What happens at WorkCover conciliation?

A WorkCover Conciliation is an informal process that is designed to try and resolve WorkCover related disputes. It is the first step that an injured worker can take to appeal a decision that the WorkCover insurer has made that they disagree with.

Here’s what happens:

Step 1

You’ll usually be asked to attend the conciliation venue slightly earlier than the scheduled time. This is so you can have a chat with your representative, whether that be a lawyer or WorkCover assist.

You’ll be able to spend some time talking about the relevant issues, and what to expect.

Step 2

The conciliation officer will call the parties into the main conciliation room. The parties included in the conciliation will usually be: the ACCS conciliation officer, you and your representative, and a representative from the insurance company.

Step 3

Sometimes, an employer representative will attend. However, this is not common. If an employer representative is going to attend the conciliation, you should have been told beforehand.

Step 4

The conciliation will commence by the conciliation officer outlining what his or her role is, and what the purpose of conciliation is. This should take a few minutes.

Step 5

The insurance company representative will then be asked to let the parties know why the relevant decision was made.

Usually, this will mean they will expand upon the written notice that you were likely provided with (this is the decision notice).

Step 6

Your representative will then be given the opportunity to put your case. Depending upon the nature of the dispute, this could take only a few minutes or much longer.

Generally speaking, the insurer will let your representative speak and will not engage in discussions.

Step 7

Once your representative has said what they need to say, the conciliation officer will then ask you whether you have anything else to add.

You can say as much or as little as you wish at this point.

It’s a good idea, prior to the conciliation, to familiarise yourself with the reason the decision was made and what you need to argue.

Step 8

Once everyone has had their say, the conciliator will then suggest a break into private discussions.

This will involve either you and your representative leaving the room, or the insurance representative leaving the room.

One party will remain with the conciliation office and discuss the matter further.

Step 9

Assuming that you and your representative left the room and allowed the conciliator time to speak to the insurance representative, the conciliator will usually then come into your room to discuss the matter further.

This might involve him or her making suggestions in relation to the dispute. They might identify the strong points and weak points of your case. Copyright – this is original content from TheWorkInjurySite.com.au.

If an initial offer was made by the insurance company, then the conciliator will relay this to you.

You are then able to make a counter offer, and the conciliator will relay this to the insurance company.

This backwards and forth between the parties can then continue until the matter has resolved.

Step 10

If the matter cannot be resolved between the parties, you and your representative will need to make a decision firstly as to whether to pursue the matter further (to the medical panel or to court), and if so, which avenue you wish to pursue.

Step 11

If the parties are able to reach an agreement to resolve the matter, then the conciliator will call the parties back into the main room.

They will outline the agreement reached and seek to clarify any issues that may need to be clarified.

If the parties cannot come to an agreement, then the conciliator will call the parties back into the room and finalise the conference in a similar way.

Step 12

All up, a conciliation can last anywhere from about 30 minutes to several hours, depending upon the nature of the dispute and the issues involved.

Note: many conciliations are being conducted over the phone due to covid-19 restrictions. These conciliations are following a very similar process to conciliations held in person.

Conclusion

Conciliation is designed to give injured workers a way to contest decisions made by the WorkCover insurance company that they disagree with. The process at conciliation involves each party being given the opportunity to put their case in an informal setting and the role of the conciliator is to help the parties reach an agreement.