Difference between revisions of "Appeals in Worker's Compensation Claims (7:XII)"
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== A. Internal Review - Workers’ Compensation Review Division == | == A. Internal Review - Workers’ Compensation Review Division == | ||
A worker, a deceased worker's dependent, or an employer may request a review of any of the following decisions of the Board: i) a decision respecting a compensation or rehabilitation matter (e.g. denial of benefits, or quantum of benefits); ii) a decision levying payment by the employer for failure to comply with the statute; or iii) a decision respecting an occupational health or safety matter. | A worker, a deceased worker's dependent, or an employer may request a review of any of the following decisions of the Board: i) a decision respecting a compensation or rehabilitation matter (e.g. denial of benefits, or quantum of benefits); ii) a decision levying payment by the employer for failure to comply with the statute; or iii) a decision respecting an occupational health or safety matter. | ||
The Review Division may also reconsider its own decisions in some cases. It can only undertake such a reconsideration during the first 23 days after the decision is made, and only if no appeal has yet been filed to the WCAT. The Internal Review Division’s powers are slightly greater than the Board’s – it can change a decision on the basis of new evidence that didn’t exist or couldn’t have been presented previously with “due diligence” on the part of the applicant. Even that authority, however, ends on the 24th day. This means that for decisions that cannot be appealed to the WCAT, like vocational rehabilitation issues and many pension amounts, there will be no way for anyone in the system to change an incorrect decision based on new evidence, even if it could not possibly have been presented earlier and shows conclusively that the decision was wrong. | |||
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Revision as of 21:17, 28 May 2016
For most issues, the first level of appeal is to the Review Division of the WCB. Certain issues may undergo a second level of appeal to the Workers’ Compensation Appeal Tribunal (WCAT).
Section 96(4) does allow the Board to “reconsider” any past decision, on its own initiative, but s. 96(5) prohibits it from doing so if a decision is more than 75 days old unless there has been fraud or misrepresentation (such as when a videotape may show that the worker is less disabled than claimed). The Board interprets this to mean that the reconsideration must be completed, not just initiated, by the 75th day, and staff have been advised that they cannot correct even an error of law after that time, or change a decision to give effect to persuasive new medical evidence not available when the original decision was made.
A. Internal Review - Workers’ Compensation Review Division
A worker, a deceased worker's dependent, or an employer may request a review of any of the following decisions of the Board: i) a decision respecting a compensation or rehabilitation matter (e.g. denial of benefits, or quantum of benefits); ii) a decision levying payment by the employer for failure to comply with the statute; or iii) a decision respecting an occupational health or safety matter.
The Review Division may also reconsider its own decisions in some cases. It can only undertake such a reconsideration during the first 23 days after the decision is made, and only if no appeal has yet been filed to the WCAT. The Internal Review Division’s powers are slightly greater than the Board’s – it can change a decision on the basis of new evidence that didn’t exist or couldn’t have been presented previously with “due diligence” on the part of the applicant. Even that authority, however, ends on the 24th day. This means that for decisions that cannot be appealed to the WCAT, like vocational rehabilitation issues and many pension amounts, there will be no way for anyone in the system to change an incorrect decision based on new evidence, even if it could not possibly have been presented earlier and shows conclusively that the decision was wrong.
next p7-30