IRO Medical Disputes Early Solutions Pilot Program
The Independent Review Office (IRO) will soon be implementing a Medical Disputes Early Solutions pilot program (the Pilot). The Pilot’s aim is to help facilitate early solutions in disputes between workers and insurers about liability for medical and related treatment in matters where the worker’s lawyer is funded through the Independent Legal Assistance and Review Service (ILARS).
Workers compensation matters where the only issue in dispute is a medical treatment claim or expense may be identified by IRO as appropriate for inclusion in the Pilot.
The Pilot will commence on 25 September 2023 for most insurers and on 3 November 2023 for the Nominal Insurer (icare).
How does the Pilot work?
The Pilot program builds on IRO’s existing successful early solutions program and will operate in a similar manner to IRO’s well-established No Response To Claim (NRTC) process, which results in hundreds of quick solutions in matters each year and is already familiar to lawyers and insurers.
As part of the Pilot, IRO will identify ILARS-funded matters that may be appropriate for intervention to prompt early solutions between workers and insurers.
Once it has been identified that early intervention by IRO may be appropriate, IRO will assist in facilitating a further review by the insurer of a decision to deny liability for a medical treatment claim or expense.
Where a quick solution is not reached, a prompt decision will be made about any request for additional funding for an Approved Lawyer to file an application with the Personal Injury Commission.
At the conclusion of the Pilot IRO will analyse the outcomes to determine whether to implement it as a permanent process, change the way it operates, or expand the Pilot consistent with our statutory function to assist in finding early solutions.
For more information, including information on which matters may be eligible for inclusion in the Pilot, you can find the Medical Disputes Early Solutions Pilot Program - FAQs