GN 8.3 Personal Injury Commission - member decisions and appeals

Published: 12 August 2019
Last edited: 11 June 2024

Application: This guidance also applies to exempt workers

Overview

The Personal Injury Commission (Commission) has exclusive jurisdiction to examine, hear and determine all matters arising under the Workplace Injury Management and Workers Compensation Act 1998 (1998 Act) and the Workers Compensation Act 1987 (1987 Act). For the Commission’s role in respect of damages, see Insurer guidance GN 9.2 Work injury damages.

This guidance outlines the types of disputes and the process in the Commission to hear and determine legal disputes.

Note: The Commission’s mediators assist parties to resolve work injury damages disputes. Generally, parties must participate in mediation before the worker can commence court proceedings. The Commission’s mediators are appointed by the President. Mediators are, in the exercise of their functions, subject to the general control and direction of the President.

Note: Coal miner workers compensation disputes are determined by the District Court of NSW where coal miners have access to a specialist mining judge and a separate hearing list which exclusively deals with coal mining claims.

The Personal Injury Commission

The Commission is an independent statutory tribunal within the NSW justice system committed to providing a transparent and independent dispute resolution service. The Personal Injury Commission Act 2020 (PIC Act) sets out the functions and powers of the Commission.

Personal Injury Commission Rules, procedural directions and policies

The Personal Injury Commission Rules 2021 (the Rules) provide operational direction to the Commission, covering matters of practice and procedure in proceedings.

Procedural directions provide a more detailed explanation of the Commission’s procedures.

The Commission’s policies set standards of practice for the Commission and the people who use the Commission’s services.

Types of dispute

Disputes are assigned to the most appropriate dispute resolution pathway:

  • legal disputes
  • medical disputes
  • expedited assessments
  • damages disputes
  • other disputes.

The Commission has produced a number of informational videos covering what to expect at different stages of the dispute resolution process including content on the different dispute pathways.

Legal disputes pathway

The legal disputes pathway is the most common pathway. The disputes that go through this pathway are about entitlements to weekly compensation, medical and related expenses compensation, lump sum compensation for permanent impairment and payments in respect of the death of a worker.

The issues in dispute could include whether an injury has occurred, whether the injury happened at work, whether work was a substantial or main contributing factor to the injury, whether medical treatment is reasonably necessary, whether the injured person was a worker, which body parts were injured, and the amount of compensation payable.

The Commission’s conciliation/arbitration process

The Commission has developed a dispute resolution model incorporating a blend of informal negotiation and formal hearing.

The pathway begins with the use of informal dispute resolution techniques to try to resolve the dispute by agreement between the parties. Initially, this is done with the parties and their representatives attending a teleconference. If the parties cannot resolve the matter at this stage, it will proceed to a conciliation conference.

If the dispute is not resolved at the teleconference or conciliation conference, it will progress to a formal arbitration hearing where the Commission will decide the dispute.

The Commission provides multiple mechanisms for the conduct of the conciliation conference and arbitration hearing. Parties can attend in person, via telephone, or via videoconferencing, depending on the circumstances of the case and external factors.

More information on dispute pathways is available on the Commission website and in the Commission videos.

Insurer participation in Commission disputes

Fully informed and good faith participation by insurers in the Commission dispute resolution process can help the timely and effective resolution of disputes. Procedural Direction PIC10 – Personal Injury Commission Hearings provides that all parties, including the worker and the insurance claims officer, are required to attend the hearing. If the hearing venue is an in-person venue, then all parties and the insurance claims officer are expected to attend in-person. In exceptional circumstances, the Commission Division Head may excuse an in-person attendance on application by a party in writing.

See Insurer guidance GN 8.2 Insurer participation in disputes and mediations for more information.

Publication of Commission decisions

Section 58 of the PIC Act requires the publication of decisions of the Commission and decisions of Appeal Panels for medical assessments. Rule 132 of the Rules allow for the de-identification or redaction of publishable decisions before publication.

Decisions of the Commission are published on the legal research databases of AustLII, BarNet Jade and Lexis Nexis.

Appeals from a decision of a member

An appeal of a member decision is made to the Commission constituted by a presidential member. An appeal is made by application to the President.

Appeals from a member’s decision are limited to the determination of whether a decision was or was not affected by errors of fact, law or discretion, and the correction of any such error. The appeal is not a review or new hearing (section 352 of the 1998 Act).

Procedural Direction WC3 – Presidential appeals and questions of law concerns the practice and procedure for an appeal to a presidential member as well as the referral of a question of law to the President.

Appeals from a decision of a presidential member

If a party to any proceedings before the Commission constituted by a presidential member is aggrieved by a decision of the presidential member on a point of law (legal principles and statutory interpretation), the party may appeal to the NSW Court of Appeal.

Permission of the Court of Appeal must be sought to bring an appeal where the amount in dispute is less than $20,000 (as adjusted), or the dispute relates to costs only, or is an appeal from an interlocutory (provisional) decision or an appeal from a decision made with the consent of the parties (section 353(4) of the 1998 Act).

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