Having a decision reviewed
If you're unhappy with a decision on a claim, you can appeal the decision through the Workers' Compensation Regulator.
The Regulator is independent from WorkCover Queensland and impartially review decisions made by Queensland’s workers’ compensation insurers.
There's no cost involved to have the Regulator review the decision, however should you engage a solicitor to help you prepare your review application you will be responsible for this cost.
Some decisions that can be reviewed:
- the decision to accept or reject a claim
- the decision to end compensation payments or increase or decrease compensation payment amounts
- the failure to make a decision on a claim within 20 business days from when the claim was lodged.
Once we've made a decision on a claim, you can ask us for a reason for decision document within 20 days of being notified of the decision. This document will outline how we made the decision. WorkCover has five business days to supply you with this document. Once you've received the reason for decision, if you are still unhappy with the decision, you'll be able to proceed with a review. You have 90 days from the date of the letter to apply for review with the Regulator.
Further information on reviews and appeals is available on the Workers' Compensation Regulator website or by calling them on 1300 739 021.
Common law secondary or unassessed injuries
Sometimes, a further injury that has not been identified or managed during the statutory claim is included in a common law damages claim.
In many cases, the additional injury has little impact on the settlement figure of the claim, however they can add to the length of time it takes to resolve the claim. In some cases the injury is subject to the same decision making and review processes as at the statutory phase. In other instances however the injury may be ‘fast tracked’.
Fast tracking is an agreement between the worker and WorkCover where evidence that supports the injury will be provided by the worker prior to informal negotiations or a settlement conference. If this information is not provided the injury will not be included in the assessment of the claim. If the claim is settled, the settlement will include all injuries from the claimed event.
If the claim does not settle, WorkCover will take all reasonable steps to assess the injury within 60 days after the negotiation/conference.
Factors considered when making a decision about fast tracking are:
- a stakeholder requires a formal decision (for example an employer)
- a notice of assessment has already been issued for the same event
- WorkCover consider it more appropriate to make a formal decision.
Common law only claims
There may be times when an injured worker may elect not to claim for statutory benefits and proceed directly to common law. It's important to note however these applications are subject to the same injury investigation and review processes as statutory claim applications.
As with all claims, WorkCover’s focus is first and foremost on rehabilitation and return to work and hence this type of application will be reviewed for possible opportunities for this type of intervention.