1.1 This Part applies in relation to a dispute or proceedings under Part 5 Division 3 of the Act.

1.2 All dispute processes of the LSA shall apply the principles of natural justice and procedural fairness.

2.1 If a participant disagrees with an assessment or any aspect of an assessment of their treatment, care and support needs, they may request one reassessment in writing.

2.2 On receipt of a request for reassessment, the LSA will appoint an assessor who was not the original decision maker. The assessor will follow the same procedures as for an original assessment.

2.3 Prior to completing the reassessment, the assessor will provide an opportunity for the participant to explain why they disagree with the original assessment.

2.4 The assessor may either confirm or vary the original assessment. If the original assessment is varied, the LSA will provide a certificate of the reassessment as if it were the original assessment under Part 5 of these Rules.

2.5 The participant will be provided with written reasons for the outcome of the reassessment.

2.6 The reassessment must occur as soon as practicable and in any event within 14 days of receipt of the request.

2.7 At any time, within 28 days after notice of the participant’s assessment of their treatment, care and support needs, and irrespective of whether a reassessment has been requested, the participant can apply directly to the expert review panel for review. When an expert review panel application is made, any reassessment process will cease.

2.8 The reassessment duration will be added to the relevant time period under section 38(3) of the Act, in relation to the review.

3.1 An application for reassessment must:

3.1.1 be in writing;

3.1.2 include a clear statement that there is disagreement with the assessment or aspects of the assessment; and

3.1.3 include reasons why there is disagreement with the LSA’s decision. If a treatment or service has not been approved by the LSA and is the subject of the dispute, the participant must outline the reasons as to why the request is necessary and reasonable.

3.2 The LSA may request that additional information is provided before the request is reassessed if the reasons for the review are unclear.

3.3 The LSA will send a written acknowledgement of the application to the participant within seven days of receipt.

4.1 The assessor will issue a certificate. The certificate will include written reasons for the decision and will be in the form approved by the LSA.

4.2 The LSA will send the certificate to the participant within 14 days of the reassessment.

5.1 A request for review can be made by a participant under section 38(3) of the Act.

5.2 An application may be made to the LSA for review of an assessment as defined in section 38(1) of the Act in relation to treatment, care and support needs.

5.3 The application must:

5.3.1 be in writing on the LSA’s “Expert Review Panel Application” form available on the website;

5.3.2 include a clear statement regarding which aspects of the assessment or reassessment are in dispute; and

5.3.3 include clear and detailed reasons why there is disagreement with the LSA’s decision. If a treatment or service has not been approved by the LSA and is the subject of the review, the participant must outline the reasons as to why it is ‘necessary and reasonable’ referring to the consideration factors outlined in Part 4 of these Rules.

5.4 A n application can only be made after the LSA has notified the participant in writing as to the LSA’s assessment of their treatment, care and support needs as certified under section 30(3) of the Act.

5.5 An application for the LSA to refer the review under section 38(3) of the Act must be made by the participant within 28 days of receiving the LSA’s certificate of assessment.

6.1 An expert review panel consists of between one and three medical experts appointed by the Convenor under Schedule 1 of the Act.

6.2 The expert review panel will give a certificate as to its determination setting out the reasons.

6.3 Further information on expert review panels is found in Schedule 1 of the Act

Page last updated: 18 December 2020