The clock started when the claim arrived, not when you opened it.
Since 1 April 2024, decision-making under the Safety, Rehabilitation and Compensation Act 1988 has had prescribed periods attached to it. The Safety, Rehabilitation and Compensation Amendment (Period for Decision-making) Regulations 2023 inserted section 11A into the Safety, Rehabilitation and Compensation Regulations 2019, giving effect to subsections 61(1A) and 62(6) of the SRC Act, which were themselves inserted in 2011 in response to the 2008 Review of Self-Insurance Arrangement under the Comcare Scheme and had never been supported by prescribed periods until now.
The periods are short and specific: 20 calendar days for claims made in respect of an injury other than a disease, or an aggravation of an injury other than a disease; 60 calendar days for claims made in respect of a disease; and 30 calendar days to decide a request by a claimant to reconsider a determination. They apply to Comcare and to self-insured licensees, and they apply only to initial claims for compensation under section 14 and to reconsideration requests made by a claimant under section 38 or 62. Determinations under any other section of the SRC Act are outside them.
Two years in, the compliance problem is rarely a delegate who does not understand the periods. It is the arithmetic underneath them. That arithmetic is this article's whole subject: the intake controls that make day one reliable, and the handling of the reconsiderations themselves, are separate disciplines with their own failure modes.
The workflow problem
The count looks simple until a file has three information requests, one examination and a claimant who says a report is coming.
Section 11A provides that the count commences on the date the determining authority receives either an initial claim made in accordance with section 54 of the SRC Act, or a claimant's request for reconsideration under section 38 or 62. Section 54 requires a written claim on a Comcare approved form together with a certificate by a legally qualified medical practitioner. Where a claim arrives without the certificate, the count does not commence until the certificate is received, which means day one is a legal conclusion about compliance rather than a date stamp on an envelope. The day of receipt is day one regardless of whether it falls on a business day, a weekend or a public holiday, though if the count ends on a Saturday, Sunday or holiday the decision may be made on the next day that is not, under subsections 36(2) and 36(3) of the Acts Interpretation Act 1901.
Then there are the freezes. For section 14 claims only, the Regulations exclude calendar days falling in five specified periods:
- the determining authority has, under section 57, required the claimant to undergo an examination by a legally qualified medical practitioner nominated by the authority
- the determining authority has, under section 58, requested the claimant give information or a copy of a document
- the determining authority has, under section 71, required an employer's principal officer to give information or documents
- the claimant has advised the determining authority that they will provide further evidence
- the determining authority considers it reasonable and necessary to obtain further medical evidence by requiring a report from the claimant's practitioner or one nominated by the authority
The count stops on the day the notice is given or the claimant's advice is received, and recommences the day after the information arrives, or the day after the claimant or employer advises it cannot be provided, or the day after the authority reasonably believes no further evidence will be provided or that a section 71 notice will not be complied with. Comcare's guidance adds a distinction that catches people: the count does not freeze when information is requested from the employee unless the request is made via a notice issued under section 58, and requests to an employer by other means do not freeze the count either. There is no limit on the number of freezes, and the guidance states that they are not to be used as a tool to delay decision-making.
None of these freeze provisions apply to reconsideration requests. Thirty days for a claimant's request under section 38 or 62 is 30 days.
Where AI genuinely helps
This is a records and arithmetic problem sitting on top of a legal one, which is the profile of task where AI earns its place. Everything below runs on a de-identified working copy, using the placeholder discipline set out in the de-identification toolkit for case managers.
1. Derive day one and show the reasoning. Give the model the receipt records and ask it to state which date it treats as day one and why, expressly naming whether the section 54 requirements were met on that date. The output that matters is not the date, it is the sentence explaining it, because that is what a delegate checks.
2. Maintain the freeze ledger. For each candidate freeze, the model records the statutory trigger, the date the notice was given, the date the count recommenced, and the trigger for recommencement. The critical field is the trigger, because it forces the question of whether a section 58 notice actually issued or whether someone made a phone call.
3. Compute the projected end date and the days remaining. With the freezes recorded, the end date is arithmetic and a model does arithmetic reliably. Ask for the working, not just the answer.
4. Triage evidence completeness against the statutory elements. A file that is 12 days in with no medical evidence on the causal question is a different problem from one with a report outstanding. The model can list what is present and what is absent against the elements a section 14 determination has to address, which is the same structuring discipline described in the claim chronology skill file.
