GOV 026283 Appendix 1.pdf

GOV-026283 Appendix 1
ZOOM MEETING GUIDE
Independent Complaint and Review Authority
Zoom Meeting Guide
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GOV-026283 Appendix 1

Step 1: Open Zoom
Open Zoom and click “Join a Meeting”.

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GOV-026283 Appendix 1
Step 2: Meeting Entry Selections
Tick both “Do not connect my audio” and “Turn off my video” boxes.
[Out of
Scope]
Independent Complaint and Review Authority
Zoom Meeting Guide
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GOV-026283 Appendix 1
Step 3: Join your meeting
Enter your Meeting ID into the meeting ID field ensuring both boxes are ticked and click “Join”.
[Out of Scope]
[Out of
Scope]
Step 4: Enter Password
Enter the meeting password.
[Out of Scope]
Independent Complaint and Review Authority
Zoom Meeting Guide
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GOV-026283 Appendix 1
Step 5: Check Participants
Click on the Participants button at the bottom of the window. The list of Participants will show to the
right-hand side of the window.
Always ensure the ICRA representative is showing in the list before joining the meeting (The ICRA
Representative will always have ICRA in their name).
[Out of Scope]
[Out of
Scope]
[Out of
Scope]
Independent Complaint and Review Authority
Zoom Meeting Guide
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GOV-026283 Appendix 1
Step 6: Start Video
Click “Start video” to being using your Webcam – this should begin sharing your video feed.
[Out of Scope]
Step 7: Join Audio
Click “Join Audio” and an option to join via phone call or computer audio is presented (generally you
should always join via Computer Audio, using “phone call” is a backup option in case of technical
difficulty).
This box also allows you to test your speaker and microphone prior to entering the meeting.
Independent Complaint and Review Authority
Zoom Meeting Guide
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GOV-026283 Appendix 1
Step 8: Leave Meeting
To leave a meeting at any time – simply click leave meeting.
[Out of Scope]
Independent Complaint and Review Authority
Zoom Meeting Guide
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GOV-026283 Appendix 1
Alternative Dispute Resolution Policy v3.0
Summary
Objective
Our alternative dispute resolution (ADR) options include mediation, facilitation and conciliation and are managed by ACC and Talk-
Meet-Resolve. ACC can refer disputes or difficult situations with clients to Talk-Meet-Resolve for ADR. A client can also ask for medi-
ation. We prefer to use ADR to resolve disputes if there was more than one possible outcome.
Occasionally when the dispute is related to a review - Fairway Resolutions Ltd or Independent Complaint and Review Authority
(ICRA) will be engaged to hold a conciliation to assist ACC in finding a resolution or way forward.
Owner
[Out of Scope]
Expert
Policy
1.0 Rules
a The Code of ACC Claimants’ Rights governs our dealings with clients.
Clients applying for review can be invited to attend some form of ADR.
Case or review owners must discuss each case with their Team Manager, resolution specialist or equivalent to determine the
most suitable type of ADR.
2.0 Exceptions
a We may not offer ADR when we receive a review application or reapplication, if:
• the Remote Claims Unit manages the claim.
• the review application or reapplication is from a risky client or a vexatious or continual reviewer.
If you think there is a case for ADR, you must discuss it with a team manager, a resolution specialist or a business unit man-
ager.
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GOV-026283 Appendix 1
Prepare and Attend an Alternative Dispute Resolution
(ADR) v35.0
Attend
ADR
Linked Process
Prepare and  Review Hearing (RH)
5.0
Action the  outcome agreement
ADR
3.0
Complete  paperwork
4.0
Prepare and attend ADR session
ADR
2.0
Select an  provider
Attend
ADR
Linked Process
Prepare and  Case Conference (CC)
1.0
Identify stakeholders to invite to the
Linked Process
Conduct Initial Customer Contact
eam Member
eam Member
Review Specialist
Recovery T
Review Specialist
External Provider
Recovery T
Review Specialist
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GOV-026283 Appendix 1
Prepare and Attend an Alternative Dispute Resolution
(ADR)

v35.0
Summary
Objective
To provide guidance on when and how to set up an Alternative Dispute Resolution (ADR) meeting with an external mediator or conci-
liator for Review Specialists and Recovery Team Members.
Background
An Alternative Dispute Resolution can occur either before or after a case conference, as well as when other issues arise during the
management of a claim.
Owner
[Out of Scope]
Expert
Procedure
PROCESS
Conduct Initial Customer Contact
Review Specialist
PROCESS
Prepare and Attend Case Conference (CC)
Review Specialist
1.0 Identify stakeholders to invite to the ADR
Recovery Team Member, Review Specialist
a Identify all relevant stakeholders who may be able to provide insight or technical advice on the decision at the ADR.
NOTE Who could be relevant stakeholders?
