Apply for review of a decision

At ReturnToWorkSA, we aim to minimise applications for a review of decisions, so the focus remains on what’s important; recovering from an injury and returning to work.

Our personalised service approach encourages open communication and early identification of issues so they can be addressed before they get too big. However, if you are not happy with a decision relating to your claim or insurance premium, you have the right to apply for a formal review.

If you wish to seek a review, you will need to make an application to the South Australian Employment Tribunal.

Work injury claim decisions

If you are dissatisfied with a decision made about your claim, we encourage you to talk to your case manager in the first instance.

If you wish to apply for a formal review, you can do so through the South Australian Employment Tribunal The following work injury claim decisions are reviewable:

• a decision regarding serious injury claim
• a decision about the nature or scope of recovery/return to work services provided, or to be provided for a worker
• a decision regarding an assessment of a worker’s permanent impairment
• a decision relating to a work injury claim, for example:
  • acceptance of a claim
  • average weekly earnings
  • the provision of services or incurred costs
  • to approve, or not approve, the costs of surgery
  • to discontinue or suspend weekly payments.

For more information on reviewable decisions by the South Australian Employment Tribunal, please visit www.saet.sa.gov.au.

Legal Costs
If you lodge an Application for Review (a dispute) or Application for Expedited Decision in the South Australian Employment Tribunal (SAET) and you obtain legal advice and representation from a lawyer (or other authorised representative such as a union or employer organisation), you can claim some of the associated legal fees from the compensating authority.

There are set limits on the amount of legal fees you can recover, depending on when your dispute resolves (e.g., at or during conciliation or following a full hearing and determination before a Presidential Member of the SAET). How much of your legal fees you may have to pay ‘out of pocket’ will depend on the fees charged by your lawyer, along with how much you are entitled to recover. Generally, you can claim legal fees from the compensating authority whether or not your dispute is ultimately successful.

However, if a party has acted unreasonably or been frivolous or vexatious in lodging their dispute or in the course of dispute proceedings before the Tribunal, the Tribunal may not allow that party to recover legal fees or might order that the party pay some or all of the legal costs of the compensating authority.

Note that you cannot claim legal fees from the compensating authority for general legal advice about your claim.

Insurance premium decisions

If you consider that a decision made by us in relation your premium is unreasonable, you have the right to apply for a review of that decision. Before applying for a review, please call us on 13 18 55 to discuss.

If you still wish to apply for a formal review, you will need to complete and submit the Section 157 – Application for review (Employer) form (PDF, 98 KB). If the decision relates to an individual employer you must submit your application within two months of being notified of the decision. For decisions relating to a class of employers, you must submit your application within four months of being notified of a decision.

Decisions that can be reviewed include:

• your classification to a particular class of industry (SAIC)
• the assessing (or fixing) of a premium
• the imposition of a penalty interest or fine
• an estimate of remuneration used for your premium calculation.

For more information on reviewable decisions, please refer to the Return to Work Act 2014.