FAQs about the Workers Compensation Independent Review Service

An independent review of a 'reviewable decision' can be requested:

• by you, when the decision relates to you
• on your behalf by a nominated representative who is 18 years or older
• by your legal guardian if you are under 18 years of age or you are living with a legal disability
• by a representative nominated by your legal guardian if you are under 18 years of age or you are living with a legal disability. The nominated representative must be 18 years or older.

A ‘reviewable decision’ is a decision 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.

WCIRS is unable to review the following types of decisions.

• 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

Unless there are exceptional circumstances, an independent review can be requested:

• 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.

Under compensation law, where a decision is sent by post, it is reasonably assumed the worker becomes aware of the decision 2 business days after posting.

Under the Electronic Transactions (Victoria) Act 2000, where a decision is sent by email, it is reasonably assumed the worker becomes aware of the decision on the same day it was emailed.

These ‘awareness’ assumptions apply unless the worker provides evidence of when they received the decision by post or email.

Exceptional circumstances are those which are out of the ordinary, unavoidable or unexpected.

Whether there are exceptional circumstances will depend on the worker's particular situation. They are circumstances that:

• are outside the worker's control;
• the worker could not reasonably have prevented or accommodated; and
• must have had a significant and demonstrably negative effect on the worker’s ability to apply to WCIRS within the prescribed time limit.

In the context of a WCIRS application, the fact that the worker has suffered an injury requiring treatment will not ordinarily be considered an exceptional circumstance.

The WCIRS exceptional circumstances policy contains further information about exceptional circumstances.

More information

There are very limited circumstances where WCIRS can still review the decision without a GDOC.

Sometimes after a 'reviewable decision' has been through a Conciliation, the conciliation officer might direct the agent to pay compensation in relation to that decision.

The direction might be revoked by a court because there is a genuine dispute about the decision.

The date of the court finding can be used instead of a GDOC date on an application for independent review to WCIRS.

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.

More assistance

You or your nominated person or representative will need to lodge an application form to ask WCIRS to review a reviewable decision.

Ways you can lodge a request for an independent review include:

• completing our online application form
• filling out the printable PDF application form.

The PDF form can be returned to us by:

• By email to:
  [email protected]
• By post to:
  Workers Compensation Independent Review Service
  WorkSafe Victoria
  PO Box 279
  Geelong VIC 3220

Online application form

PDF application form

We will let you (or your nominated representative) know in writing if the application has been accepted.

If your application is accepted, we will let you know as soon as possible how long we estimate it will take to complete your review.

We will call you and/or your nominated representative to let you know the outcome of the review before we send it to you in writing.

You can email [email protected], who will investigate any delay. Do not email before the estimated timeframe has passed.

You may be able to have the decision reviewed at arbitration or by a court. You can get advice from:

• The Workplace Injury Commission (WIC) by calling 1800 635 960, or emailing your enquiry to [email protected]
• 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.

More assistance

We understand that sometimes decisions appear wrong. The IRO will consider all the relevant information about your claim, including why you think the decision is wrong and the compensation law, and then decide whether it is 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 to the IRO during the review period.

WCIRS considers requests from workers to review a decision in an independent and impartial way that places the worker at the centre of the independent review process. The review is a merits review ‘on the papers’ which means the reviewer only considers the available information.

When deciding if the reviewable decision is sustainable, the IRO will consider:

• the decision making process
• the notice of decision
• the worker’s reasons why they feel that the decision is not right, and
• any new written information which has become available since the reviewable decision was made.

For a list of examples of the information we will consider, please see below.

The reviewer does not:

• conduct an investigation
• seek out further information
• interview witnesses
• interview the worker, their representative, or their 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

The WCIRS IRO will consider all available information which is relevant to the reviewable decision. As a general guide this may include:

• the 'Application for Independent Review of an Agent decision' form and any supporting information provided by the worker (which should be succinct, relevant, and provided within 14 days of the application being accepted)
• what the notice of decision says and whether the reasons given make sense
• any applicable compensation law, WorkSafe policies and/or guidelines
• the information available when making the decision. This could include things such as:
  • the claim form
  • medical reports
  • Medical Panel opinions
  • circumstance investigation reports
  • financial documents.
• the contact with and the information sought and obtained from the worker before the decision was made
• the quality of the information considered when making the reviewable decision
• whether any important information was overlooked
• whether any irrelevant information was taken into account 
• whether any relevant information was misunderstood
• whether any important information was missing when the reviewable decision was made
• where surveillance is relied upon to make the reviewable decision, whether it was obtained and applied fairly and objectively to the decision and the reasons given in the decision
• whether any new information was taken into account after the decision was made.

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].

If you're under the age of 18 years or are living with a legal disability, your legal guardian, representative or person nominated by your legal guardian will need to represent you. The person representing you must be 18 or over.

If you are over 18 years of age, you do not need to be represented to lodge an application with WCIRS.

However, if you would like to be represented, you are able to:

• nominate a friend or family member to represent or assist you, provided that person is 18 years or older
• ask WorkCover Assist by calling (03) 9941 0537, or emailing your enquiry to [email protected]
• ask 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
• ask your individual union representative to represent or assist you
• contact 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.

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 IRO is reviewing a decision made by the WorkSafe Claims and Recovery Support Division (rather than an agent), the IRO may:

• disagree with the decision because it is not sustainable and WorkSafe will withdraw the decision, or
• affirm WorkSafe's decision.

It depends on whether the worker was already receiving a payment or service at the time the decision was made.

If you were already receiving a payment or service at the time of the decision

If you were already receiving a weekly payment or a medical or like service related to the decision when the decision was made, within 2 business days of the decision being overturned or withdrawn the agent/Claims and Recovery Support Division will:

• take steps to restore the payment or service, including payments or services the agent would have been required to pay if it had not made the overturned or withdrawn decision; and
• write to you confirming this has occurred.

The agent/Claims and Recovery Support Division may also choose to make a new decision after a decision is overturned or withdrawn and write to you to let you know what the new decision is.

If you weren’t receiving a payment or service at the time of the decision

If a decision to deny your claim, stop weekly payments, or refuse a medical service you weren’t already receiving is overturned or withdrawn, the Claims and Recovery Support Division will, within 2 business days:

• review the decision again based on the IRO’s findings
• send you a letter confirming the review has taken place.

The decision will stay the same. If you still disagree with the decision you can:

• start or continue an application for arbitration through the Workplace Injury Commission (if eligible), or
• dispute the decision in court.

Workplace Injury Commission (WIC)

We encourage workers to seek independent legal advice about any time limitations for lodging an application for arbitration or at court.

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 Independent Review Office (IRO) can either affirm or overturn the original decision. They can’t tell the agent to make a completely new decision or change the details or outcome of the decision. They can review it, but they can’t rewrite it.

Yes. A WCIRS independent review is an optional dispute resolution process before lodging an application for arbitration (if eligible) or at court.

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

No. WCIRS is a free service and it does not pay for any legal costs you may have in seeking an independent review.

No. WCIRS cannot direct the agent to pay for medical reports for your independent review.