I Have a Workers Compensation Dispute, What Can I do?

If you’ve suffered an injury at work and don’t agree with your compensation determination, TGB’s Dimitra Bouras writes about your options.

Update- due to changes in the legislation this blog may no longer be 100% accurate. Click here to find information that is up to date regarding the new Return to Work Act.

In South Australia, compensating authorities (including Employers Mutual Limited, Gallagher Bassett or a self-insured company) can issue a determination on numerous issues.  This can include the rejection of a claim, denying that an injury is associated with a previous claim or rejecting a claim for a psychological injury.

Other causes of disputes include matters where the compensating authority has failed to accurately calculate the workers entitlements to weekly payments, or a discontinuance of a workers weekly payments or medical expense reimbursements, and also disputes over lump sum payments for permanent injuries.

The dispute process

The process for disputing a decision is set out in section 90 of the Workers Rehabilitation & Compensation Act 1986.  To dispute a determination, the worker must file a Notice of Dispute at the Workers Compensation Tribunal.  A dispute must be lodged within one month of the applicant receiving the determination.  If a worker fails to lodge a dispute within this time limit, they may seek an extension from the Tribunal and this may be granted so long as the delay in lodging a Notice of Dispute does not prejudice the compensating authority in any way.

When a dispute is lodged at the Tribunal, the compensating authority has seven days to consider the Notice of Dispute and file a reconsideration.  In some cases the compensating authority may agree with the Notice of Dispute, concede that the determination is incorrect and vary the determination.

However, in many cases the compensating authority will confirm the original determination and the dispute will proceed through the Workers Compensation Tribunal process.

The parties will then be required to attend a Dispute Management Conference before a Conciliation Officer of the Tribunal.  The issues in dispute will be discussed and the parties will determine whether further information is required, such a medical report, medical notes, medical certificate etc.

The matter will then be set down for a Conciliation Conference.  During the Conciliation Conference the parties will try to negotiate a resolution of the Dispute. This is a very important meeting that the worker must attend along with their lawyer. It usually occurs about two to three months after the Notice of Dispute has been filed. If the parties can not agree reach a settlement the matter may then be referred onto Judicial Determination. This means the matter is put before a Judge of the Tribunal.  If the matter is unable to settle at Judicial Determination, it will then proceed to a trial.

The majority of matters filed with the Tribunal do settle at the Conciliation Conference stage.

Managing your dispute

As you can see lodging a dispute with the Tribunal can be complicated, stressful and time consuming. It is highly recommended to seek the assistance of an experienced lawyer who can guide you through the process effectively and efficiently.

Workers with legal representation can recover some costs from the compensating authority during the process and often this is the majority of the actual fees charged.

Author: Dimitra Bouras

I’m happy to help with your workers compensation matter. For a free initial interview about your claim contact me via phone or email, or fill out this form and we’ll be in touch.

TGB is the largest personal injury law firm in South Australia.