6.2.2.7 Worker non-attendance at IIA-HLA for IB claims

Note: the below applies to IB Impairment Benefits claim only. For 130 week IIA Independent impairment assessment non-attendance, refer to 2.7.3 Worker Compliance

These guidelines assist Impairment Specialists in:

managing worker non-attendance at an Independent Impairment Assessment (IIA) or Hearing Loss Assessment (HLA Hearing loss assessment)

identifying circumstances in which a claim can be suspended in line with s104B(1D) as a result of failure to attend an IIA/HLA.

WIRC s200(1)

AC s104B(5AA)

AC s104B(4)

AC s104B(2)

AC s104B(1E)

AC s104B(1D)

Guidelines for managing non-attendance at IIA/HLA

If a worker fails to attend an IIA or HLA, WorkSafe recommend that:

contact is made with the worker’s legal representative to confirm the non-attendance and determine the reason for this.
if deemed necessary by the Agent, the worker is to be advised of relevant legislation, via their legal representative, in particular:
the worker must at the request of WorkSafe attend an independent examination to be conducted by a medical practitioner
a worker can only make one claim for compensation for non-economic loss for injuries arising out of the same event or circumstance.
contact is made with the worker directly to advise that IIA/HLA will be rescheduled and to determine how to best facilitate attendance.
re-schedule IIA/HLA, where possible taking into consideration the reason/s for the non-attendance and accommodate the worker’s needs, including but not limited to:
worker time/day availability
arranging transport
providing directions via road/tram/train/bus
personal circumstances
reminder calls prior to exam.

In any event, Agents should suspend claims where the worker has not attended the required IIAs within 80 days on the basis that there is insufficient medical information to determine the claim.

WIRC s200(1)

AC s104B(1D)

Direct contact with the worker to facilitate attendance at an IIA/HLA is appropriate. It is, however, to be used solely for this purpose and not to discuss the workers intentions about their claim.

Details of contact with workers and their legal representatives are to be documented on ACCtion or Novus.

Should the worker contact their legal representative, the Agent or the Impairment Assessor to advise that they are unable to attend an IIA/HLA, the appointment is to be rescheduled.

The only circumstance in which an IIA/HLA should not be rescheduled is when the worker has been advised of the legislative requirements via their legal representative and has done one of the following:

provided written confirmation that they do not wish to pursue the claim
advised they refuse to be independently assessed for their IB claim
multiple unjustifiable Unjustifiable non-attendances remain at the discretion of the Agent and should be judged on a case by case basis, however, it is expected that the worker fails to attend a minimum of three scheduled IIAs without justification. non-attendances at scheduled IIAs.

Process

Step	Agent action
Worker does not want to pursue claim	If the worker advises at any stage that they do not wish to continue with the claim, despite being made aware of the relevant legislation, refer to the guidelines specified in the Request to withdraw, cancel or hold in abeyance Policy.
Worker refusal to attend IIA/HLA	Within 90 days from ARD If the worker advises they refuse to be assessed by an Independent Impairment Assessor, despite being made aware of their obligations and the claim is within 90 days of the Agent Received Date (ARD), the Agent is advised to suspend the claim in line with the legislation. WIRC s200(1) AC s104B(1D) This suspension is based on having insufficient medical information to make a determination including liability and/or the degree of permanent impairment of the worker resulting from the injury or injuries for which liability is accepted. These claims are to be managed in line with Suspend impairment process (Suspension Policy) as a suspension arising from insufficient medical information. Greater than 90 days from ARD If the worker advises they are not willing to attend an IIA despite being made aware of their obligations and the claim has exceeded 90 days from the ARD, refer to both Inactive Claim Policy and Request to withdraw, cancel or hold in abeyance Policy for guidance in how to manage the claim. Discuss the matter with the worker/legal representative to determine the workers intentions.
Multiple unjustifiable non-attendances	Within 90 days from ARD If the worker has multiple unjustifiable non-attendances at scheduled IIAs, despite being made aware of their obligations and the claim is within 90 days of the ARD, the Agent is advised to suspend the claim in line with the legislation. WIRC s200(1) AC s104B(1D) This suspension is based on having insufficient medical information to make a determination including liability and/or the degree of permanent impairment (if any) of the worker resulting from the injury or injuries for which liability is accepted. These claims are to be managed in line with Suspend impairment process (Suspension Policy) as a suspension arising from insufficient medical information. Greater than 90 days from ARD If the worker has multiple unjustifiable non-attendances at scheduled IIAs, despite being made aware of their obligations and the claim has exceeded 90 days from the ARD, the Agent is advised to refer to Inactive Claim Policy and Request to withdraw, cancel or hold in abeyance Policy. If the worker does not satisfy the criteria outlined within these policies, the Agent is advised to use their discretion in how to best manage the claim and should discuss the matter with the worker’s legal representative to determine the worker’s intentions about their claim.

Step

Agent action

Worker does not want to pursue claim

If the worker advises at any stage that they do not wish to continue with the claim, despite being made aware of the relevant legislation, refer to the guidelines specified in the Request to withdraw, cancel or hold in abeyance Policy.

Worker refusal to attend IIA/HLA

Within 90 days from ARD

If the worker advises they refuse to be assessed by an Independent Impairment Assessor, despite being made aware of their obligations and the claim is within 90 days of the Agent Received Date (ARD), the Agent is advised to suspend the claim in line with the legislation.

WIRC s200(1)

AC s104B(1D)

This suspension is based on having insufficient medical information to make a determination including liability and/or the degree of permanent impairment of the worker resulting from the injury or injuries for which liability is accepted.

These claims are to be managed in line with Suspend impairment process (Suspension Policy) as a suspension arising from insufficient medical information.

Greater than 90 days from ARD

If the worker advises they are not willing to attend an IIA despite being made aware of their obligations and the claim has exceeded 90 days from the ARD, refer to both Inactive Claim Policy and Request to withdraw, cancel or hold in abeyance Policy for guidance in how to manage the claim. Discuss the matter with the worker/legal representative to determine the workers intentions.

Multiple unjustifiable non-attendances

Within 90 days from ARD

If the worker has multiple unjustifiable non-attendances at scheduled IIAs, despite being made aware of their obligations and the claim is within 90 days of the ARD, the Agent is advised to suspend the claim in line with the legislation.

WIRC s200(1)

AC s104B(1D)

This suspension is based on having insufficient medical information to make a determination including liability and/or the degree of permanent impairment (if any) of the worker resulting from the injury or injuries for which liability is accepted.

These claims are to be managed in line with Suspend impairment process (Suspension Policy) as a suspension arising from insufficient medical information.

Greater than 90 days from ARD

If the worker has multiple unjustifiable non-attendances at scheduled IIAs, despite being made aware of their obligations and the claim has exceeded 90 days from the ARD, the Agent is advised to refer to Inactive Claim Policy and Request to withdraw, cancel or hold in abeyance Policy. If the worker does not satisfy the criteria outlined within these policies, the Agent is advised to use their discretion in how to best manage the claim and should discuss the matter with the worker’s legal representative to determine the worker’s intentions about their claim.

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