Dispute pathways

If you feel unsatisfied with a decision that your Claims Service Provider (CSP) has made on your claim, you have the right to request a review of the decision.

This includes decisions made on:

  • liability
  • medical, hospital and related expenses
  • work capacity decisions
  • permanent impairment

The following options are available to you:

Internal review

You can request that your Claims Service Provider (CSP) completes an internal review of the decision. This will be done by someone who was not involved in the initial decision-making process.

You will receive an acknowledgement of your request, and offered an opportunity to provide any additional information that you would like to be considered.

Your CSP should provide you with an outcome in 14 days.

Independent Review Office (IRO)

The Independent Review Office is an independent statutory office who can help find solutions to your complaints by contacting the Claims Service Provider on your behalf.

IRO cannot resolve disputes, but they are able to offer advice on other support available to you.  For example, IRO can help injured workers get advice from a lawyer approved under the Independent Legal Assistance and Review Service (ILARS).

You can reach out to IRO at any point in the claim if you are feeling unsatisfied with the process or require further assistance.

Injured workers are encouraged to contact the Claims Service Provider in the first instance to try and resolve any issues they may have.

Contact the Independent Review Office

Personal Injury Commission (PIC)

If you remain unsatisfied following the internal review of the decision or you wish to bypass this step, you can lodge an application to resolve the dispute at the Personal Injury Commission.

The Personal Injury Commission helps resolve workers compensation disputes between injured workers and employers or Claims Service Providers.

The PIC aims to resolve the dispute by agreement between the parties using informal dispute resolution.

Initially, this is done through a teleconference. If the parties cannot resolve the matter at this stage, it will proceed to a conciliation conference.

If the dispute is not resolved at the teleconference or conciliation conference, it will progress to a formal arbitration hearing where the Commission will decide the dispute.

Decisions made by the PIC can be appealed and, in some instances, may be referred to the Deputy President or President of the PIC. Very occasionally, some matters are referred to the Supreme Court of NSW.

Contact the Personal Injury Commission

Learn more about the Personal Injury Commission

Learn more about disputes

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