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ACC Disputes Management Procedure

Category Health and Safety
Type Procedure
Approved by Director Human Resources, August 2000
Date Procedure Took Effect 1 August 2000
Last Approved Revision 1 August 2010
Sponsor Director, Human Resources
Responsible Officer Head, Health and Safety Compliance
Review Date 31 August 2013

Purpose

This procedure will be performed to resolve any conflict or disagreement relating to any decision by the University whether a claim is personal injury by accident (PIBA), or is work related or not, or where there is a dispute regarding entitlements or any rehabilitation initiatives implemented under the ACC Partnership Programme agreement

Organisational Scope

All workplaces of the University of Otago.

Definitions

CMT – Case Management Team (Occupational Health Nurse, ACC/H&S Administrator, Health and Safety Manager, Occupational Physician).

Disputes Manager – Director of Human Resources

DRSL – Disputes Resolution Solutions Limited

Policy Content

(1) Employee advises in writing or verbally of dispute.

  • The dispute must be received in writing, within 3 months of the original claim decision, and is to set out the reasons for contesting the decision.

(2) A complete copy of the claim file will be forwarded to the review applicant and to DRSL with a copy of ACC33 Application Review form in preparation or written application by claimant for the review hearing.

  • This must be within 7 working days of the initial review request from the claimant.

(3) CMT member to discuss the dispute with employee if verbal contact is made.

(4) The ACC Case Management Team will meet with the employee and employees’ representatives/support person in an effort to resolve the dispute.

  • The use of external mediation service should be considered for this step depending on circumstances, as well as considering referral to an ACC consultant for input in claim decision making.
  • If the review is in favor of the employee then the claim will be accepted and rehabilitation plan or entitlements issues settled as necessary. Claimant notified in writing with summary of decision and to DRSL advising of the outcome of the internal process.
  • If the review confirms the original decision, advise the claimant of outcome and second tier review process.

(5) Discuss decision with employee and arrange meeting with the Disputes Manager, Director of Human Resources.

  • The Disputes Manager (or nominee if absent) and members of the ACC Case Management Team, will meet with the employee and employee’s representative/support person.
  • In case of disputes involving claimants outside Dunedin, arrangements will be offered to facilitate a meeting in Dunedin with all parties at the expense of the University.
  • The internal review decision must be completed and parties advised within 7 working days of receipt of an application for review.
  • If the dispute management meeting rules in favor of employee then claim will be accepted and/or rehabilitation plan amended or put in place or entitlement issue settled, as necessary. If committee confirms the original decision then continue to step 7.

(6) The ACC/H&S Administrator will advise DRSL of the dispute management meeting outcome.

(7) Refer claim to DRSL for formal review.

  • A copy of the full claims file including a copy of the completed ACC33 Application Review form to be forwarded to DRSL in preparation for the review hearing, with a covering letter identifying PARTNERSHIP PROGRAMME REVIEW in large letters across the top of the page.

(8)The claimant is able to withdraw the review application at any time.

(9) Reviews are to be evaluated by the Case Management Team annually, identifying the types of decisions that are reviewed, whether Case Management Teams decisions have been overturned, and reviewing the cover and entitlement decision-making process.

  • The formal report is to be forwarded to the Disputes Manager and must not identify any individual by name. Where applicable, a plan of action for improvements developed between the Disputes Manager and the Case Management Team.

Related Policies, Procedures and Forms

Health and Safety in Employment Act 1992
Accident Compensation Act 2001
Health and Safety Policy
ACC Partnership Programme

Contact for Further Information

If you have any queries regarding the content of this policy or need further clarification, contact Andrea McMillan on andrea.mcmillan@otago.ac.nz or (03) 479 7380.