Different Levels of Appeal

Different levels of appeal

There are three levels of appeal.

1. WSIB Operating Level

Operating level decisions are made by Primary Adjudicators, Eligibility Adjudicators, Short Term Case Managers, Long Term Case Managers, SIEF Case Managers, Nurse Consultants, Account Specialists, Account Analysts, Work Transition Specialists (WTSs), and others. You may file an objection if you disagree with a decision. If the decision is not changed, you may file a formal appeal with the WSIB’s Appeals Branch.

2. WSIB Appeals Branch

The objection is referred from the operating level to the Appeals Branch and is assigned to an ARO who makes a decision on the appeal. If you disagree with the ARO’s decision, you may file an appeal with the WSIAT.

3. Workplace Safety and Insurance Appeals Tribunal (WSIAT)

The final level of appeal is conducted by the WSIAT, which is independent of the WSIB.

The OEA may be able to represent you at any or all levels of appeal.

Appeals at the WSIB’s Appeals Branch

There are two different methods used to resolve appeals at the Appeals Branch, depending on the complexity of the issue(s) in dispute.

1. 60-day decision option

This method is used when the issue is relatively straightforward. The objecting party or his/her representative may choose to have a decision made within 60 days based on the information on file and any additional information that is provided in writing by the parties. The onus is on the objecting party to gather any relevant new information.

2. Review/enquiry/hearing option

If the 60-day decision option is declined, the ARO will contact both parties to confirm the issues and determine the most appropriate way in which to resolve the appeal.

If the parties agree the issue(s) can be resolved through written submissions, the parties are given 21 days to make their submissions. After the ARO has received the parties’ submissions, the case proceeds to the Resolution Stage for a final decision.

However, if one or both parties decide they would like to provide further evidence, the case proceeds from the Review Stage to the Enquiry Stage. The case moves to the Resolution Stage for a final decision after the ARO receives the additional evidence and submissions.