Workers' Right of Access to Claims File

Published: 5 May 2009

A person who has had a worker’s compensation claim in the past or has a current claim is entitled to obtain a copy of all documents relevant to their claim from the compensating authority (either WorkCoverSA or the self-insured employer, depending on who managed the claim).

 

Section 107B of the Workers Rehabilitation and Compensation Act 1986 obliges the compensating authority to provide copies of the relevant documents within 45 days after the request is made.  WorkCoverSA has an application form that can be completed and lodged (it can be printed off from the WorkCoverSA website: www.workcover.com).  Many self-insured employers also have a form.  However, if one is not available, a letter requesting a copy of the claims file should be sufficient.  There is no fee payable for the provision of documents under this section of the Act.

 

If the compensating authority is unclear about what documents are being sought, they will contact the person applying to discuss it.

 

The compensating authority is not obliged to provide copies of materials if the material is relevant to the investigation of suspected dishonesty in relation to the claim or the material is protected by legal professional privilege.  Therefore, it is probable that they will not provide copies of surveillance reports or film or their correspondence with lawyers.

 

What can you do if you have applied for a copy of your claims file and the compensating authority has either not responded to your request within the 45 day time limit or has provided copies of only some of the documents you think they have?

 

In the first instance, you should contact your claims manager to try to sort out the problem.  If that does not achieve the desired result, you can contact the WorkCover Ombudsman’s Office.  The WorkCover Ombudsman has jurisdiction to investigate complaints about breaches of section 107B of the Act.  If a complaint is lodged, the WorkCover Ombudsman has power to obtain documents or require a person who has relevant information to answer questions under oath.  If necessary, he can inspect the file to determine whether all relevant documents have been provided in accordance with the section.

 

Please feel free to contact the Office if you have any questions about the process for accessing documents on a workers compensation claims file.