How to complete and lodge

Important Update - How to lodge a request while we operate remotely

To support the reduced spread of COVID-19, we are currently operating remotely. During this period, please can you email your Request for Conciliation to rfc@conciliation.vic.gov.au OR fax it to 03 9940 1000. This will ensure that your request is actioned in the most timely manner possible. Paper copies will continue to be accepted during this period, but please be advised that there may be some delays in processing your request as we establish new ways to process our mail.

When do I lodge a Request for Conciliation?

A Request for Conciliation Form must be lodged within 60 days of receiving a decision about your claim that you wish to dispute.  Where there is a formal decision by an Employer, VWA Agent or Self Insurer it should be attached to the Request for Conciliation Form.

A Request for Conciliation may also be made on the basis that the employer, VWA Agent or Self Insurer has failed to respond to a request made by you or on your behalf.

Information that must be supplied where possible with the form

The request form must be personally signed. It must state clearly the details of the dispute and, where possible, be accompanied by:

  • a copy of the letter advising of the decision;
  • the "reasons for decision" attached to the letter; and
  • anything else which may assist to resolve the dispute, eg medical reports, copies of accounts or receipts, payslips etc.

You must produce all documents in your possession, custody or power and disclose all information to the Conciliation Officer that:

  • relates to the dispute; and
  • is reasonably available to you

unless you claim privilege or immunity from producing the document or disclosing the information.

Information provided may be given to other parties to the conciliation. (See our privacy policy.) We will not provide your medical information to your employer.

Collection Notice

The Accident Compensation Conciliation Service (ACCS) is a body corporate established under the current workers’ compensation legislation. Personal and health information collected by the ACCS will be used for the purposes of processing and assessing this request for conciliation and conduct of the conciliation. It may also be used for other purposes related to the conciliation process, including administration and evaluation of the ACCS.

The ACCS may disclose personal and health information to your union or any other person who you have nominated to assist you; other parties to the conciliation; courts or tribunals; any person or organisation authorised by you, or by law, to obtain it; and to ACCS’ third party contractors.

The ACCS is subject to secrecy provisions in the current workers’ compensation legislation and only discloses information in accordance with that legislation. You are required to give part of this information to the ACCS by the current workers’ compensation legislation. If you do not provide any part or all of this information, your request for conciliation may not be accepted or processed. You may gain access to your personal and health information collected by the ACCS by contacting us directly (details provided below). The ACCS’s policies for the management of personal and health information are also available.

More than 60 days since the decision was received?

The ACCS may allow the application to be lodged more than 60 days after the decision if the particular circumstances are considered appropriate. Reasons for a late lodgement must be provided with the request form.

Need more information?

Contact us for more information