TransportAccident Act
NoFault Dispute Resolution Protocols – 1 March 2005
(amendedasfromAugust2008)
1.INTRODUCTION
1.1Consistent with its mission and vision statement, Client Service Charter and public commitmenttomodellitigantguidelines, theTransportAccidentCommission(TAC)strivesto prevent or minimise disputes between it and claimants.
1.2TheTAC,LawInstituteofVictoria(LIV)andAustralianLawyersAlliance(ALA)allagree theseprotocolsrecognisethat appropriatemechanismstoresolve disputesare importantfor ensuringthatclaimants’ legalrights andobligationsarebeingobserved andarenot abandoned for the lack of opportunity toenforce them.1
1.3The role played by claimants’ lawyers inthis process is recognised by the TAC.
1.4TheprotocolshavebeenagreedbytheTACwithLIVandALAwhoagreethattheyandtheir membershipwill comply with them.
2.OBJECTIVES
2.1Theprocessesgivingrisetotheassessment,considerationanddeliveryofbenefitsare,by the mutual andearlyexchange of relevantand reasonableinformationanddocuments, productive of quality decision making bythe TAC.
2.2BenefitdeliveryprocessesandproceduresforadministrativereviewofPart3orPart10 decisionsmadeunderthe TransportAccidentAct (TAA)arefair,efficientandprovide an expeditioustransparentprocessforthe deliveryofappropriatenofaultbenefitstopeoplewho sustain injuries as aresult of a transportaccident.
2.3TheTACmaintainsapubliccommitmenttoallstakeholderstoadheretomodellitigant guidelines.
2.4TheTAC,theclaimantandtheirlawyerwillendeavourtoresolvePart3andPart10benefit disputesutilisingtheseprotocolsbeforeresortingtocontested reviewproceedingsatthe VCAT.
3.APPLICATION
3.1TheseprotocolswillapplytotheresolutionofallPart3andPart10TAAdisputesarising subsequent to a TAC decision, including a deemed decision.
3.2TheseprotocolswillapplytoeveryTACPart3orPart10decisionmadeonorafter1March
2005 where aTACclaimanthas,atanytimeafterthetransportaccident,retainedalawyer who whichis amemberofeitherLIVor ALAtoprovideadviceabouttheconsequencesofthe accident injury.
3.3Claimantswhochoosenottoberepresentedbylawyerswillhavetheopportunitytohave their issues resolved through the TAC’s existing informal review process.
3.4TheTACconfirmsthattheclaimant’slawyerwillalwaysbeadvisedofadecisionatthesame time as the claimant.
1JusticeStatementMay2004ModernisingJusticeatparagraph3.3
1March 2005– 2
4.MERIT REVIEW AT THE VCAT
4.1SubjecttoChapter6,aclaimantorapersonwhoseinterestsareaffectedbyadecisionmade bytheTACunderPart3orPart10oftheTAAmay,notearlierthanthreemonthsandnot laterthan12monthsofbecomingawareofthedecision,applytotheVCATforareviewof the decision.2
4.2SubjecttoChapter6oftheseprotocols,aclaimant,whoisrepresentedbyalawyerwhoisa memberofLIVorALA,maynotissueanapplication forreviewtotheVCATuntilapre-issue reviewhasbeencompletedinaccordancewiththeseprotocols,unlessboththeclaimantand
the TAC, in writing, consent, or unless clause 4.3 applies.3
4.3IfaclaimanthasnotappliedtotheTACforapre-issuereviewwithinnine(9)monthsof becoming aware of the TAC’s decision:
4.3.1TheclaimantmayapplytotheVCATforreviewofthedecisioninaccordancewith Clause4.1.4 TheprovisionsofSection78oftheTAAwillapplyandcompliance with Chapters6, 7and 9to14ofthese protocols will constitutecompliance with Section 78 ofthe TAA; and
4.3.2TheclaimantmustcontemporaneouslyserveadisputeapplicationontheTACin accordancewith Clauses6.1 and 6.3; and
4.3.3Chapters6,7and9to14oftheprotocolswillapplyandnofurtherstepswillbe taken at theVCAT until the pre-issue review has been concluded.
5.STATEMENT OF REASONS
5.1Itisrecogniseda claimanthas an entitlementto requestfrom theTACa statementofreasons fordecision andthatthe TAC willgive a statementofreasons on requestpursuant tothe VCAT Act.5
5.2Provisionismadeintheseprotocolstoenableclaimantstomaketheserequestsandforthe
TAC to complyprior to claimants proceeding with a request for TAC to review its decision.
6.PRE-ISSUE REVIEW
6.1AclaimantorapersonwhoseinterestsareaffectedbyorwhoisdissatisfiedwithaTAC decisionmay,subjectto Clause4.3, at anytimewithin12 months ofbecoming aware ofthe TACdecision,throughthe claimant’slawyerapplytotheTACinwritingforapre-issuereview (dispute application).6
6.2Thedisputeapplicationmustidentifythedecision(s)tobethesubjectofthepre-issuereview, whetherinwholeorinpartandthereasonswhy theclaimant doesnotagreewiththe decision(s).
