7.5.1 Request for independent review form | 7.5.2 When and by whom can an Independent Review be sought? | 7.5.3 Reviewable decisions | 7.5.4 Nominating a person or representative | 7.5.5 The Independent Review | 7.5.6 Independent Review Outcomes | 7.5.7 Court Proceedings
The Workers’ Compensation Independent Review Service (WCIRS) is an independent and impartial review function that operates within the Independent Review division of General Counsel’s Office at Worksafe Victoria. The WCIRS provides injured workers with the opportunity to seek a quick and cost-effective review of certain ‘reviewable decisions’ made by Agents.
Detailed information about how to seek an Independent Review, which decisions can be reviewed, when a review can be sought, what the Independent Review Officer (IRO) can determine, how long the process takes and other detailed and useful information can be found on the WorkSafe website. The service can also be contacted on (03) 4243 7061.
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.
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 a representative nominated by a guardian who is 18 years or older;
- after a ‘reviewable decision’ made by an Agent on or after 3 December 2019 has been through a conciliation at the ACCS Accident Compensation Conciliation Service. Workers can refer disputes about Agent decisions to the ACCS.; and
- within 2 years of:
- an ACCS 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 ACCS Conciliation Officer to an Agent and being satisfied there is a Genuine Dispute in relation to the decision; and
- prior to a Victorian Magistrates’ or County Court:
- 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 Panels for assessment.
If the matter is listed for a final hearing date or referred 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 during a review, the review by WCIRS will be terminated.
A ‘reviewable decision’ is a decision made by an Agent on or after 3 December 2019 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:
- 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
- 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’.
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.