Understanding decisions about your claim
When you have a workers compensation claim, your insurer will make decisions about your support.
This page explains the most common types of decisions.
Types of decisions
Insurers make decisions about:
- whether your claim is accepted
- how much you are paid
- what treatment is approved
- what work you can do
What is a work capacity decision?
A work capacity decision is a common type of decision. It covers:
- What work you can do
- How many hours you can work
- How much you can earn
- How much you will be paid
Changes to decisions
Insurers may change decisions over time. This can happen when:
- Your condition improves or changes
- New medical information is received
- Your work situation changes
What if you don’t agree with a decision?
If you disagree with a decision, you can:
- Ask the insurer to explain it
- Ask for a review
- Contact the IRO for help
IRO services
The IRO provides independent services if you have questions or concerns about a decision.
We can:
- explain decisions in plain language
- outline the review and dispute options
- contact the insurer to address issues
- assist with complaints about how decisions are handled
If you need more support, the IRO can also refer you to legal assistance through our ILARS service.