8.13.2 Review of a decision to suspend processing of a claim

The decision by a delegate to suspend processing of a claim because of obstruction of or refusal or failure to attend a medical examination is strictly not subject to reconsideration under S62, or review by the AAT under S64, at the request of the claimant, because a decision under S57 is not nominated as a 'determination' for the purposes of Part VI of the SRCA. If, however, a claimant seeks reconsideration of such a decision, it is appropriate to refer the decision for review to a more senior officer. It must be made clear to the client that the review is being undertaken as a matter of discretion by the MRCC delegate and that a further appeal to the AAT is not available.

Note, however, that a disaffected claimant could take a judicial review action in the Federal Court on the issue of 'reasonable excuse'. Full documentation of the grounds for the decision must be kept against this possibility.

In cases where a suspension has been imposed, it is suggested that negotiations be undertaken in an attempt to resolve the problem. It is generally preferable to determine a claim for impairment on its merits rather than rely on a procedural provision such as S57.

References

1971 Act: Chapter 8

• Instructions Relating to the Compensation (Commonwealth Government Employees) Act and Regulations, Schedule E: Policy on 'likely to become totally incapacitated'
• Instructions Relating to the Compensation (Commonwealth Government Employees) Act and Regulations: Composite Injuries
• Instructions Relating to the Compensation (Commonwealth Government Employees) Act and Regulations 39/3: Only major loss is compensable
• Approved Guide Table 4.2: Facial Disfigurement
• COA 98/014: Examination of Claimants by Legally Qualified Medical Practitioners under Section 57
• COA 97/020: Permanent Impairment for 1971 Act Conditions Claimed Under the 1988 Act
• COA 96/019: Medical Certificates
• Commonwealth v Matheson (1955) 93 CLR 403: LOEU
• Hoyle v Telstra Corporation Limited (1997) 75 FCR 390; 145 ALR 148; 25 AAR 240: Total incapacity excludes compensation under S39
• Fazlic v Milingimbi Community Inc (1982) 150 CLR 345 : reasonable refusal of medical treatment to be judged on client's perception
• Hoyle v Telstra Corporation Limited (1997) 75 FCR 390; 145 ALR 148; 25 AAR 240: Total incapacity excludes compensation under S39
• McKinnon v Commonwealth & Ors (FC 98/1456, 19/11/98) : 'reasonable excuse' – possibility of further injury