6.1.3.3 Panel firm investigates claim

Death and dependency claims, including claims for medical and like expenses only, must be referred to a panel firm. The panel firm provides advice about:

Note: Where a claim is for medical and like expenses following a work-related An injury/disease is work related if it arose out of or in the course of employment and the scope of employment. death where the deceased worker left no dependants, Agents can determine liability for the death of the worker for medical and like expenses only.

Process

Follow the steps for investigating a death and dependency claim.

By Action
WorkSafe

When notified that a death and dependency claim has been received and registered:

  • allocate the claim to an approved panel firm

  • advise the panel firm of the allocation

  • advise the Agent of the allocation

  • update ACCtion

See: Approved panel solicitors

Agent

Notify the following parties that panel firm has been appointed:

  • the employer

  • the legal representative of the dependant/s or claimant/s

  • the dependant or claimant if not legally represented.

Notification can request copies of accounts or receipts for medical and like expenses, in particular burial or cremation expenses.

Payment cannot be made until liability has been accepted for the claim.

Review the claim to ensure the employer liability (excess) is met where applicable.

See: Employer threshold

Panel Firm

Manage the conduct of the claim:

  • obtain further necessary information
  • arrange where practicable
  • a conference with the claimant’s legal representative
  • a peer review with WorkSafe and Agent representatives
  • exchange information with the dependant or claimant or their legal representative
  • within 90 days from the Agent receiving the claim, make recommendations to the Agent as to the acceptance of liability for the claim and the dependency of each dependant who has made a claim.

Note: The period taken to make a decision on liability (90 days) may be extended in exceptional cases based on the circumstances of the claim and where the panel firm, the dependant's or claimant’s legal representatives and WorkSafe agree.

For information on how the panel firm investigates the claims see: Responsibilities of the panel firm | Guidelines for Claims for Compensation following the Death of a Worker

Agent

Regularly liaise with the panel firm to:

  • ensure the investigation is completed in a timely manner
  • discuss the progress of the investigation, for example, if further information or documentation is required
  • assist with obtaining necessary information from the dependant/s or claimant/s to complete the investigation
  • attend peer reviews with WorkSafe and the panel firm.

If the claim relates to dependency entitlements (particularly weekly pensions) follow up:

  • the panel firm for:
  • progress on establishing dependency
  • the employer for confirmation of:
  • the deceased worker’s PIAWE
  • employment, contracts, etc
  • the dependant/s for the following forms, to enable speedier processing of their entitlement if liability and dependency are accepted:
  • Tax File Number (TFN) Declaration forms for each dependant, advising without this form, pension payments will be taxed at the highest rate applicable under the current Australian Taxation Office (ATO) rules
  • Electronic Fund Transfer (EFT) forms for each dependant (should the dependant want to receive pension payments directly into their bank account).

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