LSLAP's Role at the Initial Decision Level for Workers' Compensation Claims (7:IV)

LSLAP Manual
This page is from the Law Students' Legal Advice Program Manual. See the full contents.
LSLAP Manual
Introduction
Chapters
1. Criminal Law · I. Introduction · II. Governing Legislation and Resources · III. Etiquette · IV. Criminal Charges · V. Substantive Law · VI. Resolving Prior to Trial · VII. Pleading Not Guilty/Trial · VIII. Other Issues · IX. Charter of Rights and Freedoms · X. LSLAP Policies · XI. Information for LSLAP Students · XII. Etiquette for Law Students · XIII. Practice Recommendations · Appendix A: Initial Sentencing Position · Appendix B: Sample Information · Appendix C: Diversion Application · Appendix D: Sentencing Hearing · Appendix E: Trial Books · Appendix F: Glossary
2. Youth Justice · I. Introduction · II. Governing Legislation and Resources · III. Youth Criminal Justice Act · IV. Youth Justice (British Columbia) Act · Appendix A: Glossary
3. Family Law · I. Introduction · II. Governing Legislation and Resources · III. Marriage · IV. Divorce · V. Uncontested Divorce · VI. Simple Divorce Procedure · VII. Alternatives to Divorce · VIII. Family Violence · IX. Assets · X. Spousal and Child Support · XI. Parenting Orders/Guardianship/Contact · XII. Children and the Law · XIII. Adoption · XIV. Name Changes · XV. Court Procedures · Appendix A: Glossary
4. Victims · I. Introduction · II. Governing Legislation · III. Crime Victim Assistance Program · IV. Avenues to Address Crime · V. Victims of Sexual Assault · VI. Victims of Relationship Violence · VII. Seniors or Those with Disabilities · VIII. Victims of Human Trafficking · IX. Missing Persons and Abductions · X. TIP and Restorative Justice · XI. Resources for Indigenous Victims · XII. Referrals and Follow-up
5. Public Complaints · I. Introduction · II. Governing Legislation and Resources · III. Review of Administrative Decisions · IV. Privacy or Access to Information · V. Complaints against the Police · VI. Complaints against Security Guards · VII. The Right to Vote · VIII. Complaints regarding UBC · IX. Complaints regarding SFU · X. Complaints Re: Other Universities · XI. Complaints against Doctors · XII. Complaints against Lawyers · Appendix A: Glossary · Appendix B: Sample Notice Letter
6. Human Rights · I. Introduction · II. Governing Legislation and Resources · III. BC Human Rights Code · IV. Canadian Human Rights Act · V. BC Civil Rights Protection Act · VI. Rights of the Child · VII. LSLAP's Role · VIII. Indigenous Complainants · IX. Online Mediations & Hearings
7. Workers' Compensation · I. Introduction · II. Governing Legislation & Policy · III. Introduction to Compensation Claims · IV. LSLAP's Role · V. Limitation Periods & Timing of Decisions · VI. Making a Claim · VII. The Claim Acceptance Process · VIII. Worker Status · IX. Disability and Causation · X. Time Limits & Procedures · XI. Claim Benefits · XII. Appeals · XIII. Health & Safety Regulations · XIV. Assessments of Employers · XV. The WCB Fair Practices Officer · Appendix A: Abbreviations · Appendix B: List of Cases · Appendix C: Referrals · Appendix :D Resources · Appendix E: Claims Process · Appendix F: Checklist for Interviews · Appendix G: Checklist for Appeals · Appendix H: Sample Authorization Form
8. Employment Insurance · I. Introduction · II. Governing Legislation and Resources · III. Qualifying for EI · IV. Types of Benefits · V. Benefit Period · VI. Quantifying Benefits · VII. Benefit Entitlement · VIII. Penalties, Violations, and Offences · IX. Keeping Out of Trouble · X. Timing for Reporting · XI. Overpayment and Collections · XII. Reconsideration · XIII. Social Security Tribunal · XIV. Appeals · XV. Judicial Review · XVI. LSLAP's Use of This Chapter · Appendix A: Initial Application Checklist
9. Employment Law · I. Introduction · II. Governing Legislation and Resources · III. Checklist · IV. Preliminary Matters · V. Employment Issues · VI. Remedies · VII. Strategies and Tips · Appendix A: Glossary
10. Creditors and Debtors · I. Introduction · II. Governing Legislation and Resources · III. Creditors' Remedies · IV. Debtors' Options · V. Dealing with Debt · Appendix A: Relevant Forms · Appendix B: Examination Checklist
11. Consumer Protection · I. Introduction · II. Governing Legislation and Resources · III. Contracts for Sale of Goods · IV. Consumer Protection · V. Direct Sales · VI. Conditional Sales Contracts · VII. Motor Dealer Act · VIII. Miscellaneous · IX. Forum of Redress · X. Consumer Transactions
