Learn more: Timeliness and Communication, in Claims and Benefits Administration, and Internal Appeals

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From the Report of the Auditor General

Claims and benefit administration
- Our testing showed that decisions on workers’ claims met policies and were supported 
- Over half the time, our testing showed workers did not receive written claim decisions within 30 days 
- Half of workers tested did not receive communication about the calculation of their benefits 
Internal appeals
- Our testing showed that appeals were evaluated in line with policies
- Several workers’ appeals were not processed in line with the WCB’s 90-day target 
- Our testing showed that workers’ appeals, on average, took 50 business days to assign 

- Almost half of the approved appeals tested took more than 2 weeks for the implementation process to begin 

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Learn more: Timeliness and Communication

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Learn more: Privacy.

Learn more: Quality assurance, training and performance documentation


Q&A: Timeliness and Communication 

What we’re doing to improve

We’re in the midst of a business transformation that includes changes to both processes and to our systems. Under that process, early phone calls will establish an early connection with the worker. And straight-through processing of some basic claims will mean much speedier processing. 

Our new systems enable much better, clearer communications. With every claim accepted, workers receive a letter explaining how rates are calculated. These are shared in easy to read, easy to understand formats that should make it much easier for a worker to understand how benefits are calculated. As another example, some expense payments will be more automated fashion. The new system will also automatically prompt follow ups when needed, based upon pre-determined schedules and service standards. This type of automation are just a few examples of how our new systems and our new approaches will help us be more efficient at what we do. 

In Internal Appeals, we have already implemented a process to centralize review of appeal decisions, document, and monitor implementation. The new system, again, will give tools for managers to monitor timelines for appeal implementation to ensure it’s timely.

Over the next 12 to 24 months, we will review the current process, and research best practice to ensure an efficient and timely internal appeals process. In the meantime, we have also hired an additional member to the Internal Appeals team.

And we have been making progress. Since January, we have significantly reduced the number of appeals waiting for decision. 



Nova Scotia’s Office of the Auditor General (OAG) news release
Audit Report
Audit Video