Dispute Resolution Service Medical Assessments
In our last bulletin we provided an update on how SIRA's Dispute Resolution Service (DRS) is rapidly adapting the way its services operate to protect the wellbeing of injured people, stakeholders and our decision makers in light of the COVID-19 pandemic.
Since that time, DRS have been consulting with stakeholders with a view of how to resolve medical disputes, including proceeding with medical examinations under some changed conditions.
The COVID-19 situation is rapidly changing and DRS will continue to adapt arrangements to align with NSW Government policy, public health advice and legal requirements as required.
Please read the articles below for details on the current approach. Information will also be updated on the SIRA website.
Dispute Resolution Services in person medical appointments will be deferred subject to new procedures to adapt to COVID-19
DRS is adapting to COVID-19 with new approaches to medical disputes procedures consistent with the requirements of the Motor Accidents Compensation Act 1999 (1999 scheme), the Motor Accidents Injuries Act 2017 (2017 scheme) and relevant guidelines.
New procedures for medical disputes
Medical matters will be considered by DRS in accordance with Guidelines 7.153-7.159 of the 2017 scheme or Guidelines 9.10-9.18 of the Medical Assessment Guidelines (1999 scheme).
DRS will contact the parties involved to undertake a process to identify an appropriate pathway for resolution of the medical dispute on a case-by-case basis. Consideration will be given to the following factors:
- the urgency of the matter
- the potential impact of delay on the injured person
- any COVID-19 wellbeing risks for the injured person or the assessor
- options for other modes of medical assessment to enable dispute resolution, and
- the feasibility of safe arrangements for a face to face consultation where required.
DRS will consider an appropriate pathway for the dispute which may include:
- urgent matters which may proceed in person - this will be only under exceptional circumstances, and with the approval of the Executive Director, DRS
- matters which may proceed to a video conference or teleconference, such as a psychological examination
- matters which are suitable to be determined on the papers or by any other means in accordance with the relevant legislation and guidelines
- deferral of any disputes to a pending medical list
Parties may apply to restore a matter from the pending medical list at any time in accordance with these procedures.
DRS apologises for the impact that deferral may have on individuals seeking resolution in their dispute and any disruption or inconvenience to medical assessors.
DRS will be working to contact all parties systematically to confirm how the matters will proceed.
DRS will ask both insurers and legal representatives to identify any injured people with exceptional circumstances who may need special consideration due to the consequences of having their decision delayed.
Dispute Resolution Service is open during COVID-19
For general enquiries
Enquiries, help with claims, feedback, complaints or disputes with insurers or others 1300 656 919 or email: firstname.lastname@example.org