A dispute occurs when someone disagrees with the decision of the Lifetime Support Authority (LSA) about eligibility for either Interim or Lifetime Participation in the Lifetime Support Scheme (the Scheme).

You may be eligible for the Scheme if you have sustained a moderate to severe brain injury, a spinal cord injury, severe burns, blindness, or an amputation from a Motor Vehicle Accident in South Australia.

Your eligibility is assessed using the injury criteria in the LSS Rules. The process is the same for both interim and lifetime participation.

The LSA makes a decision about your eligibility based on the information provided in the application form submitted by you, someone acting on your behalf or an insurer.

An eligibility dispute can be lodged by you, or someone acting on your behalf or an insurer.

A dispute can only be lodged after you have received a letter from the LSA with the decision about your eligibility. The dispute needs to be lodged within six months of receiving that letter.

This will depend on what the dispute is about. If your dispute concerns a ‘non-medical’ matter, it will be reviewed by a review officer.

If your dispute is based on medical considerations, it will be referred to an Expert Review Panel (ERP).

A dispute must be lodged in writing via the LSA website or in a letter or email to the LSA explaining why you disagree with the decision. You should include why you think you meet (or do not meet) the injury criteria in the LSS Rules.

To find out more, contact the LSA’s Review Officer on 1300 880 849 or lsareview@sa.gov.au

Your details are confidential and will only be given to those at the LSA or any other parties directly involved with your dispute.

A review officer will consider non-medical matters such as:

  • whether you sustained an injury
  • whether the incident that resulted in your injury was caused by/arose out of the use of a motor vehicle
  • whether your motor vehicle accident occurred in SA
  • whether your application to join the Scheme was within the timeframe set in the LSS Rules.

The review officer will assess the information included in your original application. You will have the opportunity to provide information in person or in writing. The review officer may also:

  • request that your treating health practitioners provide further information before the review can be assessed
  • contact any other interested party who is directly involved.

Once the assessment has been completed, the review officer will make a decision about the dispute. They will advise you in writing of their decision and provide you with reasons.

The types of disputes the ERP will consider include:

  • whether or not your injury is a result of a motor vehicle accident or is attributable to some other condition, event, incident, or factor
  • whether or not your injury satisfies the criteria for eligibility set out in the LSS Rules
  • whether or not an injury is wholly or predominately related to your motor vehicle injury. In the case of multiple injuries, the ERP will review the relationship between these injuries.

The ERP process is governed by the ‘ERP Guidelines’ issued by the Minster and available on the LSA website.

The ERP will include up to three experts from the health, medical and/or disability sectors who have significant experience in working with people with severe injuries.

The members are independent from the LSA and are chosen by a Convenor, who is appointed by the Minister. Your treating health practitioners cannot be involved in a review of an assessment or decision made.

The LSA provides administrative support services to the ERP and may contact you on their behalf.

The time it takes to resolve a dispute about eligibility will vary and depend on access to relevant information in a timely manner, or the completion of assessments. The review officer or ERP may take time to come to a resolution and ensure the right decision is made.

If you disagree with the decision of the review officer or the ERP, you may have the right to appeal to the South Australian Civil and Administrative Tribunal (SACAT) under section 35 or 37 of the Act. Any appeal must be submitted within 28 days of the ERP or review officer's decision.

For more information contact the SACAT, on 1800 723 767 or at www.sacat.sa.gov.au

For more information, please contact your Service Planner  or the Lifetime Support Authority.