Has Your Workers’ Compensation Claim Been Declined?

Has Your Workers’ Compensation Claim Been Declined?

If you have made a claim for workers’ compensation in Perth or Western Australia, and the claim has been declined by the workers’ compensation insurer, the next step is to file an application for conciliation at Workcover WA. Workcover WA is the government organisation responsible for overseeing the workers’ compensation scheme in Western Australia.

When you file an application for conciliation in WA it is your responsibility to prove:

  • That the injury occurred at work.
  • How you sustained the injury.
  • The nature of the injury.
  • Whether you have a partial or total incapacity for work.
  • The losses you have incurred.

In legal terms this is known as the burden of proof. The burden of proof is always on you and does not shift to your employer or the workers’ compensation insurer.

When filing the application for conciliation, it is important that you file evidence in support of your application. The following are examples of the types of evidence you should file:

  • Workers’ compensation claim form served on your employer.
  • First medical certificate and any progress medical certificates.
  • Any medical reports from your treating doctors.
  • A statement from you, setting out how you were injured.
  • A statement from any witnesses.
  • Pay advices from your employer.
  • Receipts and invoices for any treatment expenses.

When your application for conciliation is accepted, you will receive a notice from Workcover advising you of the day and time your application is listed for a conciliation conference. You are required to attend the conciliation conference unless it would cause you extreme hardship.

Prior to the conciliation conference, the workers’ compensation insurer will file a response to your application at Workcover. The response will detail the reasons your claim has been declined. You should also be aware that the workers’ compensation insurer may have appointed lawyers to represent its interests at the conciliation conference.

Workcover will allocate a conciliation officer to assist the parties to resolve the issues in dispute.  A conciliation officer is impartial. A conciliation officer cannot give legal advice and does not have the power to order the workers’ compensation insurer to accept liability for your claim and commence weekly payments. The conciliation officer does have the power to order an interim payment of compensation, for up to 12 weeks in some circumstances.

The conciliation conference is quite informal and usually involves a face to face meeting between you, the workers’ compensation insurer and its lawyers. Your employer may also attend.

Most people are unfamiliar with the conciliation process. If you have not fully prepared and have not filed the evidence required to assist in proving your claim, or you are not sure of what other options are available to you, this will lead to a further delay in claim acceptance or resolution of the dispute.

To ensure the best result at the conciliation conference, it is worthwhile seeking advice from an experienced workers’ compensation lawyer.

If you have filed an application for conciliation at Workcover contact Perth City Legal on 9486 8088 to speak to one of our lawyers.