6.3A pre-issue review involves the exchange of material by the claimant and the TAC in accordancewithChapters9through14followedbyapre-issueconference.Adisputemay be resolved bythe partiesprior to a pre-issue conference.
6.4Thedisputeapplicationmustbesupportedbytheinformationanddocumentsinaccordance withChapters9to13inthepossessionoftheclaimantorpersonatthattimeandwhichare to be relied on in the pre-issue review. Any other supporting material which is either
2 Sections63and77TAA
3 TheTACmayrequire,asaconditiontoprovidingitsconsent,thatthedisputeproceedthereafter incompliance withtheprovisions ofSection78TAA
4 ItisrecognisedthatSection77timeframesaresubstantiveandarenotaffectedbytheseprotocols
5 Sections45and46oftheVCATAct
6 ItisrecognisedthatSection77timeframesaresubstantiveandarenotaffectedbytheseprotocols
1March 2005– 3
unavailableorintheprocessofcollectionatthetimeofservicemustbeprovidedtotheTAC
within 28 days of the delivery of the dispute application.
6.5DisputeapplicationsmustbeservedontheManager,DisputeResolution,TransportAccident
Commission, 60 Brougham Street, Geelong 3220or DX 216079, Geelong.
6.6TheTACmust,within14daysofreceivingadisputeapplication,commenceapre-issue review byacknowledging receiptofthe disputeapplicationtotheclaimantand theclaimant’s lawyers. The acknowledgementmay bein writing orbyemailandmustincludethedateon which the dispute application was received.
6.7TheTACmustconcludeapre-issuerevieweitherwithin14daysoftheconclusionofthepre- issueconferenceorifthedisputehasbeenresolvedbeforethepre-issueconference,within
14 days of the resolution.
6.8WheretheTACfailstocommenceapre-issuereviewwithin14daysofreceivingadispute applicationthedecision(s) thesubjectof adisputeapplicationisoraredeemedaffirmedand the claimant may issue anapplication for reviewat the VCAT in respect of the decision(s).
6.9Ifthetimelinesforthecompletionofapre-issuereviewextendtoatleastnine(9)months aftertheclaimantbecameawareoftheTAC decision,thentheclaimantmaymakean application for review to the VCAT andChapter 4, Clauses 4.3.1 and 4.3.3 will apply.
7.PRE-ISSUE CONFERENCE
7.1Unlesstheissuesindisputehavebeenotherwiseresolved,thedisputantsmustcommencea pre-issue conference within 90 days of the dispute application being received bythe TAC.
7.2Oncecommenced,thepre-issueconferencemustbeconcludedwithin120daysofthe dispute application.
7.3Apre-issueconferencemaytakeplaceattheTAC’spremises,theclaimant’slawyer’soffice or at anothervenue convenient to the participants.7
7.4Apre-issueconferencerequirestheattendancebythedisputantstofacilitatetheresolution of the dispute between the parties in accordancewith Clause 7.5 through 7.11.8
7.5Who must attend the conference:
7.5.1Theclaimantand,whereaguardianoradministratorhasbeenappointedbythe
VCAT, the guardian or administrator;
7.5.2The claimant’s lawyer;
7.5.3Aprofessionalqualifiedinterpreterwheretheclaimanthasindicatedarequirement for an interpreter9;
7.5.4Arepresentativeoftheclaimsmanagementdivision(s)withintheTACresponsible for making the decision(s)and who hasauthority to resolve the issue(s) in dispute.
7.6Theseprotocolsrecognisethatdifferentdisputeresolutionpathwaysshouldbeavailableto reflectdisputants’needsandexpectations.10 Accordingly,duringthecourseofapre-issue conference the disputantsmay agree:
7 TheTACsupportsconferencesbeingconductedinruralcitiesandtowns
8 Apre-issueconferencecanbeheldbytelephone.Atelephoneconferencewillnotbeconsidereda pre-issueconferenceforthe purposesoftheseprotocolsunlessallthosethenofaultdisputeresolutionprotocolsrequiretobein attendanceare in
attendance
9 TheTACwillarrangefortheattendanceofandpayforthereasonablecostoftheprofessional interpretingservice
1March 2005– 4
7.6.1To appoint anindependentmediatorto mediate the issue between them; or
7.6.2To appoint a facilitator to assist with resolution; or
7.6.3Thatajointexpertbeappointedwheremedicalandlikebenefitsorservicesunder
Section 60 are in dispute; or
7.6.4Where a novel issue of interpretation under AMA2 or AMA4 arises, to the appointmentofajointexpertorspecial refereewithGuidesexpertiseacceptableto the parties.
7.7Amediator,facilitatororjointexpertorspecialrefereemayrecommendtothedisputantsthat thepre-issue conference beadjournedtoenablethe claimant,ortheTAC,toobtain information from a third party where this information is relevant to and would assist a resolutionoftheissuesbetweenthem.11 Wheretheclaimant’sclaimformauthorityisusedto
obtaintheadditionalinformationtheTACmustcomplywiththeProtocolsforClaimForm
Authority Useby the TAC agreed between LIV, ALA and the TAC.
