Decision not to seek damages reviewable in certain circumstances
266 Decision not to seek damages reviewable in certain circumstances
The worker may ask the insurer to consider fresh medical evidence about the worker’s injury but only—
to satisfy the insurer of the matters mentioned in subsection (7) for the purpose of seeking damages for the injury; and
within the period mentioned in section 302(1).
The insurer is required to consider the medical evidence only if the worker satisfies the insurer that—
when the worker’s DPI was decided under section 179, there was no reason to believe that there would be a material deterioration of the worker’s injury; and
the further material deterioration is a deterioration of the injury for which the worker was assessed and accepted payment of lump sum compensation under section 189; and
the medical evidence—
was not available when the worker’s DPI was previously decided or when the worker made the election not to seek damages; and
establishes there has been a further material deterioration of the worker’s injury that has resulted in an additional DPI of 10% or more.
If the insurer rejects the evidence, the insurer must refer the evidence to a review panel for review.
The review panel must consider the medical evidence produced by the worker and may accept or reject the evidence.
A decision of the review panel is final and may not be appealed against.
If the insurer or the review panel accepts the medical evidence, the insurer must refer the question of degree of permanent impairment to an appropriate medical assessment tribunal for decision.
The worker may seek damages for the injury if the insurer is satisfied that—
the worker’s further material deterioration has resulted in an additional DPI of 10% or more; and
the deterioration is a deterioration of the injury for which the worker has accepted payment of lump sum compensation; and
the deterioration does not arise from combining a psychiatric or psychological injury with another injury; and
the additional DPI, when added to the worker’s previous DPI, results in a DPI of the worker of 20% or more.
In this section—
review panel means a panel consisting of the chairperson or deputy chairperson of the General Medical Assessment Tribunal and a member of an appropriate medical assessment tribunal.
This Act’s bill:Explanatory memorandum
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