Following a workplace incident, once a decision on the application for review is made, it will be sent in writing to the applicant, other party, and the insurer within 10 business days.
Potential review outcomes include:
- Confirmation: The insurer's decision remains unchanged.
- Variation: The insurer's decision undergoes changes.
- Set Aside: The insurer's decision is altered, prompting necessary actions.
- Set Aside Undecided: The insurer's decision is set aside, and the matter is returned with specific instructions for a fresh decision.
If dissatisfied with the review decision, either party can file an appeal with the Queensland Industrial Relations Commission within 20 business days of receiving the review decision.
For workers whose claims are rejected or terminated, expenses related to the review application are at their cost. If medical examination and report costs were incurred for the review and it leads to setting aside the insurer's decision, reimbursement may be possible, contingent upon the Office of Industrial Relations' assessment of the contribution of the medical examination and report.
For employers, if a claim accepted by the insurer is overturned in the review, certain costs may be eligible for removal from the policy. Employers should contact the insurer for further discussions on this matter.