7.8Whereajointexpertorspecialrefereeisappointed,thedisputantsmayagreethattherewill beonejointagreedinstructionstatementfortheexpertandagreedattachmentsforthe expert.
7.9Thedisputantswillnot,unlesstheyagree,beboundbythereportofanindependentexpert or special referee.
7.10The TACwill pay the costs of the mediator, facilitator,joint expert or special referee.
7.11Anythingsaidordoneinthecourseofapre-issueconferenceoranassociatedmediationor facilitationmaynotlaterbedisclosedinanysubsequentproceedingbeforethe VCATunless the claimant’s lawyers and the TAC agree that the disclosure maybemadeor unless required by law.
8.OUTCOME
8.1Upon the conclusion of a pre-issue review, the TAC must either:
8.1.1Affirm its decision; or
8.1.2Vary its decision; or
8.1.3Set aside itsdecision andmake a newdecision; or
8.1.4Confirm resolution of the dispute and the agreed terms ofthe resolutionand prepare a release for execution by the claimant reflecting the agreed terms.12
8.2WheretheTACaffirmsorvariesitsdecision,itwillwritetotheclaimant’slawyersconfirming thatthedisputehasbeenthesubject ofpre-issuereviewandthattheTAC’sdecisionunder review is affirmed or varied.
8.3Subjecttoclause4.3,thedecision(s)thesubjectofadisputeapplicationisoraredeemed affirmedand theclaimant mayissue an applicationformeritreviewattheVCATinrespect of the decision(s)where theTAC fails to:
8.3.1Commenceapre-issuereviewwithin14daysofreceivingthedisputeapplication;
or
10 JusticeStatementChapter3.3
11 Examplesofthirdpartieswouldincludeemployers,doctors,theHIC,etc.
12 Includinge.g.bytheprovisionoftermsofsettlement,consentordersorareleasewhereappropriate
1March 2005– 5
8.3.2Providetheclaimant’slawyerswithalldocumentationtheTACconsideredtomake thedecisionwithin28daysofreceivingthedisputeapplication asrequired by clauses 9.3, 10.3, 11.3, 13.3 and 14.413;or
8.3.3Affirm,varyorsetasidethedecisionorprovidethewrittenconfirmationinClause
8.2 within 14days afterconcluding thepre-issue conference.
9.ELIGIBILITY DISPUTES
9.1WhereadisputeinvolvesaneligibilitydecisionunderSections3and35oftheTAA,the disputantsagreetoprovidedocuments andinformationtoberelieduponinaccordancewith this Chapter.
9.2UnlessalreadyprovidedtotheTACpriortoitseligibilitydecisiontheclaimantshallprovideto the TAC:
9.2.1Asignedstatementbytheclaimant,settingouttherelevantfactsknowntothe claimant regarding the incident said to be a transport accident;
9.2.2Anystatementsorreportsofanywitnessesrelieduponbytheclaimant.The statements should be signed whereverpossible;
9.2.3Medical reports having regard to the denial of eligibility14;
9.2.4Relevant photographs or diagrams;
9.2.5Medicalreportsandtreatingmedicalor alliedhealthprofessionalpractitionernotes, where theseare relevant;
9.2.6Anyreportbyanonmedicalexpertwitnesswherethisisinexistenceandwillbe relied upon;
9.2.7Whenrelevant,legalcontentionsincludingcitationsofanylegalauthorityrelied upon.
9.3Unlessalreadyprovidedtotheclaimant,theTACmustprovidetheclaimant’slawyerswithin
28daysofreceivingthedisputeapplicationwithallthedocumentstheTACconsideredto make the decision, including:
9.3.1Police reports and statements taken by the police where the TAC has them;
9.3.2Any report bya non medical expert witness where this is in existence;
9.3.3Statements ofany witnesses to or aboutthe incident that the TAC has obtained;
9.3.4Copies of anyinvestigation reportswhichthe TAC hasobtained;
9.3.5Copiesofanymedicalreportsincludingtreatingpractitionersreportsandclinical notes, hospitaladmission documentationand ambulance case sheets where these were relied on to deny the claim; and
9.3.6Whenrelevant,legalcontentions,includingcitationsofanylegalauthorityrelied upon and anyrelevant legal authorities.
9.4WheretheTACfailstoprovidetheclaimant’slawyerswithalldocumentstheTACconsidered tomakethedecisionwithin28daysofreceivingthedisputeapplicationasrequiredbyclause
13 Applicabletodisputeapplicationslodgedonorafter1September2007
14 WheretheTACadviseswithinseven(7)days ofthedisputeapplicationthatit willpayforthecostsof suchmedicalreports
1March 2005– 6
9.3,thedecision(s)thesubjectofthedisputeapplicationis/aredeemedaffirmedandthe claimant may issue an application forreview at the VCAT in respect of the decision(s)15.
