Apply for a claim review - step-by-step

Q-COMP independently reviews certain insurers’ decisions for workers, claimants and employers. It is not a court process or a re-investigation of the matter. Some insurers’ decisions which can be reviewed are:

• a worker’s entitlement to compensation

• an insurer’s failure to decide a compensation application

• an employer’s premium.

Some examples of Insurer decisions in relation to a worker’s entitlement to compensation that Q-COMP may review are:

• decisions about the time for applying for compensation

• decisions to accept or reject an application for compensation

• decisions to stop payment of compensation

• decisions to increase or decrease weekly payment of compensation

• decisions about injuries on a notice of claim for damages.

Q-COMP’s review service is free, but you will need to pay for any solicitor or another person who helps prepare your application—for information contact the Queensland Law Society or call the Workers' Compensation Advisory Service, Queensland Council of Unions on 1800 102 166 (you don’t need to be a union member)

Step 1: Apply for a review of the insurer’s decision within three months of receiving your insurer's notice

The reasons for the decision help you to understand the insurer's decision and put together the basis of your application for review. If the notice didn’t state the reasons, you have 20 business days to ask them for their reasons—speak to the contact person on the notice and ask them to send you their reasons.

Note: Within the initial three month period, you can ask Q-COMP to extend the review application time if there are special circumstances.

Download Form 542.3 Application for review (PDF 152.0 kb) or call Q-COMP on 1300 739 021 and we’ll post one out.

Step 2: Detail why you are unhappy with the insurer's decision ( i.e. the grounds for the review)

Keep it brief and make sure you state at least one area of dispute. The insurer's reasons should help you to do this. Attach any documents or other information you want considered with your review application and send it by email, fax or post to:

Email: reviewunit@qcomp.com.au

Fax: 07 3020 6375

Post:

Q-COMP
PO Box 10119
Adelaide Street
Brisbane
QLD 4000

Step 3: Q-COMP writes back to confirm we have received your application

We allocate your application to a review officer to review the insurer’s decision. They will consider information from:

• the insurer's file

• right of appearance

• any other relevant information.

The review officer will contact you to discuss your application and ask you if you’d like to talk with them further in person or over the phone (known as your ‘right of appearance’).

Step 4: Attend your ‘right of appearance’ (optional)

Whether you take it up will not affect our review of the insurer’s decision. It helps to resolve the matter in a non-threatening, non-legal way. This is an opportunity for you to give us any additional information, or point out particular issues or knowledge you have about your case. You can bring your legal or non-legal representatives, or a relative or friend for support.

Step 5: Q-COMP decides the review within 25 business days unless we've agreed to an extension of time and you and the other party will each receive our written decision and reasons within 10 business days after the decision is made

The review officer will either:

• confirm the original decision

• vary the original decision

• set aside the original decision and substitute another decision or

• set aside the original decision and return it to the insurer with directions.

The 25 business day decision period can be extended only if you:

• agree to allow Q-COMP to obtain more information or

• apply for an extension to supply more information for your application.

If we don’t decide the review within 25 business days, or the agreed extended timeframe, you can:

• appeal to an Industrial Magistrate or the Queensland Industrial Relations Commission or

• wait for the review decision to be made.

Step 6: Appealing the review decision

If you (or the other party) are unhappy with our review decision, you (or the other party) can appeal to an Industrial Magistrate or to the Queensland Industrial Relations Commission within 20 business days of receiving the review decision.

Privacy, confidentiality and natural justice - the fine print
Q-COMP collects information to review a workers’ compensation insurer’s decision. As part of deciding the review, the rules of natural justice require that we disclose important information, including personal information, to others for their response—for example, to the worker, the insurer, the employer and any other person whose interests might be affected by our decision.

If you believe that information you provide to Q-COMP is covered by a genuine legal obligation of confidence, tell us in writing. We may still have to reveal the substance (but not the detail) of the confidential information to another if that is what natural justice requires.

For more information about the review process, call Q-COMP on 1300 739 021.