Our complaints policy
ReturnToWorkSA is committed to ensuring it has a robust, consistent and simple complaint handling process to receive and manage complaints.
ReturnToWorkSA is responsible for regulating all Return to Work scheme participants; responding to formal complaints is an important part of this function.
If you have a concern about the service you have received from ReturnToWorkSA, its claims agents, service providers or a self-insured employer, you should raise your concern directly with the person or organisation that the complaint is about in the first instance. If you remain unhappy, ReturnToWorkSA can investigate your complaint.
The complaints process is not able to investigate complaints about claim or premium related decisions, as these decisions have legal review rights. If you are not happy with a decision relating to your claim or insurance premium, you have the right to apply for a formal review.
Making a complaint
Often the quickest and easiest way to resolve the issue is to contact the person/organisation directly. The first step in making a complaint should be to raise your concerns with organisation/person that the matter relates to. This gives them an opportunity to resolve the matter first. This can include raising the matter with the person, their Team Leader/Manager, or by following the organisation’s complaint process.
|If the complaint relates to||Contact|
|Claims agent||Please contact the agent directly.|
|ReturnToWorkSA||Contact us on 13 18 55, email firstname.lastname@example.org or complete our online complaints form.|
|Service provider||Please contact the provider directly.|
|Self-insured employer||Self-insured employers are required to have processes to address and resolve a complaint. You should use these processes to lodge a complaint.|
Before you contact the person/organisation to make the complaint, it is helpful if you:
- have specific information about the complaint, including copies of letters, emails, or factual information about the issue (date, time, name of people involved)
- consider what can be done to resolve your issue, or what outcome you are seeking from the complaint.
What to expect when a complaint is lodged
The organisation that receives the complaint will:
- work with you to address and resolve the problem
- provide a response within 10 business days after receiving the complaint or, if the matter requires extended investigation, will provide an interim response within 10 business days advising you of when a final response will be provided.
ReturnToWorkSA’s Complaints Team
If you remain unsatisfied after contacting the organisation/person your complaint relates to, you can lodge a complaint with ReturnToWorkSA’s complaints team.
When we receive your complaint, we will:
- contact you within one business day of receiving your complaint
- work with you to address and resolve your concerns
- ask you to tell us about what you’ve done to try and resolve the matter with the relevant person/organisation (often the quickest and easiest way to resolve the issue is to contact the party directly. If you have not attempted to resolve your complaint with the organisation that the complaint is about we may refer the matter back to them to address directly with you.)
- assess and, where appropriate, thoroughly investigate your complaint. If we cannot help you, we will try our best to refer you to alternative services that may assist you
- handle complaints professionally, efficiently and impartially in line with the services standards in the Return to Work Act 2014.
- treat you with courtesy and respect and maintain confidentiality.
There are no charges for making a complaint.
How to contact ReturnToWorkSA’s Complaints Team
If you are deaf or have a hearing or speech impairment:
To contact us in a language other than English call the Interpreting and Translating Centre on 1800 280 203 and ask them to contact us on 13 18 55. This interpreting service is available at no cost to you.
What to expect if a service standard has been breached
The Return to Work Act 2014 sets out service standards which are service expectations that apply to ReturnToWorkSA and self-insured employers.
If a service standard has been breached, you may receive one or more of the following:
- a written or verbal apology, or an explanation in writing
- the opportunity to discuss in person your views on the services so that a resolution can be discussed
- information, either in writing or verbally, about the status of your claim and entitlements, review rights under the Return to Work Act 2014, what services are available, and any timeframes that apply in relation to a dispute
- an opportunity to provide your feedback
- your questions/requests answered and responded to in an appropriate manner
- an opportunity to receive a copy of your work injury claim file in accordance with section 180 of the Return to Work Act 2014 or under the Freedom of Information Act 1991 when requested. Read more about accessing information.
Our commitment to our staff
We are committed to providing a safe working environment for our staff. You can assist us to do this by:
- treating our staff with courtesy and respect
- being open and honest in your dealings with us
- advising us when your personal details change
- providing all the information you hold, or are aware of, to assist with queries and investigations.
If you are not satisfied with how ReturnToWorkSA’s Complaints Team has handled your complaint, you have the right to refer the matter to the State Ombudsman for investigation.