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1.2 Determinations of Liability
The decision – either to concede or deny liability – must be issued to the employee in writing, i.e. as a 'determination', as soon as practicable after that decision has been made. The determination must give reasons for the decision and information on reconsideration rights.
A determination, which accepts liability, must specify the date of effect for this liability to commence. This commencing day is either the date of injury or, in the case of a disease, the date of diagnosis or first treatment. Liability once accepted is accepted for life. However, payments of compensation may not be payable at certain periods as the client must at the relevant time be suffering from the medical effects of the accepted condition(s). (Note: This 'liability' should not be confused with the right to receive incapacity payments, which is an entitlement that ends at Age Pension Age.)
Where a medical condition does appear to resolve completely or its effects are overtaken by another ailment, any benefits the client is claiming may be denied under the relevant section(s) on the basis there is “no current entitlement”'. This decision(s) must also be issued as a formal determination, as it is an appealable decision. A “no current entitlement” determination generally provides for payment of compensation or provision of rehabilitation to cease from a particular day (e.g. the date of a relevant medical opinion, or the date of the determination) and usually does not have the effect of cancelling the original acceptance of liability. It also does not foreclose the possibility that the client's circumstances may change with entitlement arising in the future. In some cases however (e.g. involving a fraudulent misstatement by the employee or an error in the original determination), the new determination may state that liability is rejected on and from the date of the original injury.
Refer to 14.2 Denying Benefits where there is “no current Entitlement”.
Age Pension Age refers to pension age as defined under the Social Security Act 1991, that is, pension age for people other than veterans.