10.LOSS OF EARNINGS RATE DISPUTES
10.1Whereadisputeinvolvesalossofearningsratedecisionthedisputantsagreetoprovide documents and information to be reliedupon in accordance with this Chapter.
10.2UnlesstheinformationordocumentshavealreadybeenprovidedtotheTACpriortoitsloss ofearningsratedecision,theclaimant shall providetotheTACasignedstatementbythe claimant setting out as best as the claimant is able todo so:
10.2.1Details of the claimant’s earnings in accordance withthe TAA;
10.2.2Relevantfactsandmattersgoingtotheassessmentoftherateoflossofearnings in accordance with the TAA16;
10.2.3Copiesofduplicategroupcertificates,paymentsummaries,or,inthecaseofself employed claimants,individualand partnership,corporationortrustreturnsof entities in which the claimant has a material interest;
10.2.4DetailsofanyCentrelinkpayments–forexample,unemployment,sicknessor disability benefits;
10.2.5Anaccountant’sreport(whererelevantandwheretheTACagreestomeetthe reasonablecost of such areport);
10.2.6Medicalreportsandtreatingmedicaloralliedhealthprofessionalpractitionernotes, where theseare relevant;
10.2.7Anyotherrelevantdocumentorstatementrelieduponbytheclaimantinsupportof theclaimant’scontention (e.g.booksofaccount,bankstatements,orderbooks, substitute labour payments, etc.) in accordancewith the TAA; and
10.2.8Whenrelevant,legalcontentionsincludingcitationsofanylegalauthorityrelied upon.
10.3Unlessalreadyprovidedtotheclaimant,theTACmustprovidetheclaimant’slawyerswithin
28daysofreceivingthedisputeapplicationwithallthedocumentstheTACconsideredto make the loss of earnings rate decision,including:
10.3.1TheTACIncomeAssessor’sreport,calculations,documentsconsideredand/or examined, assumptions and conclusions;
10.3.2The expert accountant’s report wherethis was relied upon to make the decision;
10.3.3Any statements obtained bythe TAC; and
10.3.4Whenrelevant,legalcontentions,includingcitationsofanylegalauthorityrelied upon and anyrelevant legal authorities.
10.4WheretheTACfailstoprovidetheclaimant’slawyerswithalldocumentstheTACconsidered tomakethedecisionwithin28daysofreceivingthedisputeapplicationasrequiredbyclause
10.3,thedecision(s)thesubjectofthedisputeapplicationis/aredeemedaffirmedandthe claimant may issue an application forreview at the VCAT in respect of the decision(s)17.
15 Applicabletodisputeapplicationslodgedonorafter1September2007
16 Forexample,as contemplatedinSections4,5and6oftheTAA
17 Applicabletodisputeapplicationslodgedonorafter1September2007
1March 2005– 7
11.LOSS OF EARNINGS DURATIONAND LOSS OFEARNING CAPACITY DISPUTES18
11.1Whereadisputeinvolvesthedurationoflossofearningsortheassessmentordurationof lossofearningcapacitythedisputantsagreetoprovidedocumentsandinformationto be relied upon inaccordancewith this Chapter.
11.2UnlesstheinformationordocumentshavealreadybeenprovidedtotheTACpriortoitsloss ofearnings/lossofearningcapacitydecision,theclaimantshallprovidetothe TACasigned statement bythe claimant setting out asbest as theclaimant is able to do so:
11.2.1Detailsoftheclaimant’srelevantearningshavingregardtotheemploymentstatus of the claimant in accordancewith the TAA;
11.2.2Relevant facts and matters going to the assessment of the rate of loss of earnings/lossofearningcapacityhavingregardtotheemploymentstatus19 ofthe claimant in accordancewith the TAA;
11.2.3DetailsofanyCentrelinkpayments–forexample,unemployment,sicknessor disability benefits;
11.2.4Copiesofduplicategroupcertificates,paymentsummaries,or,inthecaseofself employed claimants,individualand partnership,corporationortrustreturnsof entitiesin whichthe client hasamaterialinterest havingregardtothe employment status of theclaimant in accordancewith the appropriate provisions of the TAA;
11.2.5Anaccountant’sreport(whererelevantandwheretheTACagreestomeetthe reasonablecost of such areport);
11.2.6Anyotherrelevantdocumentorstatementrelieduponbytheclaimantinsupportof theclaimant’scontention (e.g.booksofaccount,bankstatements,orderbooks, substitute labour payments, etc.) in accordancewith the TAA;
11.2.7Iftheclaimanthasbeenreceivingcompensationforlossofearningsorcapacity undertheTAA,notificationofthereturn toanywork (whetherasanearneror otherwise);
11.2.8Detailsofallworkthathasbeenundertakensubsequenttothetransportaccident and attemptsby the client to obtain alternative dutiesor to return towork;
11.2.9Medicalreportsandtreatingmedicaloralliedhealthprofessionalpractitionernotes, where theseare relevant; and,
11.2.10Whenrelevant,legalcontentionsincludingcitationsofanylegalauthorityrelied upon.20
11.3Unlessalreadyprovidedtotheclaimant,theTACmustprovidetheclaimant’slawyerswithin
28daysofreceivingthedisputeapplicationwithallthedocumentstheTACconsideredto make the loss of earnings decision, including:
11.3.1Surveillance reports and video;
11.3.2Medicalreportsincludingclinicalnotes,testresultsanddiagnosticreportsand impairment assessment medical reports;
11.3.3Vocational rehabilitationreports;
18 IncludingSection55TAAreviews
19 IncludingallofthematterstowhichtheTACmusthaveregardinSection7(a)to(e)oftheTAA
20 Consistentwith VCATPracticeNote
1March 2005– 8
11.3.4Any statements obtained bythe TAC; and
11.3.5Whenrelevant,legalcontentions,includingcitationsofanylegalauthorityrelied upon and anyrelevant legal authorities.
