Agents provide documentation
Within seven working days of receiving the aplication for conciliation, the Agent must provide to the conciliation service and the worker (or their representative) a copy of the documentation on which they based their original decision.
If an Agent requests a treating doctor’s report to make or review a decision the Agent must ensure the prompt payment of the doctor’s fee. Copies of treating doctors’ reports should then be provided to the Conciliation Service within three working days of receipt.
If the dispute is about access to information, the Agent must provide copies of the exempt information directly to the Conciliation Service only. Documentation should be clearly marked as exempt as instructed under the legislation and not be released to the worker by the Conciliation Service.
Note: Public holidays are excluded in the calculation of relevant timeframes.
If new information is obtained by the Agent or employer which they intend to rely on at conference, the Agent must provide the worker with a copy of the new information prior to the conference.
The only exception is surveillance footage. However, if medical questions are to be sent to a 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 and the Agent wishes to send the surveillance to the Medical Panel, the worker should be shown the surveillance before it is sent.
Agent reviews decision
Within 15 working days of receiving the application for conciliation, a suitably qualified person (technical) (Senior Legal Manager if access to information disputes) completes a review of the decision, ensuring it is technically sound and based on reasonable evidence.
The Agent should:
- ensure that a decision checklist has been completed or that there are comprehensive file notes and
- contact the worker, employer or IME Independent Medical Examiner / Independent Medical Examination to discuss any new or additional information submitted by the worker.
Once the Agent completes their Initial Review they should advise WIC Workcover Injury Commission in writing whether they:
- have varied or reversed the original decision
- have maintained the original decision
- need extra time for further investigation.
If the review finds there is no reasonable prospect of successfully maintaining the decision should the matter proceed to Court and/or the initial decision was not made in accordance with the legislation, the decision should be withdrawn before the conference and all parties advised in writing.
Note: If the Agent requests further information from the worker, for example a treating doctor's report, they have five days following receipt to review this information.
The Agent should keep the employer up to date in matters that are to proceed to conciliation and advise them about:
- what the conciliation process involves
- what the employer has to do during and after the conciliation conference
- any requirements under the legislation arising out of the conference
- the impact of any outcome of conciliation.