If you've made a workers compensation claim in NSW, you may receive a letter from the insurer titled "Section 78 Notice". For many injured workers, this is the first indication that there is a dispute about their claim or that the insurer has made a decision affecting their entitlements.
Receiving a Section 78 Notice can be concerning, particularly if it advises that your claim has been declined, your weekly payments will stop, or your medical treatment will no longer be funded. However, receiving this notice does not necessarily mean the insurer's decision is final.
Understanding what a Section 78 Notice is, why it is issued, and what steps you should take
What Is a Section 78 Notice?
A Section 78 Notice is a formal written notice issued by a workers compensation insurer under the Workplace Injury Management and Workers Compensation Act 1998.
The notice advises an injured worker that the insurer has made a decision about their claim.
Depending on the circumstances, the notice may relate to:
- Liability for the injury
- Weekly compensation payments
- Medical or treatment expenses
- Permanent impairment
- Other statutory entitlements
The purpose of the notice is to explain the insurer's decision, the reasons for that decision, and the information relied upon when making it.
Why Have You Received a Section 78 Notice?
A Section 78 Notice is usually issued when the insurer decides to:
- Decline liability for your injury
- Reduce or stop weekly compensation payments
- Refuse approval for medical treatment
- Reject part of your claim
- Change your work capacity classification
In many cases, the insurer has completed an investigation involving medical reports, employer information, witness statements or other evidence before issuing the notice.
Receiving the notice does not necessarily mean your claim has no merit. It simply means the insurer has reached a formal decision that affects your entitlements.
What Information Should a Section 78 Notice Include?
A properly issued Section 78 Notice should clearly explain:
- The insurer's decision
- Why the decision has been made
- The legislation supporting the decision
- The evidence relied upon
- Your options for seeking a review or challenging the decision
The notice should be sufficiently detailed to allow you to understand why your claim has been affected.
For example, the insurer may rely on:
- Independent Medical Examination (IME) reports
- Treating doctor records
- Employer incident reports
- Surveillance evidence
- Vocational assessments
- Witness statements
Understanding exactly what evidence has been relied upon is often the first step in deciding whether the decision should be challenged.
Does a Section 78 Notice Mean Your Claim Has Been Rejected?
Many people assume a Section 78 Notice means their workers compensation claim has completely failed. In reality, the notice can relate to a specific aspect of the claim rather than the entire claim itself.
For example, the insurer may:
- Accept liability for the injury but decline further treatment.
- Continue paying weekly benefits but dispute permanent impairment.
- Accept some injuries while rejecting others.
- Reduce weekly payments based on a work capacity assessment.
The scope of the notice depends on the decision being made.
Carefully reviewing the wording is therefore important before assuming the claim has been completely denied.
What Should You Do After Receiving a Section 78 Notice?
The first step is to read the notice carefully. Pay particular attention to:
- What decision has actually been made.
- Why the insurer says it made that decision.
- The evidence relied upon.
- Any review rights or applicable time limits.
You should also ensure that your treating doctor understands the insurer's reasoning. In some cases, additional medical evidence may address concerns raised by the insurer.
Importantly, do not ignore the notice. Many review pathways are subject to strict statutory timeframes. Delaying action could affect your ability to challenge the decision.
Can You Challenge a Section 78 Notice?
Depending on the issue in dispute, there may be several options available. These can include:
- Providing additional medical evidence.
- Requesting the insurer reconsider its decision.
- Seeking advice about formal review options.
- Referring the dispute to the Personal Injury Commission where appropriate.
The most suitable pathway depends on the type of decision that has been made.
For example, disputes involving liability, work capacity, medical treatment or permanent impairment may each follow different review processes. Obtaining legal advice early can help identify the most appropriate course of action.
Why Evidence Is Often the Key to Overturning a Decision
Many Section 78 Notices rely heavily on medical evidence.
An insurer may conclude that:
- Your injury is unrelated to work.
- You have recovered sufficiently to return to work.
- Further treatment is not reasonably necessary.
- Your ongoing symptoms are caused by a pre-existing condition.
These conclusions are frequently based on Independent Medical Examination reports or other specialist opinions.
If those opinions are incomplete, inconsistent or fail to consider all relevant information, additional evidence from treating specialists may significantly strengthen your position.
The quality of the medical evidence often determines whether a disputed decision is ultimately upheld or overturned.
Why Early Advice Matters
Once a Section 78 Notice has been issued, your claim enters a more formal stage of the workers compensation process. Decisions about medical evidence, review options and procedural timeframes can all influence the outcome.
Acting promptly provides the best opportunity to identify weaknesses in the insurer's reasoning, obtain further supporting evidence and preserve your review rights before statutory deadlines expire.
Even where the insurer's decision appears comprehensive, it should not be assumed that it cannot be challenged.
How Law Advice Can Help
Receiving a Section 78 Notice can be overwhelming, particularly when it affects your income, medical treatment or ongoing entitlement to compensation. Understanding the legal significance of the notice, and knowing how to respond, can make a substantial difference to the outcome of your claim.
The personal injury lawyers at Law Advice regularly assist injured workers in reviewing Section 78 Notices, explaining the insurer's reasons in plain language, identifying whether the correct legal tests have been applied, and advising on the most appropriate review pathway.
They work with treating doctors and medical specialists to obtain evidence that directly addresses the issues in dispute and represent clients throughout the dispute resolution process, including proceedings before the Personal Injury Commission where required.
If you have received a Section 78 Notice, obtaining early legal advice can help ensure your rights are protected and that any challenge to the insurer's decision is supported by the strongest possible evidence.