If workcover vic fails to respond within 28 days you can go to conciliation

requesting-conciliation-vic

In Victoria, if your WorkCover insurer makes a decision in writing that you disagree with you can appeal the decision at Conciliation. However, what many injured workers don’t know is that if your WorkCover insurer fails to respond to a request within 28 days, you can also lodge a request for Conciliation!

Requesting a Conciliation

In order to arrange a Conciliation meeting, you must lodge a Request for Conciliation with the Accident Compensation Conciliation Service (ACCS). The form must be lodged within 60 days of the date of the insurer’s decision, although extensions are possible in some circumstances.

The ACCS will request information from your treating doctors in preparation for the Conciliation meeting. In other words, ensure you obtain up to date medical reports from your treating doctors for the conciliation (they will be paid for by the workcover insurer).

The ACCS will also arrange a time for you to meet with one of their representatives, together with a representative from the insurer, yourself and occasionally a representative from the employer. It usually takes around 6 weeks to obtain an appointment, depending on the back log.

You can also arrange for assistance from your Union, Union Assist or WorkCover Assist. We highly recommend WorkCover Assist. You can also (and should) bring along a support person (which can even be your psychologist).

conciliation2At the Conciliation, there are 5 possible outcomes:

  • The matter could be adjourned (rare)
  • The workcover  insurer could withdrawn their decision and reinstate your entitlements – sometimes your benefits may be reinstated or partially reinstated until a medical panel opinion is received.
  • The workcover insurer could make you an offer to settle the dispute for a limited amount of benefits
  • Your case could be referred to the Medical Panel if there are medical questions in dispute; or
  • If you are unable to reach any of the above outcomes, the Conciliator will issue a Genuine Dispute Certificate, enabling you to issue Magistrates Court proceedings

Useful to know

If you are required to take a day off work to attend the conciliation, you are entitled to be compensated by WorkCover (Vic)  for your reasonable transport costs (up to $50), and your loss of income up (to $350).

You are only entitled to compensation for loss of income if you take a day of leave without pay, rather than paid sick leave, annual leave or weekly payments.

 

For more information about the conciliation process etc, please visit the Accident Compensation Conciliation Service (ACCS) website.

 



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4 Responses to “If workcover vic fails to respond within 28 days you can go to conciliation”

  1. My latest CM has been pushing responses to the max, and sometimes a few days over the 28days… It took them from the 16th January to the end of April to make a decision on a treatment request from a pain specialist, and then the decision was to not provide treatment… They say based on an IME report, but the report was accepting that the treatment has helped in the past and is therefore reasonable… Just not a long term benefit… how much time is long term? If you get benefit for 6 to 8 months, thats pretty good. I was able to continue working…. which I cant do now. Forms have been sent to ACCS so now we wait and see.

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  2. Fascinating! Does anyone know what happens if an insurer fails to respond to a FOI request within 28 days in Victoria?

    For that matter, what if they repeatedly fail to respond to a FOI request, or leave out relevant information with no explanation as to why it was excluded?

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  3. A 6th outcome of Conciliation is that the Conciliation Officer can issue Directions to the Insurance company – this happened to me – but when the Insurer was told that Directions were to be ordered – they withdrew their claim – and reinstated my benefits

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    still in pain June 3, 2014 at 11:36 am