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      What should I do if my Comcare claim is denied?

      Quick answer

      Unfortunately, the Comcare scheme is not straightforward, and your claim may be denied for several reasons. These include providing insufficient evidence, having a pre-existing condition, or failing to report your injury to your employer immediately. The good news is that a delayed claim is not the end of the road—you’re entitled to challenge Comcare’s decision.

      Below, you’ll find everything you need to challenge a decision successfully.

      In depth answer

      To start the process, you must make a written request for reconsideration within 30 days. Comcare will then reconsider their decision and hand down a new written decision. This is called a ‘reviewable decision’.

      If you want to contest this reviewable decision, you’ll need to lodge an appeal with the Administrative Appeals Tribunal (AAT) within 60 days.

      At this stage, we’d advise getting specialist advice from a Comcare lawyer. The AAT process involves many negotiations with Comcare’s legal team to try and reach a settlement. It’s crucial to understand the Comcare scheme well before diving into negotiations.

      Generally speaking, this process takes six months to a year. However, depending on the circumstances and complexities involved, your appeal may take longer. During this time, you will need to:

      • Gather evidence: the AAT will want your medical reports and other relevant evidence. You may also need to undergo new tests to provide further evidence for your appeal.
      • Attend a conciliation: this is a formal negotiation between you, your lawyer (if you have one), and Comcare.
      • Go to an AAT hearing: This is where most cases get decided unless there is an appeal to the federal court. An appeal to the Federal Court only happens in rare circumstances.

      Lodging a successful appeal can be complex. If your claim has been denied, contact one of our Comcare team today. They will assess your application and provide advice on your situation. This ensures you meet all criteria for your appeal and gives you the greatest chance of success.

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