Any unfavourable WSIB decision can be appealed, however, all appeals must be filed within the documented timeframes or you will lose your right to proceed with an objection.
Work Reintegration, Reemployment, and Return to Work decisions must be appealed within 30 days. All other decisions must be appealed within 6 months, by completing the Intent to Object form and sending it to the WSIB. If the injured worker wishes to appeal a final WSIB decision made by the Appeals Services Decision to the Workplace Safety and Insurance Appeals Tribunal this must also be done within 6 months of the final board decision. Decisions may be appealed by workers, employers, or their representatives.
After the WSIB receives the Intent to Object form and, if the decision remains the same, the WSIB will send the objecting party an Appeal Readiness Form and a complete copy of the file. This form must be sent to the WSIB when the objecting party is ready to which submissions may be attached or if the party is requesting an oral hearing that should be indicated on the form. When a worker objects to a decision the employer will receive a participant form that they need to return to take part in the appeal.
The WSIB will review the Appeal Readiness Form and, if a decision has not changed, the WSIB will refer the file to the Appeals Services Division. Also, if there is an issue in dispute, the employer will generally be granted access to the claims file, less any harmful medical information or irrelevant information to the issue. Appeal hearings can be conducted orally or in writing. Most appeals are now resolved by a hearing in writing, particularly when the issue in dispute is simply one of policy interpretation. An oral hearing may be required in cases where there is inconsistent information between the worker and the employer, multiple issues, or complex facts. The Appeal Services Division decides whether an oral hearing is required and will notify the parties in writing.
Generally, the WSIB tries to schedule oral hearings within ninety (90) days and an Appeals Resolution Officer will generally render a decision within thirty (30) days from the date of the hearing. If an interested party still disagrees with the Appeal Branch decision, they can request reconsideration or appeal to the Workplace Safety and Insurance Appeals Tribunal (WSIAT).
Appeals must be made to the WSIAT within six (6) months of receiving the WSIB board decision. The appellant must complete the Notice of Appeal form and send it to the WSIAT. The Notice of Appeal form must be accompanied by a copy of the board decision that is being appealed. The WSIAT requires that the appellant proceed with their appeal by filing the Confirmation of Appeal form within two (2) years from filing the Notice of Appeal, unless there are extenuating circumstances. The WSIAT will also identify whether a written appeal is appropriate or whether an oral hearing is required.
You may want to consider seeking legal advice if you are not sure whether you have the grounds for an appeal. If you have any questions about WSIB claims or appeals, contact our Employment Law group.