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Injury at work place – WSIB Appeal Process

WSIB appeals process for injured workers:WSIB appeals process

There is no denying that accidents occur at a work place. The risk level at a workplace is different for every profession. For example a construction site or a mine is a risky place to work and is more prone to accidents that other places, like an office building in the CBD where an IT company is conducting their business.

As per the statistics recently published approximately 4600 workers were killed while on the job in the year 2012. In a very sad incident that occurred in Turkey in May this year (2014), more than 250 miners were killed and they happened to be from many different countries besides Turkey.

But the issue of health and safety cannot be taken lightly by any employer. It is in fact the duty of an employer to provide a safe and secure environment for the workers to work in. There are some tasks and situations that are risky however if the correct guidance and training is provided, most these accidents can be avoided. If the employees are aware of the danger involved and are informed of what precautions to take it is likely that there will be lesser accidents.

However when accidents do occur there is a support system in place that can help you in every step of the way. You are entitled to make claims with the WSIB for compensation. The claim process involves filing the WSIB Accident Report as well as the WSIB Injury report. After the WSIB claims process makes the decision is not in the favor of the worker, there is a WSIB Appeals process too. Then have the right to appeal as well.

Multiple Appeal Levels:

The Ontario Worker’s Compensation system has two levels of appeal. The two levels of appeals are:

  • The Internal Appeal at the Workplace Safety and Insurance Board (WSIB) which is to be made before the Appeals Resolution Officer (ARO).
  • The external Appeal at the Workplace Safety and Insurance Appeals Tribunal (WSIAT).
  • The appeals process usually takes place on an issue by issue basis and it must pass through each level. In general it is quite common for workers to bring up several issues during an appeal and also appeal several times during a claim process.

The time factor:

A claim in general takes time to be processed and is not instant; like just about any other claim process. However prior to that happening an initial decision process takes place. Here is a brief list of them.

  • The WSIB Case Manager makes the initial benefit decision.
  • The Nurse Consultant makes the initial decision about health care.
  • The Work Transition Specialist makes the decision about the work transition or re-entry.

There is time limit to the appeals process for each decision as well. In general the initial decision processes have approximately 6 month time limit. However the Work Transition decision will have only a 30 day time limit. This time limit will always be conveyed at the end of the decision letter that you receive. The worker can object with the intent to object form that is available from the WSIB website. At times it may be necessary to send several forms to comply with the various time limits. These time limits are usually quite strictly followed and it is only in rare cases that you can obtain an extension in the time of appeal.

Appeal Readiness:

Once the intent to object form is sent the relevant will review the issue under appeal. In the case where no changes are made to the claim decision, a copy of the file along with the appeal readiness form will be sent to the worker. The worker in turn needs to then complete this form and submit it back to the WSIB. However, this time there is no time limit for submitting this form.

Appeals Resolution officer (ARO) Appeal:

The WSIB Appeals manager makes the decision on whether the appeal requires an oral hearing or if a written submission is sufficient before the decision is made on the basis of the Appeal Readiness form that was sent by the worker. This is then passed on to the ARO. The ARO reviews the file and conducts the oral hearing if necessary during which the worker will need to testify. The final decision made by the ARO will be in the form of a written submission. The duration of this process can extend up to 20 months, however in general it takes 12 – 20 months.

Appeals Tribunal appeal:

The workers can appeal on the decision of the ARO as well once he makes his decision. They can make an appeal to the Appeals Tribunal by submitting the ‘Notice of Appeal’ form along with the decision of the ARO. This ‘Notice of Appeal’ form is easily available from the website of WSIAT however the appeal to the Appeals Tribunal needs to be made within 6 months of the decision of the ARO since it is almost impossible to get an extension of time after 6 months.

This process in this appeal is usually more thorough and then the ARO one. There are two additional forms, the readiness form and the confirmation of appeal form involved. In addition to this prior to the hearing taking place there is a telephone contact with the tribunal legal worker. Each process takes a lot of time at the end of the oral hearing the decision is finally made. The duration of this process is typically 12 – 243 months.

The decision made by the Appeals Tribunal is usually the final one and there is very little that can be done to change this decision.

How Safety First can help:

Safety First

Safety First is one of the few organizations that has the experience and means to help organizations in the matter of health and safety. Their courses are specially structured to help employees gain a better understanding of their respective working environments and thus prevent and incident from occurring. They have a strong team of certified professional safety consultants that can help businesses of all sizes and a wide range of industries as well.

Safety First Consulting Professional Corporation is a licensed paralegal firm regulated by the Law Society of Upper Canada (LSUC). Our paralegal team provides a widespread WSIB claims Ontario management system that is designed to reduce and control an employer’s costs associated with workplace injuries and illnesses. Our pro-active program begins at the point of occurrence and continues to the final resolution of the claim with a rapid response.

The professionals at Safety First Consulting can show you how to navigate the sometimes technical and often confusing OSHA regulations with health and safety program ontario. They can help you figure out what regulations apply in your workplace and what you need to do to comply. Just know About us, take one of our classes, or request a Contact us form.

About the author

Sophie MooreSophie Moore is a Digital Marketing Analyst, in charge of many digital marketing projects that involve SEO, Social Media and mobile web strategy. Moore has a background in IT, strong experience on website development and web interface, degrees in both traditional and digital marketing at Duke University, North Carolina.

Moore has a wide experience of internet projects and keeps herself up to date with the latest technologies and trends. Moore always explains that social media is her passion, SEO a motivation and a dynamic challenge where she is involved every day.

Learn more about her at her personal site. Follow her on Twitter, on Google +Sophie or become a friend on Linkedin