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3.1 Nature and Content of Determinations of Liability


Section 61 of the SRCA requires that a decision on liability must be issued as a written determination informing the client, at a minimum:


a) the terms of the determination (i.e. meaning whether the claim has been accepted or rejected etc. and, if accepted, from what date); and


b) the reasons for the determination (in all instances, Delegates are required to explain the reason for making a particular decision. In cases where liability is found, the reasons need only be fairly brief, referring to the medical and/or other evidence on which the decision to find liability was based. However, in those cases where the claim has been disallowed, the reasons must necessarily be comprehensive, bearing in mind the likelihood of a request for reconsideration and possible review by the AAT or Federal Court.)


c) a statement to the effect that the claimant may, if dissatisfied with the determination, request a reconsideration of the determination under subsection 62(2).


Delegates should issue Determinations as provided in the Defcare Standard Letter suite. There are separate Liability Determination letters for either acceptance or denial of liability. Those letters are templates only which are designed and intended to be modified to suit the circumstances of the particular case. However, they should not be changed in ways that alter the three statutory requirements referred to above.


A clear audit trail of reasons for the decision should be recorded in all cases in either the Investigation Notes within the Initial Liability Support Module or in the determination issued to the client or their representative.