Appealing to the Administrative Appeals Tribunal
The Administrative Appeals Tribunal (AAT) can undertake an independent merits review of a reviewable decision made under the Safety, Rehabilitation and Compensation Act 1988.
The Administrative Appeals Tribunal (AAT) is an independent body that reviews a wide range of administrative decisions made by Australian Government ministers, departments and agencies.
Regarding claims, the AAT:
- looks at the evidence on your claim and decides whether a correct decision has been made
- has powers that the claims manager does not have, such as the power to summons medical records or to require a person to give evidence.
For more information on the role of the tribunal visit Administrative Appeals Tribunal (AAT).
For more information on Workers Compensation matters and the role of the AAT, please refer to the Guide to the Workers' Compensation Jurisdiction available on the AAT website.
When you can appeal
If you are not satisfied with a determination that your claims manager has made on your claim, you should first ask for a reconsideration of the determination. This review is undertaken by an independent review officer who works in a different area than your claims manager.
If you are dissatisfied with the decision by the independent review officer, you can apply to the AAT to have the decision reviewed.
The time limit to apply for a review by the AAT is 60 days after you are given notice of the decision.
The appeals process
You do not need to have legal representation at the AAT. However, other parties may be represented by a lawyer at the AAT. If you would like the assistance of a lawyer you can contact the Law Society in your state or territory.
If your claim is managed by Comcare, Comcare is represented by a lawyer from our internal team or from an external law firm.
The process normally includes:
- A preliminary conference. This is run by an AAT Conference Registrar and both parties participate by appearing in person, or by remote access technology (like MS Teams or telephone). Conferences are the central component of the AAT’s pre-hearing case management process. They provide the opportunity to determine where the matter is up to. This includes determining if more medical or factual information is needed, and whether the parties are ready to progress to a conciliation conference or hearing.
- Tribunal summonses. Parties can each ask the AAT to issue a summons on a third party to produce records relevant to the matter. These are usually medical or employment records.
- Statements and further information. The AAT may direct the parties to provide additional information relevant to the matter.
- Conciliation conference. This is a more formal conference designed to help the parties either resolve the matter or agree on the issues which need to be determined by the AAT at a hearing.
Not all of these steps occur in every case.
If an agreement can’t be reached about the outcome of your case during the pre-hearing process, it proceeds to a hearing in the AAT.
A hearing usually involves you giving evidence.
It may also include evidence from medical practitioners, your employer and other witnesses.
Decision of the Administrative Appeals Tribunal
The AAT can make a decision by consent or after hearing your case. It can decide to:
- affirm the decision, which means the decision made by the review officer does not change
- vary the decision, which means the decision made by the review officer is changed or altered in some way
- set aside the decision, which means that the decision made by the review officer is changed in part or full, or
- send a decision back to the review officer to make a new decision.
When the AAT makes a decision after a hearing, you or Comcare may appeal to the Federal Court on a question of law within 28 days of receiving the decision.
Implementing a Decision
If the AAT decides to change a reviewable decision or remit it to Comcare, and there is no Federal Court appeal, Comcare will implement the decision.
Depending on the outcome of your AAT appeal, Comcare many need to notify and/or seek information from:
- Private Health insurers
- your Superannuation fund/s.
This can take some time but is necessary to ensure that compensation paid is correct and does not result in any overpayments or recovery. Comcare is legally required to make some of these notifications.
For more information on Centrelink or Medicare requirements, you can:
- Visit the below pages on Services Australia website for more information
Information required to implement a decision
Every AAT outcome is different so the information Comcare needs to implement the decision will vary from case to case.
However, in most cases you will need to provide some, or all of the following information in order for Comcare to implement a decision:
- Medical certificate/s or other documents issued by a legally qualified medical practitioner
- Copies of invoices and/or receipts for medical treatment expenses related to the accepted condition
- Confirmation of access to other income support (such as, Centrelink or superannuation)
- A claim for time off work and supporting medical information for any period of incapacity due to the accepted condition.
Your employer may also need to provide Comcare with information about:
- your earnings before you were injured
- leave you took as a result of your accepted condition/s (as leave reversal is considered part of any weeks payable in accordance with the AAT outcome)
- cessation of employment form (if you are no longer employed with the agency).
For further information about implementing an AAT outcome, speak to the Comcare representative who is engaged in the AAT process or your Comcare Claims Manager.