Record the time to decide a compensation claim or a reconsideration request
Key facts
- Human involvement
- YellowClose supervision
- How AI is used
- From the date the lawyer says a complete initial claim, or a claimant's reconsideration request, was received, count that day as day one. Apply 20 calendar days for an injury other than a disease, or an aggravation of such an injury; 60 calendar days for a disease; and 30 calendar days for a claimant's request to reconsider a determination. If the last day falls on a Saturday, Sunday or a holiday in the place where the decision is made, record the next day that is not. Do not treat a missed date as a deemed decision.
- What the lawyer must review
- The lawyer confirms that the claim is an initial claim under section 14, that it was made in accordance with section 54, and whether the injury is a disease. Comcare's guidance says the Safety, Rehabilitation and Compensation Amendment (Period for Decision-making) Regulations 2023 prescribe 20 calendar days, 60 calendar days and 30 calendar days as stated above. The periods apply to Comcare and to self-insured licensees and commenced on 1 April 2024. Section 11A of the Safety, Rehabilitation and Compensation Regulations 2019, as the guidance describes it, starts the count on the day the determining authority receives an initial claim made in accordance with section 54, or a claimant's reconsideration request under section 38 or 62. A claim in accordance with section 54 is a written claim on a Comcare-approved form and a certificate by a legally qualified medical practitioner. Receipt of the form without the certificate does not start the count. The day of receipt is day one, including a weekend or public holiday. Subsection 61(1A) requires a claim under section 14 to be determined within the prescribed period. Subsection 62(6) requires a claimant's reconsideration request to be decided within the prescribed period. The guidance says the reconsideration period does not apply to an employer's request or to a reconsideration on the authority's own motion, and the claim periods do not apply to a determination under a section other than section 14. The regulations do not prescribe a deemed determination if the time is missed.
Open a jurisdiction version of this task to see which instruments apply: NSWQLDVIC
Who does what
| Role | What they do |
|---|---|
| Assistance | Do not begin AI assistance until the responsible lawyer has defined and confirmed its permitted scope. |
| Lawyer | Set the scope, supervise the work closely, verify every part relied on, resolve omissions and exceptions, and approve the exact output. |
Checklist
- Do not start the count until both the approved claim form and the medical certificate have been received, if the matter is an initial claim.
- Count the day of receipt as day one. Do not move a mid-week end date. Move only a Saturday, Sunday or holiday in the place of the decision.
- Do not describe a missed date as an acceptance or a refusal. The guidance says there is no deemed determination.
Forms and precedents for this task
| Form or precedent | Kind | AI use | Summary |
|---|---|---|---|
| Covering letter for NIISQ internal review of eligibility or treatment, care and support | Letter | AI use Yellow | Covering letter for the NIISQ internal review form, with eligibility and treatment, care and support kept apart. |
| Request that a NSW CTP insurer concede impairment greater than 10 per cent | Letter | AI use Yellow | Letter asking a New South Wales CTP insurer to concede that permanent impairment from a motor accident is greater than 10 per cent, and recording the section 6.14 time for a damages claim. |
| NSW work injury damages: claim letter and pre-filing checklist | Letter | AI use Yellow | Letter to a New South Wales workers compensation insurer claiming work injury damages, with a checklist for the section 315 pre-filing statement. |
Signed-in accounts can read the full text of each one. All precedents.
Sources
These are suggested working checks. Confirm the required checking with the responsible lawyer before work starts; the checking approach does not establish permission to use AI.