ACC staff who had input into the decision or may assist with resolving issues. This may include:
• Case owner or decision maker
• Legal Services
• Clinical Services
• Technical Services
• Technical Accounting Services
• Weekly Compensation Team
• External medical practitioner
• Vocational Providers
• Allied health providers
• Levy Classification
Working together to find the right outcome
b Invite potential stakeholders to ADR.
NOTE What if a member of the Levy Classification Team need to attend the ADR?
Email [email address] to request a colleague attend the ADR. The subject of the email should read
'Resolution Services Attendance Request'. The email should include:
• Review number (if applicable)
• Customer/representative name (if applicable)
• ACC number
• Date and time of the ADR
• Outline a request for attendance at the IRC
10 working days’ notice is required for Levy's to attend the ADR.
2.0 Select an ADR provider
Recovery Team Member, Review Specialist
NOTE Talk-Meet-Resolve has no contractual or legislative obligation to monitor review timeframes or set-downs
therefore ultimate responsibility lies with the Review specialist to ensure legislative timeframes are met.
a Select an ADR provider.
NOTE Which ADR provider should be selected?
Talk-Meet-Resolve (TMR) are ACC's preferred provider for ADR.
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews > Prepare and Attend an Alternative Dispute Resolution (ADR)
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GOV-026283 Appendix 1
NOTE If the ADR relates to a review, what if a Case Conference has already been booked?

If a review provider has already been engaged there are two options:
• Suggest at the Case Conference that ADR is a suitable option and work through the appointed review provider to
organise a date and time for ADR.
• Proceed to the next step in the process to complete an ACC8026 to engage TMR. Please note the ADR and review
processes can be run alongside one another as long as the hearing is set far enough out to allow the ADR to be con-
cluded.
NOTE If the ADR relates to a review, What if a Case Conference hasn't yet been booked?
In these cases ACC's preference is that TMR are appointed to undertake ADR. Please note that a Case Conference
must still be booked by day 60 regardless of whether ADR is underway or not.
NOTE What if the customer/representative has requested a face to face ADR meeting?
First and foremost - explore the reasons for their preference (e.g. limited Wi-Fi, or no technology) and, if appropriate,
offer the option of an iPad being couriered to them (this is part of TMR's Digital Inclusion Strategy). If the client is open
to this, in both the TMR booking system and the ACC8026, select ‘video conference’. You will be prompted in the TMR
booking system to select whether an iPad should be sent.
If the client insists on a face to face conciliation AND wants an ACC staff member to attend - talk with your Manager
about who might be most appropriate to attend.
Arrange Face to Face to Client Meeting
NOTE How does TMR's digital inclusion strategy work?
• The customer will be couriered an iPad prior to the meeting and given separate instructions about accessing the
meeting, and arranging for the courier to collect it following the meeting with a self-addressed courier bag.
• There is zero cost to the client.
• The technology will only have the 1 application loaded (Teams) and TMR will provide any administrative support.
• No information (including ACC information) will be stored on the iPad and it will simply be used as a portal into the
Teams environment only.
NOTE What if the client requires travel assistance to attend the face to face meeting?
Any costs associated with attending a conciliation can be agreed and reimbursed as part of the conciliation agree-
ment.
If the client requires payment prior to attending the meeting ask for confirmation of the amount (e.g. copy of held
flights and costs) and arrange a payment to the client via the Resolution Coordinator. This will be paid under a Rev20
coding.
Prior approval travel policy
b If the review is about a decision on a claim, in Eos, add the ADR provider as a party to the client's claim.
NOTE What if you can't locate TMR as a provider in Eos?
When searching for TMR - change the role “Other Agent” and the party type to “Civil Agent” and then search Talk Meet
Resolve.
c If using Talk-Meet-Resolve go to their booking system and select a suitable time that has been agreed with the customer/
representative. Put a place holder in your outlook calendar to ensure you don't double book yourself while awaiting the confir-
mation email.
If using Talk-Meet-Resolve is not appropriate or suitable then continue through to a case conference and add a note to the
additional comment field in the ACC6239 that an ADR should be considered.
Talk-Meet-Resolve Booking System
http://talkmeetresolve.gettimely.com/
d If using Talk-Meet-Resolve - all attendees will be sent a confirmation email and if the meeting is online, you will also email you
a meeting invitation. When you accept the invitation for the “teams meeting”, it will go straight into your outlook calendar. If the
meeting is face to face, double check you have booked out the correct date and time.
e If using Talk-Meet-Resolve - upload the invite to Eos as VCF011 and note the description as ‘TMR booking confirmation’.
3.0 Complete ADR paperwork
Recovery Team Member, Review Specialist
a Complete the necessary paper work to engage the chosen provider.
NOTE What paperwork needs to be completed if the conciliation is being held by Talk Meet Resolve?
