Workers’ requests for injury claim information are processed by the relevant Agent administratively or in line with s9 of the WIRC Act and these guidelines.
If any such request is sent to WorkSafe it will be referred to the relevant Agent for processing.
Applicants may seek access to their personal health information directly from the relevant service provider (IME Independent Medical Examiner / Independent Medical Examination, OR Occupational Rehabilitation) pursuant to privacy laws, such as the Health Records Act 2001 or in line with the existing internal arrangements or processes of the service provider.
Scope of request
The scope of request can cover any type of document, including electronic documents (eg email, ACCtion record). If unclear about the scope of the request, seek clarification by contacting the worker to confirm the scope of their request and the type of information they wish to access.
Any clarification must be confirmed by the Agent in writing to avoid any misunderstanding or confusion regarding timeframes and to avoid any unnecessary complaints.
Searches for documents
Agents are required to conduct thorough searches to locate all documents relevant to a request. Agents should review various sources, including:
- electronic systems
- hard copy documents
- surveillance footage, discs and reports.
In situations where no documents exist or where none can be found, the Agent's letter should provide a description regarding the nature of its inquiries and the searches undertaken and the Agent should advise the worker of their right to complain to the Agent and/or WIC Workcover Injury Commission via the complaint resolution processes.
The WIRC Act sets out a number of exemptions when access to information may be denied. The exemptions provided in the WIRC Act mirror the corresponding exemptions contained in the FOI Act.
Written notice of decision
When a request has been processed under the WIRC Act, the decision must be notified to the worker as soon as practicable after the request for information is received but no later than 28 calendar days after receipt of the request.
See: Notice of decision
Costs associated with the request
Workers seeking access to information and documents about their own claim file are not charged any fees associated with processing the request, such as photocopying charges, whether the request is processed administratively or under the WIRC Act.
A summary of the WIRC Act process is set out in the following table:
|How to apply?
|Time period to process request
(Information that may not be available)
(e.g. photocopy, inspection)
|Review rights - dispute resolution
|Time to apply for review/dispute resolution
A request for information may be made by:
- a worker or
- a person authorised by the worker to obtain the information.
Note: For the purpose of these guidelines any reference to a worker includes the worker’s authorised representative.
A valid request
A request must clearly describe the document or documents being requested.
The request may be made directly to the Agent that manages the claim and which holds the requested documents.
If a request is received from an authorised representative, it must be accompanied by a current (ie dated within two years of the request) signed written consent or authority which corresponds with the information available via ACCtion.
Agents are to assist workers so that they can lodge a valid request.
An Agent may accept a verbal request made in line with the WIRC Act by:
- the worker or
- an authorised representative (if a written authority is on file)
The caller needs to provide the full name of the worker and their identity must be clearly established. The caller must be able to identify at least three of the following:
- worker’s address (mandatory)
- claim number
- date of birth
- employer details
- date and nature of injury
- treating doctor's name
- PIAWE payable (where applicable).
If there is any doubt that the caller is authorised to request information on behalf of the worker, the Agent must contact the worker for confirmation.
For example Where there is no written authority on file or the authority is out of date.
Where a verbal request is accepted, the Agent should:
- make a written record of the request
- repeat it to the worker
- request confirmation from the worker that the Agent's written record accurately reflects the request.
There is no prescribed form for written requests.
If a worker authorises another person to make a request on their behalf, written consent or an authority must be provided.
Where workers nominate a lawyer/legal firm to represent them but the relevant authority is not dated, the Agent may use the date on any cover letter that accompanies the authority as the date of the authority.
If a request for access to information does not include a current authority (ie one which is more than two years old) the Agent must contact the worker to confirm that an authority exists and make a note on the file before processing the request.
To assist workers, request forms are provided via Requests under WIRC Act.
Agents can release information to the worker or where an appropriate authority exists, to the worker's representative.
There are two types of authorised representatives who may act for a worker, including seeking access to a worker’s information.
The worker may nominate a person to represent them. This can be a union representative, solicitor/lawyer, family member or friend.
A worker must have the legal capacity to nominate a representative. Legal capacity means the capacity of an adult to make reasonable decisions about themselves, their circumstances or their financial or legal affairs that may affect their entitlements.
Legal capacity is presumed unless there is clear evidence of a disability sufficient to remove legal capacity. If concerns are raised about a worker’s legal capacity, Agents must refer the matter to the Medical Advisor to discuss with the worker’s treating practitioner.
An Agent must provide the nominated representative with any information that a worker would be entitled to access.
Legally appointed representatives
A worker can have a legally appointed representative because the worker lacks legal capacity to act for themselves. Legally appointed representative means:
- a guardian if a worker is under the age of 18 years
- an administrator appointed under an Order of the Guardianship and Administration Board
- a litigation guardian appointed by Court Order if the communications and information sought to be accessed relates to those court proceedings.
- an attorney acting pursuant to a general or enduring power of attorney
Note: Attorneys acting under a general power of attorney cannot continue to act if a worker subsequently lacks legal capacity.
Upon provision of the relevant proof of appointment, an Agent must provide the legally appointed representative with any information that a worker would be entitled to access.
Where this Claims Manual refers to a 'worker' being able to access information, a worker’s representative is also entitled to access such information as long as they have been appointed as set out in this chapter.
A worker seeking access to documents about their own claim file is not charged a fee or any costs associated with the provision of information and documents from that claim file.
This applies to requests for administrative access or under the WIRC Act.
Requests not related to workers own file information
A request for information not in relation to an injury claim file must be made under the FOI Act directly to WorkSafe’s FOI team.
A request for information for injury claim information by a person other than the worker without a written authority from the worker must be declined.
Employer access to claim information
Requests from employers for information that they originally provided or received may be processed administratively or outside the WIRC Act. This includes normal claims management processes as set out in Agent Operating Principles.
For employer related requests/communications please refer to the relevant WIRC Act provisions, applicable policy and relevant sections in the Claims Manual including but not limited to:
- Employer's access to information
- General right of access for employers
- Employer’s representatives - access to information
- Employer written request for reasons for a decision