Note: This Overview is intended to provide a general guide to Board policies and programs. It does not constitute official Board policy.
Both workers and employers can appeal decisions concerning the payment of compensation, including decisions with respect to the acceptance of claims, the payment of earnings loss compensation or health care benefits, the provision of vocational rehabilitation services or the payment of permanent impairment benefits. Employers can also appeal decisions concerning their WCB assessment.
A worker or an employer may, within 30 days of being notified of the final decision on a claim, appeal that decision to a Hearing Officer. Hearing Officers have the authority to make enquiries, receive evidence and render a final written decision concerning the issues on appeal. A Hearing Officer will either conduct a paper review of the file or hold an oral hearing. The Hearing Officer's decision is the final decision of the Board. The Hearing Officer is legally required to issue decisions within 60 days of the oral hearing or paper review, although the accepted corporate standard is 30 days.
It is important to note that it is not always necessary to file an appeal to have a decision reviewed by a WCB staff member. If new information about a claim or assessment becomes available after a decision has been made, it should be sent directly to the staff member who made the original decision. The staff member can then review his or her decision, based on the new information provided, without the file having to go through the formal internal appeals process. However, where the decision for which a review is being requested is a final decision of the Board, the new information must be truly new evidence (eg. not a reiteration of evidence already on file or a new argument based on the same evidence) and evidence which could not have been presented by the worker or the employer at the time the final decision was made.
After receiving a Hearing Officer's decision, a worker or an employer may file an appeal with the Workers' Compensation Appeals Tribunal (WCAT) within 30 days of being notified of the Hearing Officer's decision. The WCAT is an independent agency that is administratively separate from the Workers' Compensation Board (WCB). Accordingly, the WCB's Board of Directors does not have jurisdiction to pass policies concerning the process used to conduct 'external' appeals, and no such policies are included in this manual.