Appendix 1: Context and relevant provisions - Standard 24 - Factual investigations

Standard 24 - Factual investigations

Factual investigations play an important role in the workers compensation scheme; however, they can erode worker trust and must therefore be used judiciously.

Factual investigations involve the use of a third-party service provider to conduct an investigation to determine the available facts of a claim.

Factual investigations may be used to gather information to inform decision-making with respect to liability and other entitlements. Circumstances under which a factual investigation may be warranted include but are not limited to:

  • determining if a worker meets the legislative definition of a worker
  • where the issues surrounding the injury are unclear or disputed, or
  • when there may be potential for recovery from a third-party.

A factual investigation may involve an interview with the worker, employer and/or witnesses, as well as a physical inspection or other external enquiries required to determine relevant details. Factual investigators are not to provide an opinion on medical aspects of the claim.

Factual services should only be used when necessary and should be conducted in an ethical manner. Any information obtained must be used and stored appropriately.