7.5 Workers' Compensation Independent Review Service

The Workers’ Compensation Independent Review Service (WCIRS) is an independent review function within the Independent Review Division of General Counsel’s Office at Worksafe Victoria. The WCIRS provides injured workers with a quick and cost-effective review of certain Agent and WorkSafe ‘reviewable decisions’.

More information can be found on the WorkSafe website. WCIRS can also be contacted on (03) 4243 7061.

7.5.1 Request for independent review form

Workers can request an independent review through:

an online application portal: workers can fill in and lodge an application form using the online application portal.
PDF application form: workers can download the application form by clicking ‘Download PDF’, fill in the form electronically or in pen and returning it to WCIRS.
telephone: workers can call WCIRS who can assist them to fill out answers to the questions in the application form. The form will then be sent to the worker by email or post to review, sign and return to WCIRS by email or post.

7.5.2 When and by whom can an independent review be sought?

An independent review can only be sought by:

the worker to whom the decision relates,
a nominated person or representative who is 18 years or older, or
where the worker is under 18 years of age or under a legal disability, by a guardian or representative nominated by a guardian who is 18 years or older;

Unless there are exceptional circumstances, an independent review can be sought:

within 6 months of becoming aware of a 'reviewable decision' made by or on behalf of WorkSafe (unless the Worker referred a dispute to Conciliation within 6 months which remains unresolved); and
within 30 days of -
- a Workplace Injury Commission (WIC Workplace Injury Commission) Conciliation Officer issuing a Genuine Dispute A genuine dispute is one in which the parties cannot reach an agreement but the conciliation officer considers the dispute is genuine. Outcome Certificate (GDOC) relating to the decision; or
- a court revoking a direction issued by an WIC Conciliation Officer and finding there is a Genuine Dispute in relation to the decision; and
before a court or arbitration -
- listing the matter for a final hearing date for review of the decision, or
- referring a medical question relating to the decision to the 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 for assessment.

The WCIRS review will cease if the dispute is listed for a final hearing date or referred to a Medical Panel during an independent review.

Exceptional circumstances that allow a worker to apply for a WCIRS review outside deadlines

‘Exceptional circumstances’ are those which are out of the ordinary, unavoidable or unexpected.

Whether there are exceptional circumstances will depend on the worker’s particular situation. They are circumstances that:

are outside the worker’s control;
the worker could not reasonably have prevented or accommodated; and
have had a significant and demonstrably negative effect on the worker’s ability to apply to WCIRS within the prescribed time limit.

In the context of a WCIRS application, the fact a worker has suffered an injury requiring treatment will not ordinarily be considered an exceptional circumstance.

Please see the WCIRS exceptional circumstances policy on the WorkSafe website for further information.

7.5.3 Reviewable decisions

A ‘reviewable decision’ is a decision made by an Agent or WorkSafe under the workers’ compensation legislation that relates to:

a decision not to accept a worker’s claim, including a decision not to accept liability for an injury, condition or disease.
a decision relating to weekly payments, including a decision:
to stop, suspend or refuse to pay weekly payments;
about the calculation of weekly payments;
about whether a worker has or does not have a current work capacity Under the legislation, unless inconsistent with the context or subject-matter — current work capacity, in relation to a worker, means a present inability arising from an injury such that the worker is not able to return to his or her pre-injury employment but is able to return to work in suitable employment, declared training program or
a decision relating to medical and like expenses or services or
a decision relating to provisional payments for a claimed mental injury (except for those excluded below).

Decisions which are not reviewable by the WCIRS include:

to stop paying weekly payments because a worker's impairment is not 21% or more
a decision to stop paying weekly payments because WorkSafe considers that payments were obtained fraudulently
a decision about a worker’s impairment benefits entitlement, including a determination about liability for an injury or degree of impairment.
any decision relating to the death of a worker or their dependants
a decision to reject a claim for compensation (or a provisional payments entitlement) on the basis that the worker is not a worker (or a deemed worker) under the legislation

WIRC Sch 1c1

a decision to reject a claim for compensation (or a provisional payments entitlement) on the basis that the employer was not the correct employer of the worker at the time of the injury or death
any decision that is subject to a final Medical Panel determination
any decision that has been resolved by agreement between the Agent and the worker
any decision made by, or on behalf of, a self-insurer under the workers’ compensation legislation or
any decision relating to a Serious Injury or Common Law Damages application or
any other decision that is not otherwise listed as a ‘reviewable decision’.

7.5.4 Nominating a person or representative

Workers under the age of 18 years or who are under a legal disability must be represented by their legal guardian or a person or representative nominated by the worker’s legal guardian who is 18 years or over.

Workers over the age of 18 years do not need to be represented but can nominate a person such as a family member or friend, a legal representative or an organisation such as their union, Union Assist or WorkCover Assist to assist them.

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