12. Auto Insurance (ICBC) · I. Introduction · II. Governing Legislation and Resources · III. Basic Coverage · IV. Optional Insurance · V. Seeking Legal Counsel · VI. Disputes with ICBC · VII. When You Can Still Sue · VIII. On or Before April 30 2021 · IX. Limitation on Experts · X. Compulsory Coverage · XI. Optional Insurance · XII. Personal Injury Claims · XIII. Out-of-Province
13. Motor Vehicle Law · I. Introduction · II. Governing Legislation and Resources · III. At the Roadside · IV. Duties after a Collision · V. Violation Tickets · VI. Provincial Offences · VII. Vehicle Impoundment · VIII. Superintendent · IX. Alcohol and Drugs · X. Federal Offences · XI. Driving While Prohibited · XII. ICBC Breaches · XIII. Bicycles · XIV. LSLAP Program Information · Appendix A: Penalty Points and Fines
14. Mental Health Law · I. Introduction · II. Governing Legislation and Resources · III. Theory and Approach · IV. Legal Rights · V. Patient Admission · VI. Consent to Medical Treatment · VII. Involuntarily Admitted · VIII. Youth · IX. Criminal Code · X. Complaints · XI. References · XII. LSLAP File Administration Policy
15. Adult Guardianship · I. Introduction · II. Governing Legislation · III. Mental Capacity · IV. Substitute Decision Making · V. Adult Guardianship · VI. Adult Abuse and Neglect · VII. Sources and Resources · Appendix A: EPOA · Appendix B: Decision Tree
16. Wills and Estate Administration · I. Introduction · II. Governing Legislation and Resources · III. Making and Executing · IV. Mistakes and Alterations · V. Court's Power · VI. Revocation · VII. Wills Variation Claims · VIII. Intestacy · IX. Property · X. First Nations and Wills · XI. Estate Administration · XII. Duties of a Personal Representative · XIII. Taxation: RRSP & RRIF & TFSA · XIV. LSLAP File Administration Policy · Appendix A: Questionnaire · Appendix B: Checklist · Appendix C: Glossary
17. Citizenship · I. Introduction · II. Governing Legislation and Resources · III. Who is a Canadian Citizen? · IV. Advantages & Responsibilities · V. Citizenship Grants · VI. Applying for Citizenship Grant · VII. Loss and Renunciation · VIII. Proof · IX. Search of Citizenship Record · X. Referrals
18. Immigration Law · I. Introduction · II. Governing Legislation and Resources · III. Players · IV. Categories of Persons · V. PR Application · VI. Identifications · VII. IRB · VIII. Loss of PR · IX. Temporary Residence Matters · X. Removal Orders · XI. Appeals · XII. Offences · XIII. Issues at Sentencing · XIV. Contacts
19. Landlord and Tenant Law · I. Residential Tenancy Act · II. Tenancy Agreements · III. Moving In and Moving Out · IV. Security Deposits · V. Repair and Service · VI. Rent Increase · VII. Tenant's Rights · VIII. Subletting and Assignment · IX. Termination/Eviction · X. Dispute Resolution · XI. Common Law · XII. Strata Law · XIII. Assisted Living · XIV. Commercial Tenancies · XV. Manufactured Homes · XVI. Income Assistance · XVII. Illegal Suites · XVIII. Forms · XIX. Governing Legislation and Resources
20. Small Claims and the CRT · I. Introduction · II. Governing Legislation and Resources · III. Do You Have a Claim? · IV. Choosing the Proper Forum · V. Starting a Claim · VI. Responding to a Claim · VII. Default Order · VIII. How a Claim Proceeds · IX. Pre-Trial · X. Mediation · XI. Settlement Conferences · XII. Trial/Pre-Trial Conferences · XIII. Trial Preparation · XIV. Trials · XV. Costs and Penalties · XVI. Appeals · XVII. Enforcement of a Judgement · Appendix A: Registries · Appendix B: Demand Letter · Appendix C: Notice of Claim · Appendix D: Reply to Claim · Appendix E: Glossary · Appendix F: Limitation Periods · Appendix G: Causes of Action · Appendix H: Court Fees · Appendix I: Tribunal Fees · Appendix J: Settlement Conference · Appendix K: Payment Hearing · Appendix L: Appeal · Appendix M: LSLAP Policy
21. Welfare Law · I. Introduction · II. Governing Legislation and Resources · III. Eligibility · IV. Special Situations · V. Eligibility Factors · VI. Hardship Assistance · VII. Overpayments and Fraud · VIII. Rates and Payment Issues · IX. Additional Benefits · X. Health Supplements · XI. Appeals
22. Strata Law · I. Introduction · II. Governing Legislation · III. Strata Concept · IV. Strata Plan · V. Common Property and Assets · VI. Governance · VII. Management · VIII. Finances · IX. Collections · X. Bylaws and Rules · XI. Rentals and Accommodations · XII. Privacy · XIII. Insurance · XIV. Repair and Maintain · XV. Dispute Resolution · XVI. Recourse to the Courts
23. Referrals · I. General · II. Family Law & Women · III. Residential Tenancy · IV. Human Rights · V. Wills & Estates · VI. Immigration & Refugee · VII. Disability · VIII. Employment · IX. Debt · X. Indigenous · XI. Police Complaints · XII. Chinese Language · XIII. Others
v • d • e

