WorkCover Conciliation in Victoria: the complete guide

If you disagree with a decision made by a WorkCover insurer, conciliation is usually the first step available to challenge that decision.

WorkCover conciliation is a free dispute resolution process conducted through the Workplace Injury Commission (WIC). It gives injured workers an opportunity to explain why they disagree with an insurer’s decision, provide supporting material and attempt to resolve the dispute without immediately having to commence court proceedings.

For many workers, conciliation is unfamiliar territory. It’s not uncommon for people to assume that it operates like a court hearing where one party wins and the other loses. In reality, it is a much more informal process. The purpose of a conciliation is not necessarily to determine who is right or wrong. Rather, it is designed to give the parties an opportunity to discuss the dispute, exchange information and explore whether the matter can be resolved.

On this page we’ll explain how the WorkCover conciliation process works in Victoria, the types of disputes that commonly proceed to conciliation, what happens during a conciliation conference and what options may be available if the dispute does not resolve.

What is WorkCover conciliation?

WorkCover conciliation is a dispute resolution process designed to help workers and insurers resolve disagreements relating to Victorian workers compensation claims.

The process is administered by the Workplace Injury Commission. An independent conciliator is assigned to the dispute. The conciliator’s role is to facilitate discussion, identify the issues in dispute and assist the parties to explore potential resolutions.

Importantly, the conciliator is not a judge. In most cases they do not simply listen to the evidence and then decide who wins. Instead, they help the parties understand each other’s position and encourage meaningful discussion about how the dispute might be resolved.

This can sometimes be both a strength and a weakness of the process.

On the one hand, conciliation can often achieve outcomes quickly and without the expense and delay associated with court proceedings. On the other hand, there are situations where a worker may have strong evidence supporting their position, yet the insurer remains unwilling to alter its decision. In those circumstances the matter may still fail to resolve.

Understanding this distinction is important. The primary purpose of conciliation is resolution rather than determination.

When can you apply for conciliation?

Most WorkCover disputes relating to statutory benefit matters (initial claim, medical and like expenses, weekly payments) can be taken to conciliation.

The most common disputes involve decisions relating to claim acceptance, weekly payments and medical treatment. However, the scope of issues that can proceed to conciliation is much broader than many workers realise.

A worker may apply for conciliation because a WorkCover claim has been rejected, because an insurer refuses to pay for treatment, because weekly payments have been terminated or because an insurer has declined responsibility for a particular injury.

Conciliation is not limited to situations where a formal decision has been made. It can also be used when an insurer simply fails to make a decision or does not respond to a request within a reasonable period of time.

As a general rule, an application should be lodged within 60 days of receiving the insurer’s decision. However, applications lodged outside that period are frequently accepted where there is a reasonable explanation for the delay. Many workers wrongly assume that once the 60-day period has expired, they have lost the ability to challenge the decision. That is often not the case.

If an application is lodged late, the worker should provide an explanation as to why the request was not lodged within the usual timeframe.

How do you start the WorkCover conciliation process?

The process begins with the completion and lodgement of an Application for Conciliation.

The application itself is relatively straightforward. It asks for basic details about the worker, the insurer, the claim and the decision being disputed. If a worker has a representative, those details can also be included on the application form.

One of the most important things a worker can do when lodging the application is provide a copy of the insurer’s decision notice. This document often forms the foundation of the dispute and explains why the insurer made the decision that is being challenged.

Supporting material should also be provided where available. The nature of the relevant material will depend upon the dispute itself. In some cases this may involve medical reports and certificates of capacity. In others it may involve payslips, treatment requests, invoices, rehabilitation documents or correspondence between the worker and the insurer.

The more clearly the dispute is identified at the outset, the easier it is generally for the matter to progress.

What happens after the conciliation application is lodged?

Once the application is received, WIC reviews the file to ensure sufficient information has been provided.

Sometimes a worker assumes that lodging the form immediately results in a conference being scheduled. That is not always what happens. If important documents are missing, WIC may seek further information before progressing the dispute.

Once enough information has been provided, the parties will normally receive notification that the matter has been listed for conciliation.

Conciliations may occur in person, by video conference or by telephone. In recent years telephone conciliations have become increasingly common and many disputes proceed entirely in that format.

Prior to the conference taking place, there is usually a period during which information is exchanged between the parties. The insurer will generally provide the material relied upon when making the disputed decision. The worker may also provide additional evidence in support of their position.

Sometimes disputes resolve during this stage without a conference ever occurring. An insurer may receive further medical evidence and reconsider its position. In other cases, discussions continue right up until the scheduled date.