If engaging with Talk-Meet-Resolve:
• and, the issue/review is about a decision on a claim, in Eos, complete all sections of the ACC8026 Alternative Dis-
pute Resolution and Agreement to Conciliate form and leave it as incomplete in Eos or;
• If the review/issue is about a levy decision, complete all sections of the ACC8026 Alternative Dispute Resolution and
Agreement to Conciliate form.
NOTE What paperwork needs to be completed if the conciliation is being held by Fairway or ICRA?
If engaging with Fairway or ICRA:
• continue through to a case conference and add a note to the additional comment field in the ACC6239 that an ADR
should be considered.
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GOV-026283 Appendix 1
ACC8026 and Agreement to conciliate
ACC6239 Instruction for review provider
NOTE Important: The ACC8026/Agreement to Conciliate must be left as a word document allowing other parties to
sign the document.
b Send the chosen provider the relevant documents needed to hold the conciliation.
NOTE What if the relevant documents/full file have already been checked by CIR?
If the file has already been prepared by CIR, send the [PRC REV: Send submissions to all parties] task to CIR to dis-
patch relevant documents to the necessary parties.
NOTE What if the file has not yet been prepared by CIR or the ADR is not related to a review and you are engaging
with Talk-Meet-Resolve?
Email (via the Eos emailing toolset) the ACC8026/Agreement to Conciliate in word format and relevant documents that
have been privacy checked to [email address]
4.0 Prepare and attend ADR session
External Provider, Recovery Team Member, Review Specialist
a Check that the agreed relevant documents are on hand for the session.
b Re-evaluate potential resolution options as an outcome of the ADR.
NOTE If the ADR relates to a review, what are the potential resolution options?
1) If the original decision appears correct, then potential options are a resolution agreement, a withdrawal or a case
conference.
2) If the original decision appears incorrect, then the potential option is to overturn the original decision or further
investigation (this may be in the form of further medical comment; ACC to consider a different claim; client to lodge
another claim etc...)
c Await phone contact from the ADR conciliator for a 1:1 conversation to discuss the desired outcome at conciliation, and the
matter at review in anticipation for the pending meeting.
d Prepare any internal stakeholders who will be attending the ADR to represent ACC.
e Attend and participate in the ADR session.
NOTE What can you expect at the ADR session?
The provider will facilitate the hearing and may ask:
• ACC to explain the decision
• the customer/representative to outline their points of contention
• for clarification on matters under contention
The provider will then confirm the resolution outcome agreement.
NOTE What skills will you need to take with you to a conciliation?
(1) Have a clear understanding of ACC’s position, why ACC made the decision and be prepared to explain it.
(2) Explain what information the client need to bring that would allow ACC to change our decision.
(3) Show willingness to understand the client and respond.
(4) Show willingness to change ACC's approach if possible and appropriate.
(5) Don’t need to feel that you need to agree to anything. (This also of course applies to the client).
f If the ADR relates to a review, approve costs within the Review Specialists Delegation (in line with the review regulations)
when called upon by the conciliator.
NOTE What if the conciliator requests costs outside of the review regulations?
Any amounts outside of the review regulations must be considered by a Senior Review Specialist or Manager and will
likely be associated with travel to attend the conciliation.
Resolution Services Delegation
NOTE What if the conciliator or customer requests costs and there is no live review?
Contact [Out of Scope]
to discuss conciliation costs and how these can be paid.
5.0 Action the ADR outcome agreement
Recovery Team Member, Review Specialist
a Sign the 'ADR outcome agreement' document and return to the provider.
b • If the review or issue is about a decision on a claim, in Eos, upload the signed conciliation agreement to the claim.
• If the review or issue is about a levy decision, email the outcome agreement to [email address]. The subject line
should read "Resolution Services ADR Conciliation Agreement". The email is to include:
— Review number (if applicable)
— Customer/representative name (if applicable)
— ACC number
— Summary of the ADR agreement and action required
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GOV-026283 Appendix 1
c Action the ADR conciliation agreement by creating a General Task (marked high priority) and send to either the Supported or

Partnered Recovery queue.
NOTE What if the conciliation agreement does not relate to a review?
The Recovery Team Member will continue to manage the claim as normal and complete any agreed actions.
NOTE If the ADR relates to a review, what if there was an agreement to withdraw a review or overturn an incorrect
decision?
Go to Fulfil Resolution Obligations.
PROCESS Implement Resolution Outcomes
NOTE If the ADR relates to a review, what if the agreed actions will take the review past 60 days from the lodgement
date?
Set down a case conference date - go to Prepare and Attend Case Conference.
PROCESS Prepare and Attend Case Conference (CC)
NOTE If the ADR relates to a review, what if no resolution was reached?
Go to Prepare and Attend Case Conference. If a case conference has already occurred, proceed to Prepare and
Attend Review Hearing.
