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Dispute Resolution Service (DRS)

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. 

We have prepared frequently asked questions that provide you with information about the impacts of COVID-19 on the determination of disputes.

We are updating this page regularly as the COVID-19 situation evolves. Please check back for updates.

For parties to a dispute in the workers compensation system, the Workers Compensation Commission’s website provides information about changes to the management of workers compensation disputes.

How will DRS adapt to resolve disputes?

We recognise that the COVID-19 situation is rapidly changing so we will continue to adapt arrangements to align with NSW government policy, public health advice and legal requirements as required.

This means that we need a new approach to medical dispute procedures that are consistent with the requirements of the Motor Accidents Compensation Act 1999, and the Motor Accidents Injuries Act 2017, and relevant guidelines.

We are reconsidering the way assessments and conferences are conducted during the COVID-19 pandemic and will deliver alternatives as soon as reasonably possible.

Make sure you visit this website or subscribe to the SIRA bulletin if you want to stay updated.

1999 Scheme CARS matters

All preliminary conferences will continue as usual by telephone with the Assessor and parties. It is a matter for the Claim Assessor, with the agreement of the parties, whether the assessment of the claim will proceed on the papers, by teleconference, by Skype video conferencing or will be deferred.

Procedures for teleconferences and video conferences

Preparation by parties and legal representatives

Parties must notify the DRS decision-maker details of who will be attending the conference including the following:

  • First and last name of all participants (e.g. the claimant, the insurer, legal representatives including Counsel, and any witnesses if required)
  • Whether an interpreter is required and if so which language
  • Email address of all participants
  • Best contact number for all participants.

It is a matter for parties and their legal representatives to determine the best way for them to conduct the teleconference or Skype video conference (i.e. at the same premises or at different locations) ensuring that the current COVID-19 health and safety requirements are adhered to.

Prior to the teleconference or Skype video conference, parties are encouraged to consult with each other, to maximise the likelihood that the matter will settle and to also identify any agreed issues and those still in dispute.

How will teleconferences run?

Assessors may use the Telstra teleconferencing service which DRS will set up in consultation with parties.

A Skype teleconference may also be used. This is the better option if an interpreter is involved.

Alternatively, the Assessor may use their own telephone system as used in Preliminary conferences.

How will Skype video conferences run?

Skype video conferences will be scheduled generally in the standard time slots of 10:00am and 2:00pm.

DRS has currently some limitations in the number of Skype video conferences which can be held in any week however we will always endeavour to meet every request.

DRS will set up and host the Skype video conferences.

What happens after the teleconference or Skype video conference assessment conference?

In accordance with cl 18.2 of the Claims Assessment Guidelines (CAGs) the Assessor will issue a certificate and statement of reasons within 15 days of the conclusion of an assessment conference.

On-the-paper assessments

If appropriate, an Assessor may determine, with agreement from the parties, that the assessment of the claim is suitable for assessment on the papers.

In accordance with cl 18.2 of the Claims Assessment Guidelines (CAGs) the Assessor will issue a certificate and statement of reasons within 15 days of the provision by the parties of all information and documentation sought by the Assessor on a date fixed by the Assessor.

Deferral of matters

Upon reviewing a matter, the Assessor may determine, with agreement from the parties, that the assessment of the claim is not suitable for assessment on the papers, or by teleconference or by Skype video conferencing and may either vacate an already scheduled assessment conference or defer the assessment of the claim until such time that in-person assessments conferences are permitted by DRS.

On-the-paper assessments

If appropriate, an Assessor may determine, with agreement from the parties, that the assessment of the claim is suitable for assessment on the papers.

In accordance with cl 18.2 of the Claims Assessment Guidelines (CAGs) the Assessor will issue a certificate and statement of reasons within 15 days of the provision by the parties of all information and documentation sought by the Assessor on a date fixed by the Assessor.

Deferral of matters

Upon reviewing a matter, the Assessor may determine, with agreement from the parties, that the assessment of the claim is not suitable for assessment on the papers, or by teleconference or by Skype videoconferencing and may either vacate an already scheduled assessment conference or defer the assessment of the claim until such time that in-person assessments conferences are permitted by SIRA DRS.

2017 Scheme claims and merit matters

Merit Review matters

  • Merit Review matters may be conducted on the papers or by teleconference or Skype videoconferencing as appropriate, (with the exception of face-to face meetings) in accordance with cl 7.203 of the Motor Accident Guidelines (MAGs).
  • The same procedures for teleconferences and video conferences, as outlined above, apply to Merit Review matters.
  • The Merit Review matter will be determined by a merit reviewer with a certificate and a brief statement of reasons for determination being issued to the parties within 28 days of the application being made (cl 7.214 and cl 7.215 of MAGs).

