Dispute Resolution Reforms
Beginning 1 January 2019, the State Insurance Regulatory Authority (SIRA) introduced reforms to the workers’ compensation dispute resolution process, aligning with the Workers Compensation Legislation Amendment Act 2018. These reforms were designed to streamline claims handling, reduce disputes, and improve support services for injured workers and employers.
Goals of the Reform
- Minimize disputes through clearer processes
- Improve efficiency in claims management
- Ensure faster responses from insurers
- Enhance transparency and accountability
- Provide stronger support services for both workers and employers
Five Key Changes Impacting Injury Management
- Centralized Dispute Resolution
- The Workers Compensation Commission (WCC) now resolves all disputes.
- Injured workers benefit from mandatory internal reviews, ensuring fairer outcomes.
- Timely Insurer Responses
- Insurers must respond within 14 days to work capacity decisions or liability reviews.
- Legal costs for workers challenging work capacity decisions are covered by Independent Legal Assistance & Review Service (ILARS).
- Improved Decision Transparency
- Notice templates must clearly identify information received from employers, workers, and insurers.
- This ensures decisions are based on complete and balanced evidence.
- Clear Complaint Pathways
- Workers’ insurer remains the first point of contact.
- Unresolved employer complaints go to SIRA (13 10 50 / contact@sira.nsw.gov.au).
- Unresolved worker complaints go to Workers Compensation Independent Review Office (WIRO) (13 94 76 / contact@wiro.nsw.gov.au).
- Permanent Impairment Compensation
- In certain cases, the WCC can award permanent impairment compensation without referral to an Approved Medical Specialist.
Please contact us to discuss.
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