PROCESS Prepare and Attend Case Conference (CC)
NOTE If the ADR relates to a review, what if a conciliation agreement has been reached that requires ACC to take
action?
If the review is not withdrawn, the Review Specialist will continue to manage the review as normal (see 'what if the
agreed actions will take the review past 60 days from lodgement date'). If the review will be closed, the Review Spe-
cialist must keep a task open in their name and monitor the case to ensure that agreed actions are completed.
PROCESS
Prepare and Attend Review Hearing (RH)
Review Specialist
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GOV-026283 Appendix 1
Prepare and Attend Case Conference (CC) v42.0

Linked Process
Implement Resolution Outcomes
Attend
Linked Process
Prepare and  Review Hearing (RH)
Attend
Alternative
Linked Process
Prepare and  an  Dispute Resolution (ADR)
4.0
Action the case conference outcome
3.0
Prepare for and attend case conference
Task
k Print
Linked Process
Create Bu and Send CIR
2.0
Prepare documents for case conference
1.0
Schedule case conference
Attend
Alternative
Linked Process
Prepare and  an  Dispute Resolution (ADR)
tation (IRC)
Linked Process
Prepare and Lead an Internal Resolution Consu
Linked Process
Conduct Initial Customer Contact
Review Specialist
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GOV-026283 Appendix 1
Prepare and Attend Case Conference (CC) v42.0

Summary
Objective
To set a case conference time and date and prepare so that the Review Specialist can attend the case conference on ACC’s behalf.
Background
An application for review has been received and it requires a case conference to be held.
Owner
[Out of Scope]
Expert
Procedure
PROCESS
Conduct Initial Customer Contact
Review Specialist
PROCESS
Prepare and Lead an Internal Resolution Consultation (IRC)
Review Specialist
PROCESS
Prepare and Attend an Alternative Dispute Resolution (ADR)
Review Specialist
1.0 Schedule case conference
Review Specialist
a Consider whether a case conference needs to occur.
NOTE When is a case conference not required?
The ONLY circumstance in which a case conference is not required is:
• Where the reviewer already has a review active for that client AND
• The matters at review are linked (eg the subjects are intertwined and are practical to be heard together).
NOTE How do you communicate with the review provider the reason no case conference has been booked?
On the ACC6239 note the reasons under 'Additional Information'. You would note either:
• Please note that a case conference for this client is already scheduled on date/time for review XXXXXXX. It is prac-
tical that the clients two reviews are heard together.
• Please note that the client has an already active review (Review XXXXXXX). A case conference has already taken
place where is was agreed a second review be lodged. No new case conference is required. Please set review
XXXXXXX down to be heard at the same time as review XXXXXXX.
b Check the 'book and hold' date range that a case conference can occur based on dates provided in the initial 'Admin Review'
task.
NOTE What is the first possible date that a case conference can be held?
To hold a case conference all parties must have been supplied either the relevant documents or the full file (depen-
dent on what the client requested). Allow at least 28 calendar days from the date the CIR task is sent. This gives CIR
14 days to prepare and release the file, and the reviewer 14 days to familiarise with the issue at review.
NOTE What is the last possible date that a case conference can be held?
A case conference must be held by day 78. This is counted from the date the review application was received into the
corporation. This date (day 78) should be provided to the Review Specialist at the time of allocation.
• If the decision is about a review on a claim check the information provided in the PRC REV: Complete admin review
task.
• If the decision is about a levy decision check the email with the review information provided by the Resolution Coor-
dinator.
c Contact the customer/representative and using the 'Resolution Service Shared Calendar' agree a date and time for the case
conference.
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GOV-026283 Appendix 1
NOTE Do you have to provide a client with a choice of review supplier?

We must provide the customer a choice of supplier. If the customer needs a specific date and time and there is only
one available supplier at the time selected - then explain to the customer how and why their choice is limited.
ACC does need to ensure both providers receive a fair distribution of work - so it is important to be mindful of how
often you are using one supplier over the other. If a client has no preference then use this as an opportunity to ensure
your reviews are distributed between the two providers equally.
Lastly, explain to the customer that the choice relates to the supplier of reviewer services, and not between reviewers
and that once instructed the client is unable to change their mind. If a customer has a number of reviews and one has
already been set down with one organisation then we should continue with that review provider so that there is no
opportunity to have misinformation.
NOTE What if the client wants to change the review provider or the reviewer assigned after they have been en-
gaged?
It is important to understand that ACC has no influence over whether the review provider or allocated reviewer can be
changed after they are engaged and instructed. The client must direct their request for a change in provider to the
review provider/reviewer with their rationale for wanting a change.
Change of Review Provider
ACC may be asked by the review provider for an opinion regarding the clients request. ACC should consider whether
the rationale provided by the client is reasonable, and provide an opinion on ACC’s position. When considering ACC’s
position the Review Specialist may take into account the following:
1: Did the client already choose a provider to administer the review?
