Section 78 Notice

When a workers compensation insurer disputes an injured workers claim for benefits they must do so in accordance with the notice provisions pursuant to Section 78 of the Workplace Injury Management and Workers Compensation Act 1998 (NSW).

The document sent to the worker by the workers compensation insurer disputing the claim is commonly referred to as a “Section 78 Notice”.

Section 78 Notices can be issued in relation to various disputes that may arise in a workers compensation claim including payment of weekly wage benefits and an injured workers’ reasonably necessary medical expenses.

When disputing a claim the workers compensation insurer is required to include in the Section 78 Notice certain information as required by the Workers Compensation Regulation 2016 including:

• A statement identifying all the reports and documents submitted by the worker in making the claim for compensation, and by the employer in connection with the claim.
• A statement identifying all the reports relevant to the decision, whether or not the reports support the reason for the decision or not.
• Details of the procedure for requesting a review of the decision.
• A statement to the effect that the worker can seek advice or assistance including from the Independent Review Office (IRO).
• A summary in the approved form of the effect of the decision, the workers right to review, the procedure for requesting a review and the legal and other services that may be available to a worker to provide advice or assistance in relation to the dispute.

Additionally, the insurer may also have to provide a notice period to the injured worker before the dispute determination comes into effect e.g. before ceasing payment of weekly wage benefits.

An injured worker should be aware that when they receive a Section 78 Notice they may be eligible for a grant of funding from the Independent Review Office (IRO) to obtain free legal assistance in disputing the decision of the insurer.

We recommend that if you have received a Section 78 Notice you contact us for our expert advice and assistance to ensure you obtain your full entitlement to compensation.