After the insurer has completed the internal review (or has not completed the review within 30 days of the application), you may seek a merit review of the insurer’s work capacity decision.
You must apply for a merit review within 30 days of:
- receiving the internal review decision, or
- the due date of the internal review decision if the insurer has not notified you of its decision.
An application must be made using the Work capacity - application for merit review by SIRA and you must identify the reasons why you are seeking a review of this decision. You must also notify the insurer of the merit review application by providing them with a copy of the application. Further information on merit reviews can be found in the Merit review user guide .
We may decline to review a decision if the application:
- is not lodged in time
- is not on the approved form
- is or becomes frivolous or vexatious
- if you fail to provide information that might be requested