2: Are the client’s reasons for wanting a transfer to another provider reasonable?
3: Has significant work already taken place, and/or has the review been with the provider for some time?
Change of Independent Reviewer
If the client issue relates to a perceived conflict of interest, the client will need to approach the Review Provider or Re-
viewer to voice their request. Section 138 of the AC Act 2001 states that a Reviewer has a duty to act independently
and disclose previous involvement they have had in a claim other than as a reviewer. The legislation also says in Sec-
tion 139, that ACC must not allocate a claim to a reviewer who discloses to ACC previous involvement in the claim
other than as a reviewer.
This means a reviewer may hear as many reviews on a client’s claim as is referred to them unless they have acted in
some way other than as a reviewer on the claim. If a client has an issue with the reviewer allocated to hear their
review, it will be for the client to raise it with the reviewer and for the reviewer to make a determination. It is not for
ACC to interfere in that process.
ACC will abide by whatever the reviewer or review provider decides.
NOTE How you explain to a client the difference between the two review suppliers?
As a guide, a Review Specialist could say:
"When it comes to booking an independent review you have the choice of two suppliers. The two suppliers are Fair-
way Resolution Limited and Independent Complaint and Resolution Authority. They both offer the same service and
have the same contractual requirements. If you have a preference, then I can see what times we have available - oth-
erwise I can allocate one randomly. Lastly it's important for me to mention that this choice only relates to the choice of
supplier - not the choice of reviewer. The reviewer will be selected by the supplier once ACC transfers them a copy of
the review documents".
NOTE What if a conflict of interest exists between the reviewer or review provider and the client?
A conflict of interest is where a person has another interest that others may think affects this person’s independence,
their objectivity and their impartiality.
There are two potential conflicts of interest and will each be managed differently.
• Conflict of interest with the 'Supplier': If a Fairway or ICRA staff member lodges a review application, they should
choose the alternate supplier.
• Conflict of interest with a 'Reviewer': It is for the reviewer to identify a conflict of interest with the customer, and make
a determination on the next steps.
Subsequently, if you believe a conflict of interest does exist contact a Senior Resolution Specialist so they can
manage this from a contract perspective.
NOTE What if External Counsel has been engaged?
Negotiate a date and time to hold the case conference suitable to both the external counsel, and the customer/
representative.
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NOTE What if travel assistance is required to get to a review hearing (if a review hearing is scheduled)?

Advise the customer/representative that they may claim for travel costs, and these will be awarded after the review
hearing. If the travel requires air travel, and/or accommodation prior approval must be given by a manager.
If the clients travel costs are going to exceed the maximum award allowable under the regulations ($178.78) the
Review Specialist can agree to reimburse reasonably sought costs brought as a result of needing to travel a face to
face hearing.
NOTE What if there is an interested party?
• If the interested party is a client and they would like to attend, schedule a time that suits all parties.
• If the interested party is an employer advise the employer of the date and time of the scheduled case conference.
NOTE What if the customer/representative requests a face to face case conference?
First and foremost attempt to understand the clients reasons for wanting a face to face. Share with the client the
advantages of attending the hearing via video conference. These advantages can include:
• May result in the matter being heard in a more timely manner (as opposed to needing to fit in with the face to face
circuits).
• Will decrease the amount of time being spent travelling to attend the hearing, which can be especially frustrating
where the matter is adjourned part heard.
• Very easy technology to use which the RS can offer to try out at the case conference to provide the client with reas-
surance it's as effective as a face to face with the reviewer.
Lastly, share the positive feedback received from other clients who have found the option of video conference practical
and efficient AND ensure they are aware that ACC will NOT be attending face to face.
If they customer still wants a face to face review, notify the review supplier of the request on the ACC6239.
NOTE Where can a face to face hearing be held?
• Whangarei
• Auckland
• Hawkes Bay (Hastings/Napier)
• Hamilton
• New Plymouth
• Wellington
• Blenheim/Nelson
• Christchurch
• Dunedin
NOTE What if the customer/representative chooses not to agree a case conference time?
• Advise the customer/representative that a case conference will be set, and that they can choose not to attend.
• Advise the customer/representative that the review hearing is set at the case conference.
• Note 'case conference unagreed' on the ACC6239.
If a client is adament that they do not want a case conference to go ahead then please escalate the matter to a Senior
Review Specialist to discuss further.
NOTE What if the customer/representative cannot be contacted to agree to a case conference time?
Record each contact attempt (multiple attempts are expected).
At day 60 select a case conference time and notify the customer/representative in writing that:
• Contact attempts have been unsuccessful
• The time and date of the case conference
• To make contact if a copy of relevant documents are required.
d Select the chosen time in the Resolution Services shared calendar booking tool and complete the appointment subject line
with: RS name, Client name, Review number and claim number. Click on 'copy to my calendar', then save and close.
