6.2.3.4 Worker responds to notice of entitlement
By | Action |
---|---|
Worker |
The worker must complete and return the Worker’s Response Form attached to the Notice of Liability and Entitlement within 60 days. The worker may respond in the following ways:
Note: If worker disputes the liability determination in respect for one or more injuries claimed, the worker does not have to respond as to whether they accept or dispute the determinations of assessment or calculation of entitlement. |
Agent |
If worker disputes the impairment assessment If the worker disputes the impairment assessment, the Agent will refer the claim to the Medical Panel within 14 days. The Agent to refer/provide to the Medical Panel:
Agent may make a submission to Medical Panel A Medical Panel referral may include submissions by the Agent. The submission may:
|
Worker's solicitor | A worker’s solicitor may make submissions to the Medical Panel. If the Agent is provided with a copy of the submissions, they may reply to any submissions and if necessary seek advice from WorkSafe’s Impairment Benefit Team. |
Medical Panel |
The Medical Panel must:
The Medical Panel opinion is binding on all parties including the courts. |
Agent |
When the Agent receives the Medical Panel’s opinion, they must send the worker a revised Notice of Entitlement within 60 days. Note: At this time the Agent is not required to re-issue the determination of liability. |
Worker |
If worker accepts the impairment assessment The worker is able to accept or dispute in full the physical determination and accept or dispute in full the psychiatric impairment determination. A worker cannot accept or dispute only part of the physical or psychiatric impairment determination/s. |
Agent |
If worker accepts both the assessment and the calculated entitlement If the worker accepts both the impairment assessment and the calculated entitlement the Agent pays the worker his or her entitlement within 14 days. See: Pay worker impairment benefit If worker accepts the impairment assessment and disputes the calculated entitlement If the worker accepts the impairment assessment and disputes the calculation of entitlement (for example the way the formula is applied), the Agent must review the claim file to ensure that the correct entitlement has been calculated. If the correct entitlement has been calculated, the Agent should then contact the worker to confirm this. If the worker is not satisfied they can refer the dispute to conciliation. If the Agent has incorrectly calculated the worker’s entitlement they should contact the worker to resolve the matter and issue a revised Notice of Entitlement/Notice of Liability and Entitlement. |
WorkSafe |
If conciliation fails and the dispute is referred to court, the Agent must refer the worker’s claim to WorkSafe’s Impairment Benefit Team, which then allocates a panel solicitor to represent WorkSafe and the Agent in court. |