What Do I Do if My Comcare Claim Has Been Denied?

Is a Dispute Expensive or Complex? 

By TGB Lawyers 

 If your Comcare claim has been denied, it can feel frustrating and confusing – especially when you’re already dealing with the impact of an injury or illness. 

The good news is that a rejection isn’t the end of the road. Many decisions can be successfully reviewed or overturned through the proper process, and with the right support, it doesn’t have to be daunting or expensive. 

Why Claims Are Often Denied 

Comcare may deny a claim for several reasons, such as: 

• Insufficient evidence linking your injury or illness to your employment 

• Gaps or inconsistencies in your medical or incident records 

• Conflicting medical opinions 

• Administrative or technical errors in your claim documentation 

In many cases, these issues can be resolved with additional evidence or clarification – but timing and following the correct process are critical. 

Step 1: Review the Decision Letter Carefully 

If your claim is rejected, Comcare will issue a written notice of decision explaining why. 

This letter should outline: 

• The specific reasons for the decision 

• The legislation relied upon (usually the Safety, Rehabilitation and Compensation Act 1988) 

• Your review rights and the deadline for lodging a reconsideration 

It’s essential to act quickly – you generally have 30 days from the date of the decision to request a review. 

Step 2: Request a Reconsideration 

The first stage of the dispute process is called a reconsideration. This means asking Comcare to review its own decision, taking into account any new or additional evidence you can provide. 

This might include: 

• Updated or more detailed medical reports 

• Statements from colleagues or witnesses 

• Clarification from your treating practitioner about how your work contributed to the injury 

Many claims are successfully resolved at this stage without the need for a formal appeal. 

Step 3: Review by the Administrative Review Tribunal (ART) 

If Comcare confirms its original decision after reconsideration, you have the right to apply for independent review by the Administrative Review Tribunal (ART). 

The ART has a fresh look at your case and can: 

• Confirm Comcare’s decision 

• Set it aside and substitute a new decision 

• Send the matter back for reconsideration with specific directions 

You’ll have the opportunity to present your evidence and attend a hearing, but most matters are resolved without the need for a full trial. Many are settled through conciliation or negotiation. 

Is the Process Expensive or Complex? 

The review process is designed to be accessible, and legal costs are often recoverable if you’re successful at the ART. 

At TGB Lawyers, we understand that cost is a concern – which is why we regularly act for clients on a no-win, no-fee basis for Comcare disputes (subject to conditions). 

With an experienced Comcare lawyer guiding you, the process can be straightforward and far less stressful than many people expect. 

We handle the paperwork, liaise with Comcare and medical experts, and prepare the submissions on your behalf – so you can focus on your recovery. 

Why Legal Advice Matters Early 

Getting advice as soon as your claim is denied can make a significant difference. A lawyer experienced in Commonwealth workers compensation can: 

• Identify gaps in the original claim 

• Gather the strongest supporting evidence 

• Ensure strict deadlines are met 

• Present your case clearly and persuasively 

Even a short initial consultation can clarify your next steps and improve your chance of success. 

Final Thoughts 

A denied claim doesn’t mean you’re out of options. Many decisions are overturned on review once the right evidence is presented. With professional guidance, the process is manageable, cost-effective, and often successful. 

Get in Touch 

At TGB Lawyers, our team has extensive experience assisting employees covered by Comcare and Commonwealth workers compensation schemes. 

If your claim has been rejected or you’ve received a reconsideration notice, don’t wait. Our Comcare lawyers can review your case, advise on your options, and represent you through the review or appeal process. 

Contact us today to speak with one of our Comcare lawyers about your situation or visit www.tgb.com.au to learn more. 

1800 730 842 

Complete our brief enquiry form and one of our Comcare lawyers will get in touch.