NOTE What if you later want to cancel the booked case conference?
If the CC is not going ahead or is being moved, delete in your own calendar and remove the client specific information
from the subject line so another RS can use the appointment if required.
Subject line for blank appoint reads: ICRA RS: CLIENT: REV: CLAIM:
If the review has already been transferred through to a provider, then email the provider (via the Eos emailing toolset)
to notify them of the clients withdrawals and cancellation of the Case Conference.
e • If the review is about a decision on a claim, in Eos, add the case conference time, date and provider name to the [PRV REV:
hearing requested] task.
• If the review is about a levy decision, in the Levy Spreadsheet add the conference time, date and provider name.
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CC - Hearing Task.png
f If the review is about a decision on a claim, in Eos, add the nominated provider to the claim record.
NOTE What if the case conference requires rescheduling?
• The review provider will complete their own internal checks and check on the reviewers availability.
• The review provider will check with the applicant when they would available for a case conference.
• If the set down date is 21 days or more away - the provider will send an email to ACC stating 'URGENT RE-
SCHEDULE CASE CONFERENCE'.
• If the set down date is 20 days or less - the provider will ring ACC to confirm ACC availability.
• RC will check RS availability and respond to the provider.
• Provider will send through update CC notification.
• RC will update the CC details in the hearing task (replacing the existing information)
• RC will upload the new CC notification to Eos.
2.0 Prepare documents for case conference
Review Specialist
a • If the review is about a decision on a claim, in Eos generate the ACC6239, update the document description to include the
prefix Rev, space, followed by the unique review number, space and 'appoint reviewer', and save the document as incomplete.
• If the review is about a levy decision, complete the ACC6239, and upload this to the relevant review folder in the Sharepoint
levy tool. Enter the case conference provider, date and time in the Sharepoint Levy Tool.
ACC6239 Instruction for review provider
NOTE What if there are multiple reviews on a decision on a claim?
Update the document description to include the prefix Rev, space, followed by the unique review number, space and
'appoint reviewer', and save the document as incomplete for each matter.
NOTE What if the review related to a settled appeal or court decision?
The ACC6239 should have in the additional information box, that this is a matter settled after an appeal to hear the
substantive matter. A case conference should be booked per usual process.
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GOV-026283 Appendix 1
NOTE What is considered a 'Complex Review'?
• Accident Compensation Act 1982 Matters (W3 & W5)
• Vocational Independence (X7)
• Vocational Rehabilitation (X16)
• Weekly compensation - loss of potential earnings (Y19 only)
• Rehabilitation - attendant care, home help and child care (Y17 only)
• Complex Treatment injury - these cases are considered complex if there has been an ECA sought OR it is noted to
be complex in the Treatment Injury tab.
AND
• Multiple reviews - however only in the following circumstances:
1) All reviews must be from the same claim.
2) All being referral together to the provider on 1 x ACC6239 (regardless of whether they were lodged together)
3) Are about matter where the outcome of one will determine the outcome of the other (i.e. cover & surgery)
OR
• Multiple jurisdictional reviews from the same claim (codes: Z5 – Jurisdiction Other, Z6 – Jurisdiction Code & Y12 –
Failure to Issue decision),
• That are being referred to the provider at the same time (whether or not lodged together)
Examples of multi-issue disputes:
- A client lodges two review applications about 2 decisions - one decision relates to declined cover and the other deci-
sion is declined surgery. ACC prepared and sent the file to the supplier on the same day, noting the ACC6239 with
both review issues and scheduling them to be discussed at the same case conference. Both reviews were scheduled
by the reviewer to be heard at the same time because the outcome of the cover review will determine the outcome of
the surgery review.
- A client lodges one review application about one decision letter that dealt with two issues - cover and suspension.
ACC discussed the matter with the client and established that the client wished to review both decisions. ACC allo-
cated two separate reviews numbers to the application, and prepared and sent the file to the supplier on the same
day, noting the ACC6239 with both review numbers and scheduling them to be discussed at the same case confe-
rence. Both reviews were scheduled by the reviewer to be heard at the same time because the outcome of the cover
review will determine the outcome of the suspension review.
Not a multi-issue dispute example:
- A client lodges two review applications on the same day about two separate decisions issues on the same claim.
One decision was about the calculation of weekly compensation, and the other decision was about lump sum compen-
sation. ACC allocated two separate review numbers to the applications, and prepared and sent 2 separate relevant
document bundles to the supplier on the same day, along with two separate ACC6239s - one for each review appli-
cation. Two separate case conferences were scheduled on the same day, one after the other to discuss the separate
issues. Both reviews were scheduled by the reviewer to be heard on the same day, one after the other.
If you have a review which you believe is complex that isn't covered off in one of the above categories, please contact
[Out of Scope]
NOTE What if the client belongs to the Wellington Central Unit (WCU) or Remote Claims Unit (RCU)?
