An improved workers compensation dispute resolution system commenced on 1 January 2019, following the passing of the Workers Compensation Legislation Amendment Act 2018.
The changes have made the Workers Compensation Commission the central body for workers compensation dispute resolution and have simplified the pathways for enquiries and complaints.
Changes to dispute pathways
The Workers Compensation Independent Review Office (WIRO) now manages all enquiries from workers, or made on behalf of workers, as well as complaints about the conduct of the insurer regarding the handling of their claim.
SIRA assists workers who have a complaint about their employer or a provider (for example, a treatment provider). SIRA also manages enquiries and complaints from employers and other stakeholders related to workers compensation.
Changes to dispute processes
The Workers Compensation Commission is now the central body for resolving workers compensation disputes. A worker may choose one or both of these options:
- the worker (or their legal representative) can ask for an optional review of the decision by the insurer, by someone other than the person who made the initial decision, or
- the worker (or their legal representative) can lodge a dispute directly with the Commission.
Note: Workers who requested an internal review by the insurer of a work capacity decision prior to 1 January 2019 are not able to lodge a dispute with the Workers Compensation Commission.
- Insurers must issue a decision notice which clearly outlines the reasons for the decision and the impacts on the worker’s entitlements.
Workers can contact a lawyer if they are unsure about what the insurer’s decision notice means or if they would like to challenge the decision. WIRO has a list of approved lawyers who can give advice which may be at no cost to the worker. The list is available on the WIRO website www.wiro.nsw.gov.au. Workers can also call WIRO on 13 94 76 or email: firstname.lastname@example.org
Consultation and implementation
SIRA consulted widely with key stakeholders, including industry representatives and the public, on the implementation of the improved workers compensation dispute resolution system and the development of supporting regulations and guidelines.