3.9.12 Material change
'Material change’ is a concept linked to the Victorian Worker’s Compensation scheme and legislation. There is no formal definition of ‘material change’ under the legislation, however Agents are required to obtain and consider carefully all relevant evidence to determine whether there has been a ‘material change’.
A ‘material change’ needs to be one that is real and quantifiable to the degree that it can easily be demonstrated to have positively (or negatively) impacted the worker’s condition.
There are many situations during the life of a claim where ‘material change’ may trigger the Agent to review a worker’s entitlements, including situations where there has been a prior Medical Panel Under the legislation, unless inconsistent with the context or subject-matter — Medical Panel means a Medical Panel constituted under Division 2 of Part 12 opinion on the same issue.
Review timing
A re-evaluation of a worker’s entitlements by the Agent post a previous Medical Panel opinion on the same issue should not occur until a minimum of 12 months after the previous opinion. A longer period of time makes it easier to assess if there has been a ‘material change’ in the worker’s condition.
Any of the following may trigger an Agent to review for ‘material change’ in an injured worker’s circumstances post a previous Medical Panel opinion on the same issue.
Treatment
The change, addition or completion of a procedure or regimen, such as a drug, surgery, exercise, in an attempt to cure or mitigate a disease, condition or injury.
Symptoms
A measurable range of indicators that may be documented relating to changes in functioning tolerances eg via a structured physical or mental re-conditioning.
Return to work or training
Sustained ability to improve return to work activities or completion of further vocational training to improve transferable skills.
Sustainable decision making
An Agent when making a decision should be guided by the WIRC Act Workplace Injury Rehabilitation & Compensation Act 2013 as well as the principles of good administrative decision making. Evidence behind an Agent decision on ‘material change’ must be robust and therefore Agents are encouraged to refer to the Quality and Sustainable Decision Making Framework.