In the additional notes box - put a bold, large, capital 'R' in red if the claim belongs to the RCU.
b Check if the 'Client Care Indicator' is active.
NOTE This is necessary for both reviews on decisions on claims and on levy decisions, where the levy payer is self
employed.
NOTE What if the 'Client Care Indicator' is active?
On the ACC6239 check [Yes] next to the [Care Indicator] and add the following information on the risks the customer/
representative may present at the review hearing.
• Who is involved, eg. the client, their advocate, or a family member
• Incident type - the incidents or behaviours that led to the care indicator being applied
• Incident timing – when the incidents occurred. This should not be a specific date but more a general statement, such
as ‘two years ago’, or ‘last month’
• Incident frequency – this could be a specific number of incidents or a more general statement, such as ‘repeated’.
c Arrange of the preparation and/or dispatch of agreed relevant documents.
d Go to Create bulk print and send CIR task.
PROCESS
Create Bulk Print and Send CIR Task
Review Specialist
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GOV-026283 Appendix 1
3.0 Prepare for and attend case conference
Review Specialist
a Prepare for the case conference by reading all of the background information and determining whether aspects of the decision
will require additional preparation.
b Re-evaluate all potential resolution options as an outcome of the case conference.
NOTE What potential resolution options are available if the original decision was or appears correct?
• A resolution agreement
• A review hearing
NOTE What potential resolution options are available if the original decision was or appears incorrect?
• Overturning the original decision
c Ensure any new information relevant to the review has been sent to all parties prior to the case conference (eg CAP comment,
newly obtained medical notes).
d Attend and participate in the case conference.
NOTE Please note a Case Conference may be recorded at the Reviewer's disrection.
NOTE What happens at the case conference?
The provider will spend:
• 10 minutes discussing and clarifying the decision at review
• 10 minutes discussing whether further information is required, or resolution options
• 10 minutes scheduling hearing arrangements.
NOTE What questions must the reviewer ask during the case conference?
• What was the decision date?
• What was the date the review application was made (ie review lodgement date)?
• Are there any preliminary jurisdictional issues?
• What are the issues to be decided?
• What facts must be proven?
• Are there any other relevant documents that have not been provided?
• Are there any issues that place an onus of proof on ACC or an Accredited Employer?
• Is conciliation an option?
• What is the hearing attendance preference of the client, customer, or representative?
• If the hearing preference is in person, where is the preferred location?
• Is there a requirement for timetabling directions?
• When will all parties be ready for a hearing?
• What is the preferred communication method for the client, customer, or representative?
• Is the correct address for the preferred communication method recorded by the provider?
NOTE What if you want to view the same file that was sent to the client/advocate and provider?
A copy of the file that was sent to all parties is available for you to view in the CIR Shared Portal.
Client Info Requests - Shared Portal
e Take note of the hearing date agreed in the Case Conference, and add the date and time of the set down to the [PRC REV:
Hearing Requested] task as seen in the image below.
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GOV-026283 Appendix 1

Hearing booked - Hearing task.png
NOTE What if the customer/representative requests a face to face hearing?
Advise the customer/representative that they may claim for travel costs, and these will be awarded after the review
hearing. If the travel requires air travel, and/or accommodation prior approval must be given by a manager.
4.0 Action the case conference outcome
Review Specialist
a Read and action the case conference minutes.
NOTE What if an agreement was reached to gather additional information?
Gather the requested information, and then send copies to the customer/representative and the provider.
NOTE What if no resolution was reached?
The case conference provider will set down a review hearing date. Go to Prepare and Attend Review Hearing (RH).
PROCESS Prepare and Attend Review Hearing (RH)
NOTE What if there was a successful resolution agreement, an agreement to withdraw the review or overturn an
incorrect dedsion?
Go to Implement Resolution Outcomes.
PROCESS Implement Resolution Outcomes
b Email the case conference minutes to [email address] if the review is about a levy decision.
NOTE What should the email contain?
The subject of the email should read 'Resolution Services Case Conference Minutes'. The email is to include:
• Review number
• Customer/representative name (if applicable)
• ACC number
• Any actions required.
PROCESS
Prepare and Attend an Alternative Dispute Resolution (ADR)
Review Specialist
PROCESS
Prepare and Attend Review Hearing (RH)
Review Specialist
PROCESS
Implement Resolution Outcomes
Review Specialist
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GOV-026283 Appendix 1
Prepare and Lead an Internal Resolution Consultation
(IRC)

v9.0
Linked Process
Implement Resolution Outcomes
Attend
Linked Process
Prepare and Case Conference (CC)
Attend
Alternative
Linked Process
Prepare and an Dispute Resolution (ADR)
5.0
Action the IRC outcome
4.0
Facilitate the Internal Resolution Consultation meeting
3.0
Schedule the Internal Resolution Consultation Meeting
2.0
Identify Stakeholders to invite to the IRC
1.0
Prepare for the Internal Resolution Consultation meeting
Linked Process
Conduct Initial Customer Contact
Review Specialist
ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Manage Customer Reviews > Prepare and Lead an Internal Resolution Consultation (IRC)
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GOV-026283 Appendix 1
Prepare and Lead an Internal Resolution Consultation
(IRC) v9.0
Summary
Objective
The objective of this process is to use information and advice from relevant internal experts in an attempt to seek a resolution for the
customer/representative. It will involve explaining the decision (and the reasons for the decision with the customer/representative),
and provides them with an opportunity to hear from relevant internal experts.