11.4WheretheTACfailstoprovidetheclaimant’slawyerswithalldocumentstheTACconsidered tomakethedecisionwithin28daysofreceivingthedisputeapplicationasrequiredbyclause
11.3,thedecision(s)thesubjectofthedisputeapplicationis/aredeemedaffirmedandthe claimant may issue an application forreview at the VCAT in respect of the decision(s)21.
12.MEDICAL AND LIKE BENEFIT DISPUTES
12.1WhereadisputeinvolvesamedicalandlikebenefitdecisionunderSection60oftheTAAthe disputantsagreetoprovidedocuments andinformationtoberelieduponinaccordancewith this Chapter.
12.2UnlesstheinformationordocumentshavealreadybeenprovidedtotheTACpriortoits medicalandlikebenefitdecision,theclaimant shallprovidetotheTACasignedstatementby the claimant setting out asbest as theclaimant is able to do so:
12.2.1Clarifying thenature and extent of the benefit or treatment sought;
12.2.2Anysuchserviceortreatment provided for thisconditionbeforethetransport accident;
12.2.3The reasons why the benefit or treatment should beprovided orcontinued;
12.2.4Medicalreportsandtreatingmedicaloralliedhealthprofessionalpractitionernotes, where theseare relevant; and
12.2.5Copiesofreportsbyeveryrelevantnonmedicalorparamedicalsupportingexpert relied upon suchasa physiotherapist,pharmacist,chiropractor,occupational therapist, speech therapist, rehabilitationconsultant, architect or builder.22
12.3Unlessalreadyprovidedtotheclaimant,theTACmustprovidetheclaimant’slawyerswithin
28daysofreceivingthedisputeapplicationwithallthedocumentstheTACconsideredto make the medical and likebenefit decision including:
12.3.1Surveillance reports and video;
12.3.2Any statements obtained bythe TAC;
12.3.3Medicalreportsincludingclinicalnotes,testresultsanddiagnosticreportsand impairment assessment medical reports;
12.3.4Vocational orother relevantrehabilitationreports;
12.3.5Relevant occupational therapist orotherparamedicalprovider reports; and
12.3.6Whenrelevant,legalcontentionsincludingcitationsofanylegalauthorityrelied upon and anyrelevant legal authorities.
12.4WheretheTACfailstoprovidetheclaimant’slawyerswithalldocumentstheTACconsidered tomakethedecisionwithin28daysofreceivingthedisputeapplicationasrequiredbyclause
21 Applicabletodisputeapplicationslodgedonorafter1September2007
22 TheTACagreestopayreasonablecostsofexperts suchasarchitectorbuilderwherethisis relevantandthecostofthereport isapprovedbytheTACinadvance
1March 2005– 9
12.3,thedecision(s)thesubjectofthedisputeapplicationis/aredeemedaffirmedandthe claimant may issue an application forreview at the VCAT in respect of the decision(s)23.
13.DEPENDENCY AND DEATHBENEFIT DISPUTES
13.1Whereadisputeinvolvesadependencydisputethedisputantsagreetoprovidedocuments and information to be relied upon in accordance withthis Chapter.
