What to do when your request to use a SIRA funded program has not been approved.
Download a PDF fact sheet of this information.
Talk to the insurer
If there is a disagreement about the use of a SIRA funded program you should speak to the insurer and ask them to review their decision. If you need help to do this a member of your support team can assist you.
You may wish to provide additional information to support your request or application.
Appeal a decision
If a review has been completed by the insurer and you are not happy with the decision you can appeal. You can also appeal if your application was assessed by SIRA.
To appeal you must email or write to SIRA outlining your reason and include:
- confirmation that the insurer has completed a review of their decision and reason(s) why the insurer has not approved your application (not required if your application was assessed by SIRA)
- supporting information to address SIRA funded program principles (if applicable)
(for example, medical or workplace rehabilitation reports; course or service information)
- information about any other relevant workers compensation dispute process that you are involved with (if applicable).
Send your request with any supporting information to:
Mail: Director, Claimant Outcomes
State Insurance Regulatory Authority
Locked Bag 2906
Lisarow NSW 2252
SIRA will confirm that your appeal has been received within two working days and let you know if any further information is required. If you are appealing a decision from SIRA a different decision maker will be assigned to assess your appeal.
If you are appealing an insurer’s decision and new information has been provided SIRA will:
- ask the insurer to review this information and make a new decision
- advise you if the insurer approves the SIRA funded program application and close your appeal.
If the insurer does not change their decision or you are appealing a decision made by SIRA, SIRA will:
- contact you or the insurer to discuss your appeal and if necessary request further information
- assess your appeal and advise you of the outcome within 10 working days of receiving all the necessary supporting information needed to make a decision about your appeal
- provide you with an opportunity to respond
- send you and the insurer a letter to confirm the outcome of your appeal outlining the reason(s) why your SIRA funded program application may or may not have been approved.
For more information contact SIRA on 13 10 50.