TAC claim rejected?
Once you lodge a TAC claim, the claim will be determined by the TAC.
The TAC will either accept or reject the claim.
If you are interested in how the initial claim determination process works and the timeframes involved, you should visit this page.
The rest of this page will provide you with information as to what to do if your claim has been rejected.
If your claim has been rejected
You will be notified by the TAC in writing as to the reasons why your claim has been rejected.
If you disagree with the rejection of your claim by the TAC and wish to continue to pursue a claim, there are a number of options open to you to appeal the decision.
However the first decision that you need to make is between asking the TAC to perform an internal review or alternatively lodging what is called a dispute application.
TAC internal review
After your claim has been rejected, you can contact the TAC and ask them to perform an internal review in relation to the decision.
The TAC will then organise for someone that was not involved in the making of the original decision to review the rejection of claim.
They may require further information and if this is the case they will let you know this.
If the original decision is altered and they change their opinion and accept your claim, then you’ll be entitled to be back paid any income benefits that you would’ve been paid had your claim been initially accepted.
You would also be entitled to the payment of any medical expenses that you would’ve been entitled to if your claim had been initially accepted.
And you would also be entitled to claim both for income benefits and medical and like expenses on an ongoing basis given that you now have an accepted claim.
Dispute application and conference
The alternative option to requesting an internal review is a TAC dispute application.
A dispute application is a form that can be lodged online or alternatively a paper form can be sent off to the TAC.
A dispute conference will then be organised involving the TAC (or their representatives) and your representative.
At the conference, which usually occurs via video conference, the parties will discuss the matter and try and reach an agreement.
A dispute application is something that is usually pursued only if you have legal representation and not something that applicants that are not represented pursue by themselves.
As above, if the TAC agree to accept your claim as a result of the dispute application process, you’ll be entitled to be back paid any income payments and medical and like expenses that you would have been entitled to had your claim initially been accepted.
VCAT
Let’s say that you’ve gone through either the internal review process or the dispute application process and the TAC has not altered their decision to reject your claim.
The next step is to pursue the matter to VCAT.
Proceedings would need to be issued in VCAT within 12 months from the date of the decision.
The matter will be listed for hearing and you’ll be notified of the hearing date and in most cases you’ll be required to attend.
You should certainly have legal representation if you are pursuing a rejection of your TAC claim matter matter to VCAT.
If the matter reaches hearing, then a tribunal member will need to make a determination in relation to whether to accept or reject your claim.
If your claim is accepted then as mentioned above you’ll be entitled to be back paid for any income payments and medical expenses that you would have been entitled to had your claim initially been accepted.
Keep in mind that if you do issue VCAT proceedings, that the matter can resolve by way of negotiations between the parties before reaching a hearing.
Income after your claim has been rejected
Unfortunately, if the TAC has rejected your claim and you are not work because of injuries suffered in a motor vehicle accident, your options for income are somewhat limited.
You may be able to access your employment entitlements, specifically your sick leave but also consideration could be given to accessing annual leave and potentially long service leave.
You may, if your claim is later accepted, have your employment entitlements re-credited.
However, keep in mind that if your TAC claim is rejected and the TAC does not change their original decision to reject the claim via either internal review or the dispute resolution process, and if you need to go to VCAT, it can take 6 months or more from when you issue in VCAT to have the matter determined.
So you could potentially be many months without an income if you exhaust all of your accrued leave entitlements.
Another option is to claim Centrelink benefits if you are not able to work. If your claim is later accepted, the TAC benefits that are paid to you will need to be reduced to take into account the money that you received from Centrelink on a dollar for dollar basis.
Conclusion
If your TAC claim is rejected, the first step is to either pursue a review of the decision by way of internal TAC review or if you have a lawyer, for a dispute application to be issued.
If the matter then doesn’t resolve the final option is to pursue the matter to VCAT.
Although your matter may be listed for hearing in VCAT, it is possible for your matter to resolve by way of negotiations before a hearing.
If your claim is initially rejected and later accepted, you’re entitled to be back paid income benefits and medical and like expenses that you would’ve received had your claim initially been accepted.
