Applying for, or lodging an appeal at Conciliation (ACCS) can certainly seem confusing and may also be quite stressful – and it certainly helps if you understand the process.
As you know by now, when you sustain an injury at work, you can make a workcover claim. The workcover insurance company of your employer (e.g Allianz, Xchanging, Gallagher-Bassett, CGU, QBE etc) is then (or shall I say SHOULD then) be responsible to pay for ALL your reasonable and necessary medical and related expenses, as well as your lost wages (if you can’t work).
However, more often than not the workcover insurer will refuse to accept your claim in the first instance, or will often refuse to pay for certain necessary and deemed reasonable medical and related expenses or weekly payments which you and your treating doctors believe you are entitled to.
The Accident Compensation Act (the law which covers work injury claims in Victoria – see bottom right for the link to the Act under the “blogroll”) states that the first step in resolving the dispute is to go to conciliation at the Accident Compensation Conciliation Service (ACCS).
Going to Conciliation won’t not cost you any money, and your workcover insurer even has to reimburse your travel costs now too, and is presided over by a Conciliator whose job it is to bring the parties (a representative of the workcover insurer and you+support person, which can be a union member) together for discussions, but who has quite limited powers to make decisions.
Conciliation for work injuries – what you need to know
To request conciliation you need to fill out a Request for Conciliation form. It is extremely important that you are aware that (in Victoria) you MUST lodge a conciliation within 60 DAYS of receiving a decision about your claim that you wish to dispute. For example, if you received a letter from the workcover insurance company advising you that your physiotherapy is ceased or being ceased, you have 60 days from the date of that letter to lodge an appeal at conciliation.
Only in very “special circumstances” will the Conciliator (or the ACCS) allow you to lodge an appeal with the ACCS past the 60 days and you will have to substantiate the very reasons why your appeal for conciliation is late; and they may or may not accept it.
Last year I managed to lodge a conciliation over 4 months past it’s due date and the reason – being really suicidal at the time – had been accepted. Ironically or sarcastically the dispute was about the fact that Xchanging had ‘decided” to cease my psychology treatment entitlements – fully knowing that I had recently been referred to a psychiatrist and that I was suicidal. Moreover a recent psychiatry IME had reported that I was severely depressed and needed an increase and increase in intensity of treatment if I was to recover! The bitch (case manager)’s opinion was “that I did not need to see a shrink or a psychologist because I could talk to her”. I kid you NOT!!!
While lawyers usually do not attend conciliations (unless it’s a very important matter such as disputing liability for injury(ies)), you can (and should) organise for WorkCover Assist, or, if you are a union member, your union representative or Union Assist, to attend the conciliation with you. There is no charge for these services either.
Another important thing, like Lisa (our reader and contributor) pointed out in a recent comment; dealing with all things workcover insurance (including ACCS) can be extremely stressful, and sometimes it is “good” to distance ourselves from ‘them’ and to see ‘them’ for what they truly are: ‘a business’. Lisa has/is experiencing HAIR LOSS due to the stress from it all (I am losing heaps of weight… and you?). So, ask yourself the question: is it worth going through the ACCS process at the cost for your mental health,e.g further hair loss, further weight loss, further depression, whatever-symptoms stress brings on to you?
For example, if you are just going to fight about a $2 shop-type long handled toilet brush (home help appliance) the insurer has not provided you with, for f*ck’s sake, don’t bother! I know it’s unjust in the sense that this is exactly what those insurers want (and it all adds up for them, if they deny 100,000 long handled toilet brushes they make a profit of $200,000, right), but for your sanity’s sake, just drop it. It’s not worth getting SICK over.
Whilst we all know that workcover insurances will deliberately deny us (workcover victims) any and everything possible -because they are a BUSINESS -chances are of course that you will win big time at the Conciliation, provided that you have a good case (i.e. weekly payments, taxi travel, denied MRI, denied surgery, need a cleaner, wheelchair etc) and that you sufficient support from your treating doctors. GO FOR IT.
Once you have lodged a Conciliation, you will receive a letter acknowledging your request for conciliation within a few days, however it can take up to several weeks before you get your actual appointment for the ‘hearing’ itself.
At the conciliation conference various outcomes are of course possible:
- The conciliator orders that the workcover insurer accepts your claim or expense. Great! Matter over and dusted with
- The conciliator orders that you are wrong and the insurer is right – you get bugger all!
- The insurer may, upon the conciliators advice, offer a compromise for a limited period. Be aware that if you accept the compromise you may not be able to claim further payments or expenses. It is recommended you seek legal advice before accepting a limited period offer. I always ensure that my lawyer is contactable via telephone when I have to attend conciliation, so that in the event that I need legal advice, he’s just a call away!
- If there is a medical dispute, the matter may be referred to the Medical Panel. Because the opinion of a Medical Panel is binding so it is strongly advised you seek legal advice before going to the Medical Panel
- If the matter can not be resolved at conciliation, the conciliator may certify that dispute has not been resolved despite reasonable steps taken. You may now bring proceedings in the Magistrates Court if you wish to take the matter further.