Miscellaneous claims matters

  • Miscellaneous claims matters may be conducted on the papers or by teleconference or Skype videoconferencing as appropriate, (with the exception of face-to face meetings) in accordance with cl 7.432 of the MAGs.
  • It is a matter for the Claim Assessor, with the agreement of the parties, whether the determination of the miscellaneous claims matter will proceed on the papers, by teleconference, by Skype videoconferencing or will be deferred.
  • The same procedures for teleconferences and video conferences, as outlined above, apply to Miscellaneous claims matters.
  • The Miscellaneous claims matter will be determined by a claims assessor with a certificate and brief statement of reasons being issued to the parties within 21 days of receipt of all relevant information, or as soon as practicable thereafter (cl 7.435 and cl 7.436 of MAGs).

Assessment of a claim for damages

  • A claims assessment may be conducted on the papers or by teleconference or Skype videoconferencing as appropriate, (with the exception of face-to face meetings) in accordance with cl 7.472 of the MAGs.
  • It is a matter for the Claim Assessor, with the agreement of the parties, whether the determination of the assessment of the claim for damages will proceed on the papers, by teleconference, by Skype videoconferencing or will be deferred.
  • The same procedures for teleconferences and video conferences, as outlined above, apply to claims assessment matters.
  • The claims assessment will be determined by a claims assessor with a certificate and brief statement of reasons being issued to the parties within 21 days of the assessment (cl 7.492 and cl 7.493 of MAGs).

Medical disputes

DRS will work with the parties to limit in person medical assessments and determine alternative methods of resolving disputes

Determining alternate pathways

  • The DRS will contact the parties to determine whether an alternative to in-person assessment can be used to determine a medical dispute
  • The DRS will instruct parties of the time, date and mode of assessment once determined.  This may take time, especially when alternate arrangements are made
  • DRS requires insurers and legal representatives to respond promptly to requests regarding the appropriate mode of assessment.

When an alternative pathway is not suitable

  • Any matters that are cancelled because the assessment can only proceed as an ‘in-person’ assessment, and there are no exceptional circumstances, the matter will be placed on a pending medical matters list for allocation as soon as practicable.

Exceptional circumstances

  • Parties should advise the DRS if a matter that cannot be progressed with an alternate approach should continue to be considered for in-person medical assessment due to exceptional circumstances. This may include, but is not limited to:
    • A decision is required to determine an entitlement to a statutory benefit
    • A decision is required for an urgent claims assessment matter
    • The Claimant has a terminal illness
    • The Claimant has financial hardship
    • The Claimant has travel, residency or visa restrictions
    • A dispute matter is currently in court

In-person assessments require approval of the Executive Director at DRS to proceed.

When an ‘in-person’ assessment is approved

  • DRS will work with medical assessors conducting ‘in-person’ assessments and confirm that assessments proceed in line with NSW Public Health Orders.

Other frequently asked questions

What if a dispute is already in progress?

We have deferred all in-person medical appointments subject to new procedures.

We will contact the parties involved in disputes to identify an appropriate pathway for resolution of the medical dispute on a case-by-case basis, after consideration of factors which include:

  • the urgency of the matter
  • the potential impact of delay on the injured person
  • any COVID-19 wellbeing risk for the injured person or assessor
  • options for other modes of medical assessment to enable dispute resolution and
  • the feasibility of safe arrangements for face to face consultation where required.

The appropriate pathway for the dispute may include determination ‘on the papers’, via video conference or teleconference or deferral. Urgent matters may only proceed in-person in exceptional circumstances, and only with the approval of the Executive Director, DRS.

The parties may apply to restore a matter from the pending medical list at any time in accordance with these procedures.

We apologise for the impact that deferral may have on individuals seeking resolution in their dispute, and any disruption or inconvenience to medical assessors.

What if I have an upcoming medical assessment?

We will contact you to confirm how the matters will proceed.

I’m concerned that it will be detrimental for the claimant if the decision is delayed. What should I do?

We will ask both insurers and lawyers to identify any claimants with exceptional circumstances who may need special consideration due to consequences of having their decision delayed. They can contact us on 1800 34 77 88.

Is SIRA’s Dispute Resolution Service still open?

We are still open and continuing to provide essential services.

We will continue to accept and manage applications for disputes and will progress all matters as far as possible within the COVID-19 restrictions and approach described here.

We are expediting our digital capability and ask stakeholders to submit documents by e-mail to support this endeavour. This will enable a greater number of matters to proceed during this time.

How will DRS adapt to resolve disputes?

Where possible, DRS determination of disputes will be held by teleconference or ‘on the papers’ to reduce in-person contact.

How should I lodge documents?

You should submit all file material electronically via our email address drsenquiries@sira.nsw.gov.au. This includes lodgement of applications, replies, submissions and all other correspondence. Stakeholders should not lodge material in-person at the DRS office.

Contact

Our team is here to support you at this challenging time. Phone: 1800 347 788 or email: drsenquiries@sira.nsw.gov.au