Conciliation – what is it?

What is it?

Conciliation is an informal dispute resolution process that is used to try and resolve disputes before they go to court. Conciliation is often used in the context of WorkCover claim disputes when an injured worker does not agree with a decision made by a WorkCover insurer. If you have lodged a WorkCover claim, it is important that you know what your rights and entitlements are throughout the conciliation process.

If you have been injured at work, you may be eligible to make a WorkCover claim for that injury. This means you may be able to recover costs for reasonable medical expenses relating to that injury or weekly compensation payments if you cannot work your normal duties.

Once you have lodged a WorkCover claim, your employer’s WorkCover insurer can choose to:

1. Reject the claim;
2. Accept the claim in full: accepting to pay for reasonable medical expenses and/or weekly compensation where applicable; or
3. Accept in-part: only accept to pay for certain elements of the claim and refuse to pay for other parts, such as particular medical expenses or compensation payments.

If you believe the insurer’s decision is unreasonable or unfair, you can lodge a dispute to fight it. In order to dispute a decision, you must first go through conciliation to attempt to resolve the dispute with the insurer.

To do this you must fill out and lodge a Request for Conciliation form within 60 days of the insurer’s decision with the Accident Compensation Conciliation Service (ACCS). You will then be required to attend a conciliation meeting.

If you miss this 60-day window, you may still lodge a dispute, however you will need to attach a cover letter explaining why you missed the deadline.

What should I expect?

The ACCS is an independent body that is charged with facilitating and moderating conciliation meetings between claimants (the person making the claim) and insurers. They will appoint a conciliator who will attempt to resolve the dispute, through conciliation, to avoid the matter going before a court.

It is important to note that conciliators have very few powers to make decisions. If you are unhappy with the outcome of conciliation, generally, you can continue to dispute the insurer’s decision through the courts.

How should I prepare?

Conciliation meetings are organised by the ACCS and generally occur in person.

These meetings are quite informal. However, it is a good idea to be clear on the details of your claim and bring along any relevant documents that substantiate the basis of your dispute.

Can I have a lawyer come with me to the conciliation conference?

No. Unfortunately lawyers are not usually permitted to attend conciliation meetings, however you are entitled to bring a support person to these meetings.

If you are a union member you can bring a union representative with you or engage an advocate from Union Assist. Otherwise, you can organise an advocate from WorkCover Assist to attend the meeting with you. Both of these options are free of charge.

At the conciliation meeting, the insurer may make an offer of weekly payments for a limited period of time, as a compromise. This can potentially limit your ability to seek further payments or expenses in the future, so it is important that you seek legal advice from a lawyer before accepting a limited offer.

Conciliation hasn’t worked. What next?

If the matter cannot be resolved through conciliation, the conciliator can certify that reasonable steps have been taken to attempt to resolve the dispute, allowing further dispute proceedings to be brought before the courts. At this point, it is advised that you should seek legal advice about your options.

If the dispute relates to the medical merits of the claim, the conciliation will have the discretion to refer the dispute to a Medical Panel for their opinion. The Medical Panel’s decision is final, so it is a good idea to seek legal advice before agreeing to have your matter referred to a Medical Panel to ensure your interests are properly represented.

If you have need help with a WorkCover claim, contact Gordon Legal today on (03) 9603 3000. Our expert lawyers specialise in WorkCover claims and are able to assist you at any stage of your claim.