/Party costs, which will be payable by you.

I was not successful in the AAT – What do I do now?

Once you receive a decision from the AAT you have 28 days to file an appeal in the Federal Court of Australia (FCA). An appeal to the FCA can only be made on a question of law. Your solicitor and barrister will advise you whether an appeal of the AAT decision has reasonable prospects of success.

Should you have any questions regarding your rights in workers’ compensation or have been injured at work, please contact our offices to speak with highly experienced experts in workers compensation for further advice.

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