13.2Unless the informationordocuments have alreadybeenprovidedtotheTACbeforea decisionaboutdependencyortherateofdependencybenefitstobepaid24,theclaimant25 whoclaimstohavebeendependentshallprovidetotheTACa signedstatementasbestthe claimant is able to do including:
13.2.1Details of the claimant’s relationship with the deceased which support a dependency relationship between the claimant and the deceased26;
13.2.2Details relevant to any person27 claiming to be dependent on the deceased;
13.2.3AletterfromCentrelinkconfirmingtheamount,typeandperiodofbenefitsreceived bytheclaimantand whetherthesepayments were basedona singleormarried rate;
13.2.4The durationof the relationshipbetweenthe claimantand the deceased;
13.2.5Detailsofwheretheclaimantandthedeceasedresidedatthedateofdeathand whether the property was owned or rented by either the claimant orthe deceased;
13.2.6Detailsofanyjointacquisitionofassetsorownershipofanyjointpropertybythe deceased and the claimant;
13.2.7Details of any joint liabilities by the deceased and theclaimant;
13.2.8Detailsofanysuperannuationbenefitspaidasaresultofthedeceased’sdeath includingthe beneficiaries ofthebenefitspaid andanyclaimmade bytheclaimant in respect of them;
13.2.9Documentsevidencingtheclaimant’sfinancialdependencyonthedeceasedatthe time of the deceased’s death28;
13.2.10Documentsevidencingthattheclaimantandthedeceasedwerelivingtogetherat the time of the deceased’s death;
13.2.11Documentsevidencingtheamountthatthedeceasedearnerwouldhavehadthe capacity to earn in the 12months after the death, hadthe accidentnot happened29;
13.2.12Documentsevidencingthedeceased’strainingskillsandexperienceinthe12 months before the death30;
13.2.13Anyadditionalmaterialorinformationrelieduponparticularlyinrespectofchildren who are saidto have beendependent upon the deceased;
23 Applicabletodisputeapplicationslodgedonorafter1September2007
24 UnderSections57,58or59TAA
25 Includingapersonwhoclaimstohavebeendependentonthedeceased
26 Attachingamarriageorbirthcertificatewhererelevant
27 Includingchildrenofthedeceased
28 Forexample,creditcardstatements,loandocuments,bankstatements,receipts,rentalagreements,orincometaxreturns
29 Forexample,evidenceofearningsfromallemploymentfromadate atleast12monthspre-accident andsupportingmaterialfrom preaccidentemployers(Section58(6)TAA)
30 Section58(6)TAA
1March 2005– 10
13.2.14When relevant, legal contentions including citations ofany legal authority reliedon.
13.3Unlessalreadyprovidedtotheclaimant,theTACmustprovidetheclaimant’slawyers,within
28daysofreceivingadisputeapplication,withallofthedocumentstheTACconsideredto make the dependency decision including:
13.3.1Any statements obtained bythe TAC;
13.3.2Any investigation report into the question of dependency;
13.3.3Whererelevant,legalcontentionsincludingcitationsofanylegalauthorityreliedon and any relevant legal authorities.
13.4WheretheTACfailstoprovidetheclaimant’slawyerswithalldocumentstheTACconsidered tomakethedecisionwithin28daysofreceivingthedisputeapplicationasrequiredbyclause
13.3,thedecision(s)thesubjectofthedisputeapplicationis/aredeemedaffirmedandthe claimant may issue an application forreview at the VCAT in respect of the decision(s)31.
14.IMPAIRMENT DISPUTES
14.1Whereadisputeinvolvesanimpairmentdecisionthedisputantsagreetoprovidedocuments and information to be relied upon in accordance withthis Chapter.
14.2UnlesstheinformationordocumentshavealreadybeenprovidedtotheTACpriortoits impairment decision, the claimant shall provide to theTAC:
14.2.1Asignedstatementbytheclaimantwhichsetsoutthecircumstancessurrounding thetransportaccidentandallmatters knowntotheclaimantwhich arerelevantto the review ofthe decision;
14.2.2Any additional medical reports or information relied upon in addition to the informationprovided orexchangedin supportofthe claim forimpairmentbenefits and which were consideredby the TAC in making the decision.
14.3Aclaimant’slawyermayprovideasummaryifthelawyerdeterminesclarificationisrequired inrespectofthefollowingissueswhichhavenotbeenadequatelydealtwithbytheprovision of a claimant’s statement or in the content of the medical reports relied upon:
14.3.1Pre-existing injuries; or
14.3.2Overlap; or
14.3.3Unique pointof law.
14.4If a summaryis provided bythe claimant’s lawyer it is to:
14.4.1IdentifytheparticularassessmentthatisdisputedincludingidentifyingtheChapter and Table in AMA2 or AMA4 concerned;
14.4.2IdentifywhichspecificpartsoftheTAC’sassessmentaboutwhichthereisno dispute; and
14.4.3Specifyanyconditionsthathavenotstabilisedandidentifyingthemedicalevidence for nonstabilisation.
31 Applicabletodisputeapplicationslodgedonorafter1September2007
1March 2005– 11
14.4.4Any additional medical reports or information relied upon, in addition to the informationprovided orexchangedin supportofthe claim forimpairmentbenefits and which were consideredby the TAC.
14.5Unlessalreadyprovidedtotheclaimant,theTACmustprovidetheclaimant’slawyerswithin
28daysofreceivingthedisputeapplicationwithallthedocumentstheTACconsideredto make the impairment decision including:
14.5.1Police reports and police statementswhere the TAC has them;
14.5.2Medicalreportsincludingclinicalnotes,testresultsanddiagnosticreportsand impairment assessment medical reports;
14.5.3A document that:
14.5.3.1Sets out howthe impairment is assessed and calculated;32
14.5.3.2Identifieswhichpart(s)oftheAMAassessmentaboutwhichthere appears no dispute or which has beencompromised;
14.5.3.3Identifies the particular assessment(s) that remain(s) in dispute includingidentifyingtheChapterand Tablein AMA2orAMA4 concerned;
14.5.3.4Specifies which conditions have not stabilised and identifying the medical evidence fornon-stabilisation;
14.5.4Copies of anysurveillance reportsand videos;
14.5.5Any statements obtained bythe TAC;
14.5.6Vocationalorotherrelevantrehabilitationreportswheretheyhavebeenrelied upon;
14.5.7Relevant occupational therapist orotherparamedicalprovider reports; and
14.5.8Whenrelevant,legalcontentions,includingcitationsofanylegalauthorityrelied upon and anyrelevant legal authorities.
