Independent Review Office Can Help with Your Compensation Claim

In NSW the Independent Review Office (IRO) was created in 2021 as a successor to the WorkCover Independent Review Office (WIRO), which was first established in 2012 to provide an oversight mechanism across the state’s workers’ compensation scheme.

The IRO is an independent statutory office created under the Personal Injury Commission Act 2020 (‘PIC Act’). Its functions are set out in the Act and include:

• finding solutions for persons injured at work or in motor vehicle accidents who have complaints about insurers that affect their entitlements, rights or obligations under the workers’ compensation and motor accidents legislation;
• administering the Independent Legal Assistance and Review Service (ILARS);
• conducting inquiries into matters arising from the operation of the Act and NSW legislation covering workers’ compensation and motor vehicle accident schemes.

The IRO also maintains a role running education programs for stakeholders in compensation matters in NSW.

Further detail on the IRO’s work

In 2018 legislative reforms were introduced which expanded the remit of WIRO, as it then was. Under these changes the office was empowered to deal with complaints and enquiries from all categories of injured workers, including police officers, firefighters, paramedics and coal miners. It was also now able to meet legal costs for legal representatives to advise and assist workers with work capacity decisions that had not previously been subject to review.

With the establishment of the IRO in March 2021, the office’s responsibilities were further enlarged to deal with complaints about the actions or omissions of insurers by persons injured in motor vehicle accidents, in addition to its workers’ compensation responsibilities.

IRO’s ‘Solutions Group’ seeks to solve complaints by persons injured at work or in motor accidents about insurance companies, and also responds to their enquiries.

Additional responsibilities of the IRO include inquiring into and report to the Minister on any matters arising from operation of the PIC Act or the workers’ compensation and motor accidents legislation, and to encourage complaint resolution procedures by insurers and employers under the schemes.

Helping injured parties access legal advice through ILARS

Apart from its key responsibility in investigating and resolving complaints made by injured workers about an insurer’s conduct or a decision made in assessing a workers’ compensation claim, IRO’s other main role is to fund free legal advice for injured workers about a potential or existing claim, regardless of their financial circumstances.

Through ILARS, funding of legal advice by the IRO ensures that injured workers can:

• obtain legal advice and assistance about their rights and entitlements under the workers’ compensation legislation;
• attempt resolution of disagreements or disputes;
• have their claim determined in the PIC where a dispute is unable to be resolved by agreement or dispute resolution procedures;
• obtain legal representation to pursue or defend appeals at the PIC and to higher courts, where appropriate.

An injured worker’s lawyer must apply to ILARS for a grant of funding to cover their legal fees and other related expenses such as medical reports. An ‘Approved Lawyer’ is then able to claim legal costs, comprising professional fees and disbursements, from the IRO.

It should be noted the IRO must be satisfied the claim or the challenge to an insurer’s decision has some prospect of succeeding in order for a grant to be approved.

Examples of decisions by insurers that may require a grant under the ILARS scheme include where an insurer refuses to pay weekly compensation benefits, medical treatment expenses, or lump sum compensation for permanent impairment; where the insurer makes a decision on an injured worker’s work capacity which reduces their entitlement to weekly compensation benefits; and where an employer refuses to arrange suitable duties for an injured worker to return to work in a modified capacity.

Get Further Information From Our Compensation Specialists

If you have been injured at work or in a motor vehicle accident and believe you need the assistance of the IRO in dealing with your employer or the insurer, first contact our compensation specialists at Gajic Lawyers. We can help clarify how the IRO operates and whether you have a case that justifies applying for a funding grant to cover legal advice. It’s our mission to make this process as trouble-free and streamlined as possible in what can be a complex area of law, so contact us for an initial consultation today.