How are declined claims decided by the Workers Compensation Commission?

If you have any aspect of your claim for workers compensation declined by a S.74 Notice your lawyer will make an Application to the Workers Compensation Commission (WCC) to appoint an independent Arbitrator to hear and determine the issues in dispute.

The process is as follows;

  1. Your lawyer files an Application for Dispute resolution with the WCC which includes all evidence to be relied upon.
  2. The Insurer or its lawyer must file a reply with their evidence within 28 days.
  3. The matter is reviewed by the WCC and a telephone conference is appointed usually 28 days later.
  4. You are notified by the WCC of the date and time of the telephone conference.
  5. You should attend the telephone conference in person at your lawyer’s office or via the telephone.
  6. At the telephone conference the Arbitrator will discuss the matter and the issues in dispute. The Arbitrator will attempt to resolve the matter by agreement. If not the Arbitrator will make orders for further preparation of the claim and list the matter for a face to face Conciliation/Arbitration Conference. Your lawyer will do the majority of the talking at the telephone conference.
  7. Your lawyer will then confirm in writing the date and time of the Conciliation/Arbitration Conference which is usually 28 days following the telephone conference.
  8. If further preparation is necessary your lawyer will contact you for further information.
  9. The Conciliation/Arbitration Conference has two phases;
    1. The Conciliation phase - the Arbitrator will discuss the issues and see if the parties can reach agreement, if no agreement can be reached the matter proceeds to;
    2. The Arbitration phase – the lawyers are asked to make submissions outlining what the outcome of the claim should be and occasionally questions are asked by the Arbitrator about the claim. The Arbitrator then makes a written decision within 21 days.
  10. The Arbitrators decision is final and binding on both you and the insurer unless the Arbitrator has made an error of law.
  11. The outcome is confirmed by the WCC 28 days later.
  12. The insurer will then pay the compensation awarded to you.
  13. Usually 10% of that lump sum is deducted and sent to Medicare as a deposit until it has been determined if Medicare is owed any money.