Section 78 Notices and SIRA: What You Need to Know

If you’re involved in a workers compensation claim in New South Wales, you may have heard of a Section 78 notice. For many injured workers, receiving one can feel confusing or even intimidating. This article will explain what a Section 78 notice is, why it matters, and how you can navigate the process effectively.

What is a Section 78 Notice?

Under the Workers Compensation Act 1987 (NSW), insurers are required to provide clear written reasons when they decide to reduce, discontinue, or deny liability for a worker’s claim. This formal notice is issued under Section 78 of the Act.

A Section 78 notice must:

• Clearly set out the insurer’s decision (e.g., denying liability, stopping weekly benefits, or declining certain medical treatments).

• Provide the reasons for the decision.

• Reference the evidence relied upon (such as medical reports, surveillance, or employer records).

• Inform the worker of their rights to challenge the decision.

  
  

In short, it is the insurer’s legal obligation to explain why they are rejecting or changing part of your claim.

Why Does SIRA Matter?

The State Insurance Regulatory Authority (SIRA) is the regulator that oversees workers compensation in NSW. SIRA does not decide individual claims, but it sets the rules insurers must follow. That means:

• The content and wording of Section 78 notices are shaped by SIRA’s guidelines.

• SIRA ensures that insurers act fairly, provide proper reasons, and give workers access to review options.

• If insurers don’t comply with these standards, their decisions can be challenged.

  
  

What to Do if You Receive a Section 78 Notice

1. Read it CarefullyDon’t ignore the notice. Check exactly what part of your claim is affected—weekly payments, treatment approval, or overall liability.

2. Look at the Evidence CitedThe notice must list the documents or reports relied upon. If you disagree, you may need to gather your own medical evidence to respond.

3. Seek Advice EarlyYou can contact:

   • Your treating doctor, to provide clarification or supporting reports.

   • An independent workers compensation lawyer (many offer “no win, no fee” advice).

   • The Independent Review Office (IRO), which offers free legal assistance to injured workers.

4. Consider an Internal ReviewYou have the right to ask the insurer to review their decision. Sometimes mistakes or oversights can be corrected at this stage.

5. Escalate if NeededIf the insurer upholds their decision, disputes can be taken to the Personal Injury Commission (PIC), an independent tribunal that can resolve workers compensation disputes.

   
   

Practical Tips to Navigate the Process

• Act quickly: There are time limits to dispute decisions, so don’t delay.

• Stay organised: Keep copies of all correspondence, medical certificates, and reports.

• Get support: These processes can feel overwhelming—professional advice makes a big difference.

• Don’t panic: A Section 78 notice doesn’t always mean the end of your claim. Many disputes are successfully overturned or resolved.

  
  

Key Takeaway

A Section 78 notice is not the final word on your workers compensation claim—it’s simply the insurer’s way of saying “this is our decision and why.” Thanks to SIRA’s rules, you have clear rights to challenge that decision, and multiple avenues to seek review and support.

If you receive a Section 78 notice, the best approach is to stay informed, act promptly, and get the right advice. With the right steps, you can ensure your entitlements are protected.