When you have a claim for workers’ compensation, on occasion you will be involved in a dispute with the workers’ compensation insurer. A dispute could be over lots of different things. You and the insurer might disagree about whether the insurer should pay for surgery, or whether you are entitled to claim weekly payments for some time off work due to your injury. The insurer might have denied liability for your claim because it has some evidence that your injury isn’t work-related. Whatever the dispute may be, often the only way to resolve that dispute is to file proceedings in the Personal Injury Commission.
Once your application has been filed with the Personal Injury Commission, and the insurer has filed a reply to your application, your case will proceed down the Dispute Pathway. The first step along this pathway is for both parties (meaning you, the insurer, perhaps your employer, and any legal representatives) to attend a Teleconference.
What is a Teleconference?
A Teleconference is where all the parties gather on one telephone line to discuss the dispute that the Personal Injury Commission is being asked to decide on.
Usually, the following people attend the Teleconference:
- A Member, who is appointed by the Personal Injury Commission;
- You, the worker;
- An interpreter (if you need one);
- Your lawyer;
- A case manager from the workers’ compensation insurer;
- The workers’ compensation insurer’s lawyer; and
- A representative from the employer (if necessary).
The Member is an experienced decision maker who is appointed by the Personal Injury Commission. The Member conducts the Teleconference on behalf of the Personal Injury Commission and has the power to make decisions about the dispute that is being dealt with and how the case proceeds.
At the Teleconference, the goal is for the Member to be able to confirm the dispute between the parties, identify if there is any common ground (issues that can be agreed upon and set to one side) and for the parties to discuss the dispute to see if it can be resolved without going further down the Dispute Pathway at the Personal Injury Commission.
When is the Teleconference held?
After your lawyer files an application with the Personal Injury Commission, the Commission will issue a Timetable that provides relevant dates for how the case is going to progress, including the date of the Teleconference.
Usually, the date of the Teleconference will be about 6 weeks after the application is filed with the Commission. Before the Teleconference, the insurer should file and serve their reply to your claim.
What do I need to attend the Teleconference?
The Personal Injury Commission will tell your lawyer whether the Teleconference is going to be held by telephone or by audio-visual link (ie. By video).
You can either attend the Teleconference from wherever you are by telephone or audio-visual link, or, you can go into your lawyer’s office and attend from there. Because you, the injured worker, are at the centre of the process, it’s compulsory for you to attend the Teleconference. On occasion, the Member may excuse you from attending, but this is not common and really applies on a case-by-case basis.
If you are attending the Teleconference via telephone, the Personal Injury Commission operator will telephone you on the phone number provided by your lawyer a few minutes prior to the scheduled Teleconference and ask you to hold until all participants are joined. It’s really important that you have good telephone reception and that you are in a quiet room where you will not be interrupted, and with no background noise when you participate in a Teleconference. It’s also a good idea to keep your phone on mute when you are not talking during the Teleconference, as any background noise, no matter how small, can affect the other people on the telephone line being able to hear.
If you are attending the Teleconference via an audio-visual link, you will need a laptop, iPad or tablet with a webcam and microphone and a reliable internet connection. A link to join the Teleconference will be sent to you by the Personal Injury Commission prior to the Teleconference. You need to click on the link to join the virtual ‘meeting room’, and you will wait there until everybody is connected to the Teleconference, and the Member is ready to commence the Teleconference.
How does the Teleconference proceed?
Once all the people participating are connected to the Teleconference, the Member will introduce themselves and explain the process to you and to any other non-lawyer present. The Member will likely ask you to confirm that you can hear everyone talking and that you understand what is happening.
You should allow an hour and a half to attend the Teleconference, but most don’t run for that long.
Every person at the Teleconference has read all of the evidence, including your statement, that has been filed by the parties with the Personal Injury Commission.
During the Teleconference, you are not required to do anything other than giving your lawyer instructions about any questions that arise during the process, or any offers that are made by the insurer or their lawyer.
The Commission has made a very helpful video for injured workers about the Teleconference which you can watch here.
If an offer is made to settle the dispute which you accept, the Member will record the details of the settlement and the Teleconference will end. After the Teleconference has ended, the Personal Injury Commission will issue a Certificate of Determination through the Commission’s online portal. Your lawyer will send you a copy of the Certificate of Determination.
If the dispute can’t be settled at the Teleconference, the Member will ask the lawyers if further evidence (like updated medical reports, or orders for treating doctors to produce your clinical records) is required to progress your case. If it is, the Member will make orders for the production and service of that evidence. The Member will also offer the parties a date for your claim to be heard by the Personal Injury Commission. The hearing is called a Conciliation/Arbitration hearing, which is the next step along the Dispute Pathway at the Commission. We’ll cover what to expect at a Conciliation/Arbitration hearing in another blog.