WORKERS REHABILITATION AND COMPENSATION ACT 1986 - SECT 53
This legislation has been repealed.
WORKERS REHABILITATION AND COMPENSATION ACT 1986 - SECT 53
(1) On receipt of a
claim for compensation the Corporation shall make such investigations and
inquiries as it thinks necessary to determine the claim.
(2) 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
medical expert nominated by the Corporation from a list of approved experts.
(3) If a claimant for
compensation—
(a)
fails or refuses to furnish information reasonably required by the Corporation
to 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
shall determine claims for compensation as expeditiously as reasonably
practicable and where the claim is for compensation by way of income
maintenance shall, wherever practicable, endeavour to determine the claim
within 10 business days after the date of receipt of the claim.
(4a) Where—
(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.
(4b) 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.
(5) As soon as
practicable after determining a claim for compensation the Corporation shall
give notice in writing of the determination—
(a) to
the claimant; and
(b) to
any employer who may be directly affected.
(6) Where any part of
a claim is rejected, the notice referred to in subsection (5)
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.
(7) The Corporation
may, in an appropriate case, by notice in writing to the worker, redetermine a
claim.
(7a) For the purposes
of subsection (7)
, 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
(ca) the
redetermination is for the purposes of section 4(11)
and is appropriate by reason of the stabilising of a compensable injury; or
(d) the
original determination was made as the result of an administrative error and
the redetermination is made within two weeks of the making of the original
determination; or
(e) the
redetermination is made in prescribed circumstances.
(7b) A regulation made
for the purposes of subsection (7a)(e)
cannot come into operation until the time for disallowance has passed.
(8) 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.