Appealing a Workers' Compensation Decision (Script 286)

From Clicklaw Wikibooks

If you think that the Workers’ Compensation Board, now called WorkSafeBC, made the wrong decision in your case, or if you don’t understand the decision, ask the WorkSafeBC officer handling your claim to explain it. Ask for a decision letter, if you didn’t already get one. If you are still not satisfied with the decision, you may request a review, and if you are not satisfied with the decision on the review, you may file an appeal.

Reviews

Before you can ask for an appeal, you first have to ask WorkSafeBC’s Review Division to review the decision.

Time limit to ask for review—you have to ask for a review within 90 days of the date of WorkSafeBC’s decision letter or, in some cases, within 90 days of the date that WorkSafeBC told you its decision orally or stopped paying you. An employer who wants to ask for a review of a decision or an order issued by WorkSafeBC on an occupational health and safety matter, has only 45 days to ask for a review.

Because WorkSafeBC routinely issues some decisions orally, the Review Division accepts review requests from oral decisions. After you request a review, you will receive a letter setting a time to make written submissions. The Review Division does not normally hold oral hearings.

The Review Division considers the written submissions and WorkSafeBC’s file and gives its decision, usually within 150 days. The WorkSafeBC website has more information on reviews and appeals. The phone numbers for the Review Division are 604.214.5411 in the lower mainland and 1.888.922.8804 elsewhere in BC. At the same time, if you feel that WorkSafeBC has treated you unfairly, you can also complain to its Fair Practices Office and the Ombudsperson of BC (1.800.567.3247).

Appeals

If you disagree with the decision of the Review Division, you can usually appeal to the Workers’ Compensation Appeal Tribunal. But you cannot appeal decisions of the Review Division on specific issues, such as vocational rehabilitation, commutations, prevention orders (other than penalties), and certain types of disability awards.

Time limit to appeal—if you want to appeal, you have to do so within 30 days of the date of the decision by the Review Division. Contact the Tribunal in writing (see address below) or phone 604.664.7800 in the lower mainland and 1.800.663.2782 (toll free) elsewhere in BC.

You can appeal by phone or letter, or you can use the Notice of Appeal form on the Tribunal’s website. If you appeal by phone, you have to follow it up with the form within 21 days. If you use a letter or the form, fax them to 604.664.7898 or mail them to:

WCAT
150 – 4600 Jacombs Road
Richmond, BC V6V 3B1

What the Tribunal does

The Tribunal will send you a letter to confirm that it got your appeal and give you an appeal number. You should always include this appeal number, and your WorkSafeBC file number, in any material you submit. The Tribunal will ask you to make your submissions in writing or tell you the date for your oral hearing. Normally, the Tribunal decides a case within 180 days of when it receives your claim file from WorkSafe BC.

The Tribunal must apply the law and the policies of the WorkSafeBC Board of Directors that apply to your appeal. You should find out what policies apply to your case. You can see previous Tribunal decisions on its website.

Preparing for reviews and appeals

Before you start, see the information guides on the Tribunal’s website for detailed information. Decide whether you want to handle your own appeal or have someone help you. If you are a union member, discuss your case with the union. They may have a representative who can help you, or they may hire a lawyer for you in a serious case. You may want to hire your own lawyer anyway. Make sure the lawyer has experience in workers’ compensation.

If you don’t get help from a union or lawyer, you should contact the Workers’ Advisers Office of the BC Ministry of Jobs, Tourism and Skills Training. Workers’ Advisers are separate from WorkSafeBC and there’s no charge for their service. They can help workers apply for reviews and appeals, and they have detailed information on their website. Their phone numbers are 604.713.0360 in Vancouver and 1.800.663.4261 elsewhere in BC.

If you are an employer, you should contact the Employers’ Advisers. They provide independent advice, assistance, representation and training to employers, potential employers and employer associations concerning workers' compensation issues. There is no charge for their service. They have detailed information on their website.

What you need to show

Reviews and appeals are serious. You need to show clearly what’s wrong with the decision. You may need new evidence to support your appeal. You may need more evidence than you had when you first made your claim, such as medical evidence from doctors and specialists. It’s important to get all the evidence you need, as soon as you can.

It is not the role of the Review Division or the Tribunal to tell you what evidence you need.

Check the Information Guides and your WorkSafeBC file

To prepare your case, in addition to looking at the Tribunal’s Information Guides, you should also look at your WorkSafeBC file. You have the right to see it and you should automatically get it when you ask for a review. You will automatically get updated disclosure when you appeal a Review Division decision.

Even if you don’t have an active review or appeal, you can request disclosure of your claim file by sending a written request, using a form on the WorkSafeBC website, to:

Disclosure Department
WorkSafeBC
PO Box 4700 Stn Terminal
Vancouver BC V6B 1J1
Fax: 604.233.9777 or toll free 1.888.922.8807

All your personal information is usually in your claim file, but sometimes other WorkSafeBC records also have personal information. To see these records, under the Freedom of Information and Protection of Privacy Act, send a written request to:

Freedom of Information and Protection of Privacy Office
WorkSafeBC
PO Box 2310 Stn Terminal
Vancouver, BC V6B 3W5
Phone: 1.866.266.9405
Fax: 604.279.7401

You can also see most of your claim file information online on the WorkSafeBC website. You will need your claim number and your personal access number.

For more on this, check script 235, called “Freedom of Information and Protection of Privacy”. As well, check the Freedom of Information and Protection of Privacy Act.

For more information


[updated November 2015]

The above was last edited by John Blois.



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