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My workers compensation claim has been rejected – What happens now?

If your claim is rejected this can be a stressful situation, but should not be considered as the end of the road. This blog article is intended to provide general advice as to steps you can take after receiving notice that your workers compensation claim has been rejected.

Disputing the decision

An injured worker is entitled to dispute an insurer’s decision to reject a claim, as follows:

  1. A dispute notice called an Application for Review is filed in the South Australian Employment Tribunal within 30 days of you receiving the decision. To ensure your rights are best protected you should consider seeking legal advice before lodging any application.
  2. An independent officer from the insurance company must reconsider the decision.

(a)  If the decision is changed you will be notified. If you are happy with the new decision then the matter is finalised.

(b)  If the decision is confirmed then it will be referred to the Tribunal.

  1. The first hearing is called an initial directions hearing. At that hearing the parties will outline their case and outline the issues and how to prepare the matter for conciliation. If you have a legal representative then he or she can attend the hearing on your behalf.
  2. About 4 weeks later the matter is listed for a conciliation conference. You must attend the conference in person unless you have permission of the Tribunal to attend by phone. The parties will explore the possibility of settling the matter at conciliation and your interests are best protected by having a legal representative attend with you at the conference.
  3. A further conciliation conference(s) can be listed and if the matter is not resolved then it is referred for hearing and determination in a trial.

It is important that you seek legal advice regarding your claim as early as possible. With competent legal advice it may be possible to avoid your claim being rejected, or if a determination has already been made rejecting your claim then it may be possible to resolve the dispute before proceeding to a costly and expensive hearing and determination.

Get in touch with us

Our workers compensation lawyers can assist you at any stage of your claim. To arrange a free no obligation initial conference with us telephone 8213 1000.

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