Step-by-step guide to the Workers Compensation Independent Review Service

About WCIRS

WCIRS is a free, impartial service that reviews certain disputed decisions made by or on behalf of WorkSafe, when a worker believes a decision isn't right and conciliation hasn't resolved it.

An Independent Review Officer (IRO) looks at the available written information and decides whether the original decision was sustainable – that is, whether it has a reasonable prospect of being upheld by a court.

What we review

Decisions we can review

WCIRS can review decisions made by or on behalf of WorkSafe:

• relating to provisional payments for mental injury
• not to accept a worker's claim (including a decision not to accept liability for an injury, condition or disease)
• relating to weekly payments, including:
  • a decision to stop, suspend or refuse weekly payments
  • the calculation of weekly payments, or
  • whether a worker has current work capacity
• relating to medical and like (similar) services.

Decisions we can’t review

• Decisions about impairment benefits or degree of impairment.
• Decisions made by, or on behalf of, a self-insurer.
• Decisions relating to the death of a worker or their dependants.
• Decisions to stop weekly payments because impairment is not 21% or more.
• Decisions to stop weekly payments where WorkSafe considers payments were obtained fraudulently.
• Decisions to reject a claim on the basis the person is not a 'worker' under the compensation law.
• Decisions to reject a claim on the basis the employer was not the correct employer.
• Decisions where there has been a final Medical Panel determination.
• Decisions settled by agreement between the agent and the worker.
• Decisions relating to a Serious Injury or Common Law Damages application.

Not sure if your decision fits? See Help and contact.

What WCIRS can and can't do

We do

• Conduct a merits review 'on the papers' – meaning the Independent Review Officer (IRO) only considers the written information already on file, plus anything relevant you provide
• Decide whether the original decision was a 'sustainable decision'. A sustainable decision is one which has a reasonable prospect of being maintained by a court, taking into account the information that was before the agent and any further information provided during the review
• Consider all relevant material already on your claim file

We don’t

• Conduct an investigation
• Seek out further information ourselves
• Interview witnesses
• Interview you, your representative, or the WorkSafe agent
• Act as your case manager
• Conduct a hearing
• Conduct a conciliation conference or mediation
• Consider what happened at conciliation
• Review decisions relating to impairment benefits or self-insurer claims – these fall outside our jurisdiction entirely
• Provide you with legal advice about your application
• Provide you with advice about your claim

How to apply

Am I eligible to apply?

You can apply if you're the worker the decision relates to, or a nominated representative aged 18 or over (for example a family member, union, or lawyer).

If you're under 18 or living with a legal disability, your legal guardian or their nominated representative will apply on your behalf.

Unless exceptional circumstances apply, you must lodge your application:

• within 6 months of becoming aware of a 'reviewable decision' made by or on behalf of WorkSafe (unless a dispute referred to Conciliation within 6 months remains unresolved), and
• within 30 days of:
  • a Workplace Injury Commission (WIC) Conciliation Officer issuing a Genuine Dispute Outcome Certificate (GDOC) relating to the decision; or
  • a court revoking a direction issued by a WIC Conciliation Officer and finding there is a Genuine Dispute in relation to the decision, and
• before a court or arbitration:
  • listing the matter for a final hearing date for review of the decision, or
  • referring a medical question relating to the decision to the Medical Panel for assessment.

If the 'reviewable decision' is listed for a final court or arbitration hearing date or referred to the Medical Panel during an independent review, we will cease the review and take no further action.

Our Exceptional Circumstances Policy explains what counts as exceptional circumstances.

Follow the link below for more information about nominating a person or representative for your WCIRS review.

After your application is accepted

If you have further relevant information to add, please provide it within 2 weeks of acceptance.

This helps us keep your review moving. Submissions received after this point, or that are longer than necessary, will cause delays in completing the review.

During your review

What happens during the review

Once your application is accepted, an Independent Review Officer (IRO) is assigned to your case.

The IRO reviews all relevant material on your claim file, along with any further relevant information you've provided, to decide whether the original decision was sustainable.

This is a merits review conducted ‘on the papers’. The IRO doesn't hold a hearing, interview witnesses, or contact you for a discussion in the way a case manager or conciliator would.

If something in your file needs clarifying, the IRO may contact WorkSafe, the agent, or you directly.

How long will it take?

We’re not able to give a fixed timeframe. Every application is different, and the time needed depends on the complexity of the decision and current demand.

Can I withdraw my application?

Yes, you can withdraw your application at any time before a final outcome is communicated to you.

If you would like to withdraw your application, please email WCIRS at [email protected].

Review outcomes

Possible outcomes

Once the Independent Review Officer (IRO) completes the review, there are 2 possible outcomes:

• the IRO affirms the decision – it remains in effect and unchanged, or
• the IRO disagrees with the decision – because it's not sustainable – and directs the agent to overturn it.

An agent can also choose to withdraw a decision at any point before the review concludes, if they agree it isn't sustainable.

If the decision is affirmed

The decision stays as it is.

If you still disagree, you can pursue a court application, or (if eligible) arbitration through the Workplace Injury Commission.

What WCIRS can't do

The IRO can only affirm or overturn the decision. They cannot replace it with a different decision or change its substance.

Help and contact

Need help?

If you aren’t sure if you can ask for a review, please contact our service directly on (03) 4243 7061 between 8:30 am and 4:30 pm, or email [email protected].

You don't need to call to check on general progress – we'll contact you if we need anything from you.

Calling ahead of an update generally won't speed things up, since it can only tell you the review is progressing rather than deliver the outcome sooner.

Other places to get support

For further support or advice with a WCIRS review, you may consider contacting:

• WorkCover Assist by calling (03) 9941 0537, or emailing your enquiry to [email protected].
  • Union Assist (if you’re a member of one of the unions they support) by calling (03) 9639 6144, or sending an online message on the Union Assist website
  • your union representative
  • a lawyer.

If you need a lawyer, the Law Institute of Victoria (LIV) offers a 'Find Your Lawyer Referral Service' on the LIV website.

Note: WorkSafe does not pay for the cost of your lawyer for a WCIRS review.

The link below provides a list of more organisations you can contact for help with a WCIRS review.