7.5.6 Independent Review Outcomes

The possible outcomes of a WCIRS Independent Review are:

  • The Independent Review can be discontinued prior to a final determination of the IRO because:
  • the worker withdraws their WCIRS application or
  • the Agent withdraws the reviewable decision or
  • The WCIRS concludes the Independent Review and finds that the reviewable decision:
  • is not a ‘sustainable decision’ and directs the Agent to overturn the decision in accordance with the compensation legislation or
  • is a ‘sustainable decision’ and confirms the decision
Worker withdraws WCIRS application

A worker can withdraw an application for an Independent Review at any time before a final outcome is communicated by the WCIRS.

The Agent will be notified in writing by the WCIRS when a worker withdraws their application for an Independent Review.

Agent withdraws ‘reviewable decision’

An Agent can reconsider a reviewable decision at any stage during the Independent Review period and prior to a decision issued by the WCIRS IRO.

The Agent is able to withdraw a reviewable decision prior to the conclusion of a WCIRS Independent Review. The effect of the Agent withdrawing the reviewable decision will be different for each application and, generally will depend on whether the worker was already receiving a payment or service at the time the Agent’s decision was made (see below).

Upon notification of a withdrawal by the Agent of a reviewable decision, the WCIRS will discontinue the Independent Review. The WCIRS will also provide confirmation in writing to both the Agent and the worker that the Independent Review has been discontinued as a consequence of the Agent’s decision to withdraw the reviewable decision.

Reviewable decision is found not to be a sustainable decision and is overturned

The effect of a direction by the WCIRS to an Agent to overturn a reviewable decision (or where it is withdrawn by an Agent) will be different depending on whether the worker was already receiving a payment or service at the time the reviewable decision was made by the Agent.

Already receiving a payment or service at the time of the Agent’s decision

If the worker was already receiving a weekly payment related to the decision or a medical or like service when the Agent decision was made, within 2 business days of the decision being overturned or withdrawn, generally, the Agent will:

  1. restore the payment or service, including payments or services that the Agent would have been required to pay if it had not made the decision, in accordance with the compensation legislation and
  2. write to the worker confirming this has occurred.

Where the worker was not receiving a payment or service at the time of the Agent’s decision

If the worker was not receiving a weekly payment related to the decision or a medical or like service when the Agent decision was made, within 2 business days of the decision being overturned, generally, the Agent will:

  1. commence re-assessing and re-making the decision in accordance with the findings, reasons or recommendations given or made by the IRO and the workers’ compensation legislation and
  2. write to the worker confirming that this has occurred
Reviewable decision is found to be a sustainable decision.

If the WCIRS determines that a reviewable decision is a sustainable decision, the decision remains unchanged and the worker can still exercise their right to go to Court or arbitration.

7.5.7 Court or Arbitration Proceedings

The Independent Review process is an optional step in the workers’ compensation dispute resolution process. It can be triggered by the worker before, during or after lodging an application at Court or for arbitration at the WIC Workcover Injury Commission, so long as the application is made within 2 years of the 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 being issued by the WIC and prior to a Court or Arbitration Officer listing 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.

There may be occasions where an Agent may need to respond to Court or arbitration proceedings issued by the worker at the same time as the decision is being reviewed by the WCIRS.

Next | Back to top