5. Draft the claimant update. Comcare guidance says the claimant should be advised of when the periods in which calendar days are not counted start and end. That is a letter with a fixed structure and no discretion in it, which is a good use of drafting assistance and a poor use of anyone's afternoon.
Where human judgement is non-negotiable
The determination is not in scope for any of this, and neither are the decisions that shape it.
Whether it is reasonable and necessary to obtain further medical evidence is a judgement about the claim, made by a person with delegation. Whether to require an examination under section 57 is a decision with its own consequences, covered separately in building a section 57 referral. Whether the authority reasonably believes a claimant will provide no further evidence is a state of mind the Regulations attribute to the authority, not to a tool. Whether liability is accepted or rejected under section 14 is the determination itself.
There is also a use that has to be named and refused. The freeze provisions can be read as a lever, and a system that surfaces "issue a section 58 notice to gain 11 days" is a system that has learned the wrong objective. Comcare's guidance says the measures are only to be used where the determining authority requires further information in order to make a determination under section 14, and that actions triggering them do not need to be taken if the authority already has sufficient information to make a sound determination. Any AI layer that ranks or suggests freezes should be configured to surface evidence gaps, never deadline relief.
Worked example. An initial claim for [CLAIMANTNAME], claim [CLAIMNUMBER], in respect of an injury other than a disease is received on a Monday with a compliant certificate, so the count commences that day and the 20 day end date is calculated. On day four the delegate forms the view that a report from the treating practitioner is reasonable and necessary and requests it. The ledger records the trigger, the request date and the count as frozen. The report arrives eleven days later; the count recommences the following day and the end date moves accordingly. On the delegate's instruction a section 58 notice issues for an outstanding document, and that freeze is recorded separately with its own trigger. At every point the ledger shows a date, a trigger and a statutory basis, and at no point does it express a view about [CONDITION] or about liability.
What does a missed timeframe actually mean?
It is worth being precise, because the answer is not what many teams assume.
The Regulations do not prescribe a deemed determination or a reviewable decision where the period is not met. Comcare guidance states that determining authorities should have regard to other legislation that may enable a claimant to seek review of a determination not made within the prescribed timeframes. Because the statutory timeframes, including the periods during which calendar days are not counted, are not determinations under subsection 60(1), they are not subject to reconsideration under section 62 or appeal to the Administrative Review Tribunal. A claimant disagreeing with a determining authority's conduct in applying them would make an application to the Federal Court of Australia.
The practical consequence is that timeframe performance does not correct itself through the review pipeline the way a contested determination does. It surfaces as complaints, as scheme reporting, and eventually as a question from a regulator about the records. Which is the strongest argument for the ledger: Comcare guidance directs that all periods in which calendar days are not counted are recorded in claims management systems, and a record built as the claim moves is evidence, while a record reconstructed at audit is an assertion.
Bottom line
The periods are prescribed, the freezes are exhaustively listed, and the arithmetic is unforgiving. That combination is well suited to an assistant that tracks and shows its working, and badly suited to one that is asked what to do next. The clock is a control. The determination is a decision. Keep them in different hands.
Do this Monday
- Confirm your claims system captures the date a compliant section 54 claim was received, separate from allocation date
- Check whether recorded freezes are backed by an actual section 58 or section 71 notice
- Build the freeze ledger fields if they do not exist: trigger, notice date, recommencement date, days excluded
- Run one de-identified file through an AI ledger draft and have a delegate check the day-one reasoning
- Confirm no prompt, template or report presents a freeze as a way to extend a deadline
Content disclaimer: This article is for general educational purposes only and does not constitute legal advice, liability determination guidance, or a substitute for professional judgement. Workers compensation decisions are made by appropriately qualified and authorised persons under the Safety, Rehabilitation and Compensation Act 1988. All AI outputs described in this article require human review before use in any claims management context.
Primary sources
- Comcare, Scheme guidance, Statutory timeframes for decision-making under the SRC Act, SRC339, April 2025. https://www.comcare.gov.au/scheme-legislation/src-act/guidance/statutory-timeframes-decision-making
- Safety, Rehabilitation and Compensation Amendment (Period for Decision-making) Regulations 2023, Schedule 1, Part 2, inserting section 11A into the Safety, Rehabilitation and Compensation Regulations 2019.
- Safety, Rehabilitation and Compensation Act 1988 (Cth), sections 14, 38, 54, 57, 58, 60, 61(1A), 62(6) and 71.
- Acts Interpretation Act 1901 (Cth), subsections 36(2) and 36(3).
TheAICommand. Intelligence, At Your Command.
