Both the employer and worker have the right to appeal a decision made on a claim. Employers can appeal WCB decisions regarding claims or matters related to company classifications and assessment rates.
If a worker disagrees with a claim decision after discussing it with a case worker, they may file an appeal within 30 days of receiving a written decision. It’s important to note that the appeal process is not intended as a second look at the entire claim. The process exists to review specific errors or oversights.
It is important that appeals be as specific as possible.
Whether you are a worker or an employer, this brochure is intended to help you understand your options, and to explain the process when you have questions or concerns about a decision of the WCB.
Forms needed to file an appeal:
Notice of Appeal form-Employer
Notice of Appeal form-Worker
Questions about the appeal process:
How are decisions on my claim made?
When you’ve been injured on the job, the injury will be reported to the WCB, who will also receive health care information as you receive treatment. The WCB makes a decision about whether or not the claim is covered under the Workers’ Compensation Act.
This involves an in-depth look at all information surrounding the claim, including medical records.
The WCB also determines if you are entitled to benefits, and what those benefits may be. Other decisions may also be made throughout the claim process.
If you are an employer and you are appealing a decision regarding a claim of one of your employees, you may request a copy of the relevant information from the worker’s claim file.
Are decisions final? Can I appeal?
At any point, as a worker or as an employer, if you have questions or concerns about a decision, talk to us.
If you still disagree with a claim decision after discussing it with your Case Worker, you may file an appeal within 30 days of receiving the written decision. It’s important to note that the appeals process is not intended as a reconsideration of the entire claim. The process exists to review specific errors or oversights in the claim decision. It is important that appeals be as specific as possible.
Employers may also appeal a decision with respect to their assessment rate, classification or any penalties. The procedure outlined on page 3, and the 30-day deadline, also applies to these appeals.
I want to appeal a decision. How do I do that?
For both workers and employers wishing to appeal a decision, the process starts with a form called a Notice of Appeal to Hearing Officer.
Step 1. Complete a Notice of Appeal to Hearing Officer and return it to the WCB.
If you cannot download this form, contact the WCB through the general information line: 1.800.870.3331 in mainland Nova Scotia, 1.800.880.0003 in Cape Breton.
Step 2. Fill out the form in as much detail as possible. Provide any and all information pertaining to your appeal. Be specific about why you are appealing.
IMPORTANT: Your Notice of Appeal to Hearing Officer must be received within 30 calendar days of the date you receive the written decision. After this point, the decision is final.
Step 3. Send the form and all documentation by mail or fax to: WCB Internal Appeals Department WCB of Nova Scotia PO Box 1150 Halifax, NS B3J 2Y2 Fax: 902.491.8001.
When we receive your appeal, we will contact you to ensure the Notice of Appeal is completed correctly and that we fully understand your appeal. Your appeal will then be reviewed by a Hearing Officer, a specialist in workers’ compensation law and policy.
In a paper review, the Hearing Officer reviews all of the documentation relating to the appeal. In an oral hearing, the Hearing Officer meets with relevant parties in an informal setting to discuss the issues of the appeal and any new information.
When the review or hearing is complete, the Hearing Officer will issue a decision. This is the final decision of the WCB.
What if I receive new information?
If you receive new information after the Hearing Officer Decision, or on a claim or assessment matter, you may present this information to us. New evidence – not just new arguments on evidence already filed – may mean a decision will be reviewed in light of that new information.
I disagree with the outcome of an internal appeal. Do I have other options?
Yes. The Workers’ Compensation Appeals Tribunal (WCAT) is an independent body to which final decisions of the WCB may be appealed. The WCAT reports to the Minister of Justice, and is separate from the WCB. An appeal to the WCAT must be filed within 30 days of being notified of the WCB Hearing Officer’s decision.
Workers’ Compensation Appeals Tribunal
Is assistance available for my appeal?
The WCB will be pleased to answer any questions workers or employers may have about a WCB decision. Beyond that, the Workers’ Advisers Program (WAP) is available and may be able to assist workers in filing an appeal or handling their claim through legal advice, assistance and representation.
Worker’s Advisers Program: Toll-free 1.800.774.4712 or locally at 902.424.5050
This isn’t clear to me. I still have questions. Can I speak with someone?
The WCB of Nova Scotia exists to support those whose lives are touched by workplace injury. Our goal is to reduce the human and financial toll workplace injury takes in Nova Scotia through injury prevention and return to work.
At any point, do not hesitate to contact us.