Published: 26 August 2015
Author: Ryan Carlisle Thomas
Comcare decisions can be appealed, but deadlines apply
The Comcare workers compensation scheme is not easy to navigate.
The most common enquiries we receive are determinations to reject a Comcare claim for injury compensation, or when an existing benefit such as the payment of medical expenses is terminated.
You are entitled to appeal any Comcare determination. The determination might be in relation to:
- Rejection of a claim for compensation;
- Rejection of a claim for a lump sum payment for injury;
- Termination of incapacity benefits;
- Rejection or termination of claims for medical expenses such as physiotherapy or psychological treatment; or
- A decision made by your case manager or your employer to return you to work prematurely.
To get the dispute process started, you must make a request for reconsideration of the determination. The request must be made within 30 days of receiving the determination, and should outline your reasons for disputing the determination. A good Comcare lawyer can assist you with the preparation of your request for reconsideration.
Upon receipt of your request for reconsideration, the Comcare Insurer will review the determination internally, and issue a further determination, known as the reviewable decision. Unfortunately there is no deadline or timeframe for the Comcare Insurer to provide the reviewable decision. Further, as this step is purely an internal process of review, determinations are not often overturned.
If the reviewable decision affirms the initial determination, you can take the matter further by lodging an application of review of decision with the Administrative Appeals Tribunal (AAT). The application must be lodged within 60 days of receiving the reviewable decision.
At this stage, the legal issues become complex. In our extensive experience as Comcare lawyers, we find that the chances of reaching a favourable resolution or having a determination overturned by the AAT are reasonably good. If you reach this stage and have not already sought advice from a Comcare lawyer, you should do so.