College of Law Workers Compensation Seminar Workers Compensation Commission Update and Outline of Medical Assessments and Medical Appeals. Sian Leathem Registrar, Workers Compensation Commission. Content. Commission Upda te Legislative instruments Client Survey Evaluation of changes
College of LawWorkers Compensation SeminarWorkers Compensation Commission Update and Outline of Medical Assessments and Medical Appeals
Registrar, Workers Compensation Commission
Medical Assessments and Appeals
Workers Compensation Commission Rules 2011 – operational 1 July 2011.
Workers Compensation Legislation Amendment Act 2010 - amends both the 1987 and the 1998Acts – operational 1 Feb 2011.
Workers Compensation Regulation 2010
- operational 1 Feb 2011
Areas for further attention:
Suitability of conference rooms on level 21
Regional venues for con/arbs
Further Arbitrator recruitment
Consideration of accommodation options
Continued review of regional venues
Workers Compensation CommissionUpdate
Medical Assessments and Medical Appeals in the Workers Compensation Commission
What matters are certified in the MAC to be presumably correct?
Section 326(1) of the 1998 Act:
(a)the degree of permanent impairment of the worker as a result of an injury
(b)whether any proportion of permanent impairment is due to a previous injury or pre-existing condition or abnormality
(c)whether impairment is permanent
(d)whether the degree of permanent impairment is fully ascertainable
What are the grounds of appeal?
Section 327(3) of the 1998 Act
an increase in the degree of permanent impairment
(b) there is availability of additional relevant information (being
evidence that was not available to the appellant before the
medical assessment appealed against and that could not
reasonably have been obtained by the appellant before that
(c) the assessment was made on the basis of incorrect criteria
(d) the MAC contains a demonstrable error
When can a medical appeal be filed?
- if ground of appeal is for incorrect
criteria and/or demonstrable error
- Rewitu Pty Ltd v The Registrar of the
WCC & Anor  NSWSC 441
- if ground of appeal is for deterioration
and/or additional relevant information
When can a medical appeal not be filed?
What are special circumstances that allow the extension of time to file a medical appeal?
Section 327(5) of the 1998 Act:
Who is the “gatekeeper”?
What is the role of the “gatekeeper”?
Section 327(4) of the 1998 Act:
- 4,379 MACs issued
- 566 medical appeals lodged
- 569 medical appeals finalised
- 69 medical appeals rejected by the gatekeeper
- 4,833 MACs issued
- 606 medical appeals lodged
- 685 medial appeals finalised
- 38 medical appeals rejected by the gatekeeper
What happens next after the Registrar is satisfied that a ground of appeal has been made out?
(1) Section 328(1) of the 1998 Act:
Medical appeal is by way of review but is limited to the grounds on which the appeal was made (section 328(2)).
(2) Section 329 of the 1998 Act:
Grounds of appeal under section 327(3) of the 1998 Act
a. Registrar’s Guideline on Medical Appeals
b. WorkCover Medical Assessment Guidelines (Chapter E)
Sian Leathem, Registrar
Workers Commission of NSW