LSLAP students may only assist workers with a few formal procedures at the initial decision level. However, the student’s role at this point is still important. If the initial claim is done well, appeals may be avoided. These types of inquiries are usually done by correspondence, but may be in person at the worker’s request.

One important aspect of the CMS data management system is the “portals” which allow workers, employers and representatives to access claim files directly. The worker needs to call the Board and obtain an ID and PIN in order to do this. Such access allows an advocate or advisor to see exactly how the claim has been handled.

Students should get a copy of the file and review the relevant documents with the worker. They may also request that the Board provide an opportunity to make submissions prior to the final decision. Some officers will comply with these requests.

It is important to help a client prepare the best possible case at this level. For example, a projected loss of earnings assessment always includes an extensive interview between the Vocational Rehabilitation Consultant and the worker regarding the types of employment that are suitable and available to the worker. The worker should be prepared for this interview, and should be ready to explain issues such as what they are capable of doing, what job activities they cannot perform, and why this is the case. The Board rarely decides that a worker is 100 percent disabled, and workers should therefore be discouraged from expecting such a ruling, unless thereis very strong medical evidence of unemployability.

In addition to filing an appeal, a student can contact the officer who made the decision to request that it be reconsidered on the basis of significant new evidence, or to seek further explanation of the officer’s reasons. Note that this must take place within 75 days of the original decision.

Initial decision-making at the Board level is extremely important, and very informal in its procedure. In general, if a representative doesn’t understand how or by whom a decision will be made, or what factors will be considered, it is always possible to call the Board and ask. The Claims Manual, Workers’ Advisors Office, and other sources of information mentioned in Section I: Introduction of this chapter can also help prepare a successful claim. See Appendix B for a checklist for a student conducting a client interview.

A. The WCB Fair Practices Officer

The WCB has a Fair Practices Officer (Formerly “Chief Complaints Officer” and before that “Ombudsman”), who has been assigned to deal with issues of alleged unfairness related to the WCA. A claimant who has a complaint about a decision must first pursue all available routes of appeal. The Fair Practices Officer may investigate a complaint after all routes of appeal are exhausted. Individuals or groups with complaints about the fairness of WCB decisions, recommendations, actions, procedures, practices, or regulations may contact the WCB Complaints Officer by phone, fax, mail, or in person.

The WCB Fair Practices Officer should not be confused with the province’s Ombudsman, who still has authority to investigate complaints against the WCB. The BC Ombudsman’s policy is to suggest that all complaints go first to the WCB Chief Complaints Officer, but a worker may ask that the provincial Ombudsman intervene immediately if the Fair Practices Officer is unable to resolve the problem. Advocates are beginning to make more complaints to the BC Ombudsman recently, and students can insist that this be done if the complaint process seems ineffective. See Chapter 5: Public Complaints Procedures.

LSLAP's Role at the Initial Decision Level for Workers' Compensation Claims (7:IV)

A. The WCB Fair Practices Officer

Navigation menu

Search