RETURN TO WORK ACT 2014 - SECT 31
RETURN TO WORK ACT 2014 - SECT 31
(1) On receipt of a
claim, the Corporation may undertake such investigations and inquiries as are
necessary in order to achieve an evidence based decision with respect to the
determination of the claim.
(2) Without limiting
any other provision, for the purpose of satisfying itself of the nature,
extent or probable duration of an injury, the Corporation may require a worker
to submit to an examination by a recognised health practitioner nominated by
the Corporation.
(3) If a
claimant—
(a)
fails or refuses to furnish information reasonably required by the Corporation
to assess or determine the claim; or
(b)
fails or refuses to submit to an examination as required under
subsection (2),
the claim may be rejected.
(4) The Corporation
must determine claims for compensation as expeditiously as reasonably
practicable and where the claim is for compensation by way of income support
must, wherever practicable, endeavour to determine the claim within
10 business days after the date of receipt of the claim.
(5) If—
(a) the
injury results from a road accident; and
(b) no
member of the police force attends at the scene of the accident; and
(c) the
claimant is required to report the accident to a member of the police force or
at a police station under the Road Traffic Act 1961 ,
the Corporation may refrain from determining the claim until the accident is
so reported.
(6) If an employer
notifies the Corporation, before the Corporation determines a claim, that the
employer disputes that the injury is compensable under this Act, the
Corporation must, before determining the claim, make a reasonable
investigation into the grounds on which the employer disputes the
compensability of the injury.
(7) As soon as
practicable after determining a claim the Corporation must give notice in
writing of the determination—
(a) to
the claimant; and
(b) to
any employer who may be directly affected.
(8) If any part of a
claim is rejected, a notice under subsection (7) must include—
(a) such
information as the regulations may require as to the grounds on which the
claim is rejected; and
(b) a
statement of the claimant's rights to have the determination reviewed.
(9) The Corporation
may, in an appropriate case, by notice in writing to the worker, redetermine a
claim.
(10) For the purposes
of subsection (9), an appropriate case is one where—
(a) the
redetermination is necessary to give effect to an agreement reached between
the parties to an application for review or to reflect progress (short of an
agreement) made by the parties to such an application in an attempt to resolve
questions by agreement; or
(b) the
claimant deliberately withheld information that should have been supplied to
the Corporation and the original determination was, in consequence, based on
inadequate information; or
(c) the
redetermination is appropriate by reason of new information that was not
available and could not reasonably have been discovered by due enquiry at the
time that the original determination was made; or
(d) the
redetermination is for the purposes of section 5(11) and is appropriate
by reason of the stabilising of a work injury; or
(e) the
original determination was made as the result of an administrative error and
the redetermination is made within 2 weeks of the making of the original
determination.
(11) The
redetermination of a claim does not give rise to any right on the part of the
Corporation to recover from the worker money paid under a previous
determination unless the previous determination was made in consequence of the
worker's fraud.