14.6WheretheTACfailstoprovidetheclaimant’slawyerswithalldocumentstheTACconsidered tomakethedecisionwithin28daysofreceivingthedisputeapplicationasrequiredbyclause
14.5,thedecision(s)thesubjectofthedisputeapplicationis/aredeemedaffirmedandthe claimant may issue an application forreview at the VCAT in respect of the decision(s)33.
15.LEGALCOSTS
15.1Inrecognitionofthevalueaddedbyaclaimant’slawyerduringapre-issuereviewunder theseprotocolstheTAC agreestopaylegalcoststoaclaimant’slawyeraccordingtothis Chapter where the TAC revokes or varies its decision the subjectof a dispute.
15.2Whereadisputeisresolvedastheresultofapre-issuereviewbutbeforeapre-issue conference, the TAC shallpay legal costs of:
15.2.1$3,150 in respect of medical and like benefit disputes;
15.2.2$3,680 in respect of eligibilityor loss ofearnings ratedisputes;
32 TheexistingTACimpairmentcalculationsheet
33 Applicabletodisputeapplicationslodgedonorafter1September2007
1March 2005– 12
15.2.3$4,200inrespectofimpairmentorlossofearningsdurationandcapacitydisputes;
or
15.2.4$4,200inrespectofadisputeinvolvinganycombinationofdisputesidentifiedin this Clause.
15.3Whereadisputeisresolvedastheresultofapre-issuereviewduringorwithin14daysafter a pre-issue conference, the TAC shall pay legal costs of:
15.3.1$3,680 in respect of medical and like benefit disputes;
15.3.2$5,250 in respect of eligibilityor loss ofearnings ratedisputes;
15.3.3$5,780inrespectofimpairmentorlossofearningsdurationandcapacitydisputes;
or
15.3.4$5,780inrespectofadisputeinvolvinganycombinationofdisputesidentifiedin this clause.
15.4ThelegalpricepointsdescribedinClauses15.2and15.3includecounsel'sfeesandallother disbursementsexceptfor thereasonablecost ofrecordsor reportsprovided tothe TAC pursuantto Chapters9to14,the reasonablecostofFreedomofInformationAct1982 applicationfeesandassociatedchargeswhere therecords obtainedareprovidedtotheTAC pursuanttoChapters9to14,thereasonable costofinterpreterfeesincurredforadispute applicationandthereasonabletravel costsincurred bytheclaimant’ssolicitor inattending a pre-issueconferencein Melbourne wherethesolicitor travelsfrom anofficeinruralVictoria or aregionalcityinVictoria.Thereasonablecostofrecordsorreports,Freedom ofInformation Act1982applicationfees andassociatedchargesandthereasonable costofinterpreterfees provided or incurred in the circumstances prescribed, will be paid separately by the TAC. Reasonabletravelexpenses willbepaidbytheTAConthe same basisasthese wouldbe paid if claimed on a party/party basis.
15.5FormeritreviewsattheVCATlegalcostsshall,unlesstheVCATotherwiseorders,bebased onScaleAoftheCountyCourtscaleofcosts. AnorderfortheTACtopayanapplicant’s legal costsshallby consentoftheparties belimited incaseswheretherehasbeen a pre- issue review to:
15.5.1Alumpsumpaymentcalculatedinaccordancewiththecategoriesdescribedin
Clause 15.3; plus
15.5.2Costs for activityfollowingthe conclusion of the pre-issue review.
15.6ThelegalcostpricepointsdescribedinClauses15.2and15.3willbeindexedannuallyfrom
1January2006inaccordancewiththeConsumerPriceIndexforMelbourneaspublishedby the AustralianStatistician for the preceding period prior to the indexation date.
15.7Thefollowingclausesdealwithpointsofoverlapandwhatpricepointswillbepaidandin whatcircumstances,wherethereare concurrentapplicationsundertheNoFaultDispute ResolutionandCommon LawProtocols inrelationtoimpairmentgenerallyorin relationtothe
30%thresholdandforaseriousinjurycertificateand/oracommonlawsettlementpursuant to the provisions of the Common Law Protocols is negotiated.
15.7.1ANoFaultDispute ResolutionProtocols(impairment)pricepointwillbepaidwhere thefollowing materialis providedin supportofa NoFaultDispute Resolution Protocols (impairment) application and the conditions in clauses 15.7.1.4 and
15.7.2 are met:
15.7.1.1Claimant’s statement (including a list of injuries); and
15.7.1.2Medical reports; and
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15.7.1.3Lawyer’sstatement (whereprovided); and
15.7.1.4Thematerialprovidedsupportsawholepersonimpairment determination greaterthan theTAC’sdeterminationandoneofmore than10%at thetimetheseriousinjurycertificateisgrantedora common law settlement isnegotiated.