Background
The Internal Resolution Consultation (IRC) is used to bring relevant parties together with the client to help clarify customer/
representative understanding of a decision. The IRC is often used when a decision is robust, but not understood by the customer/
representative. New information may be raised at this meeting by the customer/representative.
Owner
[Out of Scope]
Expert
Procedure
PROCESS
Conduct Initial Customer Contact
Review Specialist
1.0 Prepare for the Internal Resolution Consultation meeting
Review Specialist
a Identify the customer/representative's point/s of contention or grievance with the ACC decision.
b Gather documents or other evidence to support a discussion of the point/s of contention or grievance.
c Re-evaluate potential resolution options as an outcome of the IRC.
NOTE What potential options are available if the original decision was or appears correct?
• A resolution agreement
• Alternative Dispute Resolution
• A case conference
NOTE What potential options are available if the original decision was or appears incorrect?
• Overturning the original decision
2.0 Identify Stakeholders to invite to the IRC
Review Specialist
a Identify all relevant stakeholders who may be able to provide insight or technical advice on the decision at the IRC.
NOTE Who could be relevant stakeholders?
ACC staff who had input into the decision. This could include:
• Legal Services
• Clinical Services
• Technical Services
• Technical Accounting Services
• Weekly Compensation Team
• External medical practitioner/s
• Vocational Providers
• Allied health providers
• Levy Classifiation
Working together to find the right outcome
b Contact the potential stakeholder to determine attendance.
NOTE What if a member of the Levy Classification Team need to attend the IRC?
Email [email address] to request a colleague attend the IRC. The subject of the email should read
"Resolution Services Attendance Request". The email should include:
• Review number
• Customer/representative name (if applicable)
• ACC number
• Date and time of the IRC
• Outline a request for attendance at the IRC
10 working days notice is required for Levys to attend the IRC.
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GOV-026283 Appendix 1
3.0 Schedule the Internal Resolution Consultation Meeting
Review Specialist
a In Outlook, set up a teleconference by sending a meeting appointment to the customer/representative and identified relevant
stakeholders.
NOTE What should be in the body of outlook meeting appointment?
• Information on the decision and why ACC made the decision
• The customer/representative's grievance with the decision and the specific points of contention
• Potential outcomes from the IRC
• A list of meeting attendees
• Contact details for the Review Specialist
4.0 Facilitate the Internal Resolution Consultation meeting
Review Specialist
a Using Skype for Business or Teams, initiate the meeting. Allow internal parties to join first and then dial in the customer/
representative last.
NOTE What if one or more parties cannot be reached?
Reschedule the IRC for another time.
b Introduce all the participants to each other and explain the purpose of the internal resolution consultation.
c Facilitate the meeting ultimately steering/directing the conversation towards a resolution, or a clearly agreed outcome.
5.0 Action the IRC outcome
Review Specialist
a Using the IRC contact tool (this exists on the second tab of the CIR calculator tool) enter the outcome agreement.
• If the review is about a decision on a claim copy and paste the information generated by the 'IRC contact calculator' into an
Eos contact.
• If the review is about a levy decision copy the IRC contact tool information into an interaction in Juno_CRM.
CIR Calculator Tool
Customer Resolution Hub - ACC SharePoint
NOTE What type of contact should be added in Eos?
• Reason: Dispute
• Direction: Internal
• Method of contact: Phone
b Action the IRC outcome agreed during the consultation.
NOTE What if no resolution was reached?
Decide whether to proceed to an ADR, or directly to case conference.
NOTE What if the agreed actions will take the review past 40 days from the lodgement date?
Set down a case conference date.
NOTE What if there was a successful resolution agreement, an agreement to withdraw the review, or overturn an
incorrect decision?
Fulfil the resolution obligations.
PROCESS
Prepare and Attend an Alternative Dispute Resolution (ADR)
Review Specialist
PROCESS
Prepare and Attend Case Conference (CC)
Review Specialist
PROCESS
Implement Resolution Outcomes
Review Specialist
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GOV-026283 Appendix 1
Out of Scope]

GOV-026283 Appendix 1

GOV-026283 Appendix 1
[Out of Scope]
[Out of Scope]