Preparing for a WorkCover conciliation

In our experience, the best way to prepare for a conciliation is to identify precisely what issue is actually in dispute.

Many workers arrive at conciliation with a lengthy list of grievances about how their claim has been managed. While those concerns may be entirely understandable, not all of them will necessarily be relevant to the particular decision that is before the conciliator.

For example, imagine that weekly payments have been terminated after 130 weeks. The central issue may be whether the worker satisfies the legislative requirements to continue receiving payments. Allegations that physiotherapy invoices were processed slowly six months earlier are unlikely to assist in resolving that particular dispute.

The workers who tend to present most effectively at conciliation are often those who remain focused on the specific issue that needs to be addressed.

Evidence should ideally be directed toward the insurer’s reasons for making its decision. If the insurer relies on a medical opinion suggesting a worker has capacity for employment, evidence addressing work capacity is likely to be far more useful than evidence dealing with unrelated aspects of the claim.

Do you need a lawyer for conciliation?

Many workers are surprised to learn that they are not required to have a lawyer at conciliation.

Some workers participate without legal representation. Others receive assistance from WorkCover Assist, Union Assist or another support service.

That said, some disputes are more complicated than others. Cases involving weekly payments after 130 weeks, complex medical disputes, significant factual disagreements or issues that are likely to proceed to arbitration or court can sometimes benefit from legal advice.

There is not an automatic right to have a lawyer represent you at conciliation. Permission generally needs to be obtained from WIC. The conciliator ultimately decides whether legal representation will be permitted.

In practice, legal representation is commonly allowed where there is a good reason for it.

What happens during a WorkCover conciliation conference?

One of the most striking features of the conciliation process is how informal it is.

The conference normally begins with the conciliator introducing themselves and explaining the process. They will identify the parties, explain their role and outline the issues that are to be discussed.

The insurer is usually invited to speak first. The insurer’s representative will explain the reasons behind the disputed decision and identify the material that was relied upon.

The worker or their representative will then be given an opportunity to respond. This is the stage where the worker explains why they disagree with the decision and refers to any supporting evidence.

What follows is often the most important part of the conference.

The parties engage in discussion. Questions may be asked. Areas of agreement may be identified. The conciliator may challenge aspects of each party’s position or seek clarification about particular evidence. The focus is generally on understanding the dispute and exploring whether there is a practical way forward.

In many conciliations the parties then move into separate discussions. The conciliator speaks privately with each side and moves between them discussing possible resolutions.

This is often where meaningful negotiations occur.

The conciliator may convey offers, discuss the strengths and weaknesses of each party’s position or speak about alternative pathways that may be available if the dispute remains unresolved.

At the conclusion of the process the parties are usually brought back together and the conciliator confirms the outcome.

Does conciliation usually work?

This is one of the most common questions asked by injured workers.

The answer is that many disputes do resolve through the conciliation process, although not all do.

The Workplace Injury Commission reported that 64.3% of disputes referred to conciliation resolved during the 2024-2025 reporting period. In practical terms, that means almost two out of every three disputes achieved a resolution during the conciliation process.

Even where a dispute does not resolve completely, the process can still be valuable. It often narrows the issues, identifies evidence that needs to be obtained and provides clarity about the next step.

Common WorkCover conciliation outcomes

There are several possible outcomes following a conciliation conference.

The most common outcome is an agreement between the parties. An agreement may involve the reinstatement of weekly payments, approval of treatment, payment of expenses, acceptance of liability or some other compromise that resolves all or part of the dispute.

Not every matter resolves through agreement. In some cases a conciliator may make a recommendation designed to assist the parties in resolving the dispute. The parties can then consider whether they wish to accept that recommendation.

In limited circumstances a conciliator may issue a direction. Directions are generally reserved for situations where the legislation permits intervention of that nature and should not be regarded as an outcome that commonly occurs in every dispute.

Medical disputes can sometimes result in a referral to a Medical Panel. Medical Panels consist of independent doctors who answer specific medical questions relating to a claim. Their role is not to determine every aspect of the dispute but rather to provide an opinion on the medical issues put before them.

Another possible outcome is the issue of a Genuine Dispute Certificate, commonly referred to as a GD.

A GD is often misunderstood by workers. It does not mean that the worker has lost the dispute. Nor does it mean that the insurer has won. It simply confirms that the dispute was not resolved during conciliation and that further options may now become available.

There are also circumstances in which a Progress Certificate may be issued. This usually occurs where additional evidence or further discussions are required before a final outcome can be reached.