15.7.2Therequiredmaterialmusthavebeenreceivedatthetimetheseriousinjury certificateis granted orthecommonlaw settlementisnegotiated(whenever the paymentofa NoFaultDisputeResolutionProtocolsprice pointissought). Wherea claimantisrelyingonthemedicalmaterialheldby theTACandnoadditional medicalmaterialisto beprovided,thismustbe clearlystatedin aletterand any differing interpretation of the medical material articulated.
15.7.3ThepricepointthatwillbepaidwilldependonwhatstagetheNoFaultDispute ResolutionProtocols(impairment)disputeapplicationhasreached atthedatethe seriousinjurycertificateisgranted orthecommonlawsettlementisnegotiated (wheneverthepaymentof aNoFaultDisputeResolutionProtocolspricepointis sought).Ifa pre-issueconferencehasbeenheldatthedateofgrantingorthe resolutionofanycommon lawdamagesclaim,thenthe‘pre-issue conferenceheld’ pricepoint willbepaid.Ifithasnotthentheprice pointapplicabletowhere the application isresolved before a pre-issueconference is heldwill bepaid.
16.THE VCAT
16.1UnlesstheTACandtheclaimant’slawyersconsentinwriting,anapplicationforreviewtothe
VCAT shall be in accordance withChapter 6.
16.2A Directions Hearingwill otherwise proceed in accordance with theVCAT Practice Note.34
16.3BoththeclaimantandtheTACmayissueasummonsforproductionofdocuments,notesor report returnable at the Directions Hearing.35
16.4AnapplicationforanexpeditedhearingmaybemadeataDirectionsHearingsubjecttothe provisions of Chapter 4.
16.5SubjecttotheVCAT’sdirection,compliancewiththeseprotocolsandtheirobjectivesshould obviate the necessity for compulsory conferences or further mediation.
16.6Thisprotocolcontemplatesthatwhereadisputehasbeenthesubjectofapre-issuereview, theApplicationforReview willhavedefinedand confinedtheissuesremainingindisputeand thatallrelevantdocumentationrequiredfor reviewofthedecisionthat are relevantandin existence should have been exchanged.
16.7TheTACmay,withtheagreementandtheassistanceoftheclaimant’slawyer,preparea joint TribunalBook for theVCAT. The joint TribunalBook must contain:
16.7.1A Section 49statement bythe TAC;
16.7.2The client’s statement of legal contentions;
16.7.3AllofthedocumentationthatwasexchangedbetweentheTACandtheclientand bytheclientandtheTAC whichwasprovidedatanystageuptotheconclusionof the pre-issue review orpre-issue conference.
34 Clauses6,8and13ofthePracticeNote
35 Thisprovisionwillnotlimittheentitlementofeitherpartytoissueasummonsforproductionand,whererelevant,attendancereturnable atthehearing
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16.8The supporting documents must be suitably paginated and indexed by the TAC in accordancewith the VCAT Practice Statement.
16.9Itisanticipatedthatbothpartieswillhaveexchangedallmaterialanddocumentsonwhich theyintendtorelyand willhaveincludedthemintheTribunalBookpreparedinaccordance withClause 16.2. Apartyshouldnot callawitnesswhosestatementisnotincludedinthat TribunalBookoradduceevidenceinchiefbeyondthatcontainedinanystatementprovided intheTribunalBookinanyproceedingbeforetheVCAT,exceptbyconsentorby theleaveof the VCAT.
16.10SubjecttoClause16.3itisexpectedthatneitherpartywillrelyonevidenceordocuments which werenotexchanged anddisclosedatthepre-issue review orthe pre-issueconference in accordance with Chapter 6 above, exceptby consent or by the leave of the VCAT.
17.TRAVELCOSTS
17.1The TAC will meet the reasonable travel and accommodation costs associated with a claimant attending a pre-issue conference or mediation for the purposes of these protocols, wherethe claimantlivesinruralVictoriaorinterstate. Thesecosts willbemetinaccordance with the TAC’s ‘Travel andAccommodation Expenses’policy.
18.PROTOCOL DEVELOPMENT FORUM
18.1TheTACwillconveneaforumwithrepresentativesofLIVandALAatleastonceeverysix months after these protocols come into force.
18.2The forum will discuss and review:
18.2.1Quality improvement initiatives to enhance the effectiveness of these protocols;
18.2.2The procedures and definitions in theseprotocols;
18.2.3Specific identified examples of noncompliance with these protocols, if any;
18.2.4Reportscontaining relevant data aboutparticipation in the protocolprocesses;
18.2.5Developmentand consideration of key indicators of success of these protocols;
18.2.6Thedevelopmentofreportingandmeasurementmethodologyforusewiththe protocols;
18.2.7Preparing a report to the VCAT’s TAC Interest Group suggesting appropriate changes to the Tribunal’s procedures processes, rules and practice directions;
18.2.8Any other matter of relevance to participants.