Examination Provisions In The Act

Section 36 (4) states:

“Where an employee refuses or fails, without reasonable excuse, to undergo an examination, or in any way obstructs an examination, the employee's rights to compensation under this Act, and to institute or continue any proceedings under this Act in relation to compensation, are suspended until the examination takes place.”

As with section 57 (2), this provision serves to not only reinforce how important it is that an employee attends the examination, it also places an obligation on the employee to actively participate in the assessment process.

When reading through subsections (4) through (7), regard should be had to the information which was detailed under section 57 in volume 7, Review Processes, if it is not clear what the provisions mean.

And, while the Act may look the same, there are some minor differences to be aware of in relation to suspending claims, especially on PRACSYS.

The case manager has the delegation under section 36 to commence the suspension process.  This is done by initially advising the employee of his or her rights and obligation and the reasons why he or she is considered to be not complying with the rehabilitation assessment.

A request to comply or provide a “reasonable excuse” for non-compliance will be included in the letter to the employee, with a copy forwarded to Comcare for information.

If the employee offers no reasonable excuse and Comcare agrees to proceed with the suspension, a further letter is written to the employee by Comcare.  In this letter the employee is once again advised of his or her rights and obligations and provided with 7 days to comply or provide a reasonable written excuse for non-compliance.

If, after the 7 days have elapsed, the employee still refuses to comply with the rehabilitation assessment or has not provided a reasonable written excuse, procedures to suspend the claim should commence.

Although the employee then has 30 days to request a reconsideration of this decision, suspension may occur before this.  Comcare selects the suspension date.