Appealing a WSIB decision
Most WSIB decisions can be appealed if you believe they are incorrect, or contrary to the WSIA or WSIB policy.
Different levels of appeal
There are three levels of appeal.
1. WSIB Operations Level
Operating level decisions are made by adjudicators, case managers, Account Specialists, Account Analysts, RTWSs, 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 Services Division (ASD).
2. WSIB ASD
The objection is referred from the operating level to the ASD and is assigned to an Appeals Resolution Officer (ARO) who makes a decision on the appeal. If you disagree with the ARO’s decision, you may file an appeal with the WSIAT.
The final level of appeal is conducted by the WSIAT, which is independent of the WSIB.
Time limits for appealing a WSIB decision
There are strict time limits for appealing all WSIB decisions. You have 30 days from the decision date to appeal WR/return to work, re-employment, and WT/labour market re-entry decisions, and six months from the decision date to appeal any other decisions including NAICS classification and other employer account decisions, to an ARO.
If the appeal period is missed, you may have lost your right to appeal as an extension to appeal is granted only on very limited grounds. You should still file an appeal as quickly as possible, and contact the OEA for advice.
ARO decisions must be appealed within six months of the decision date to the WSIAT.
How to appeal a WSIB decision
To appeal a WSIB decision regarding a worker’s benefits, WR or WT, complete an “Intent to Object Form” 2397A (ITO Form) which is available in the Employer Forms section of the WSIB’s website. You can also call the WSIB at 416-344-1000 or 1-800-387-0750 and ask to have one mailed to you. This form is to be used for claims-related matters only. The ITO Form has extensive directions on it which must be followed.
Once you submit the ITO Form, the time limit to appeal stops running. You may then take as much time as you need to submit an Appeal Readiness Form (ARF) to the WSIB.
To appeal a WSIB decision regarding classification or other revenue-related issues, write a letter to the decision-maker indicating your disagreement with his/her decision. Note that the WSIB will not automatically send you a copy of your firm file for employer account appeals. You will need to contact the Firm File Access area and ask for your firm file to be sent to you. For more information about accessing employer-specific information, refer to OPM Doc. No. 21-01-01 “Access to Employer Information,” which is available on the WSIB’s website.
If you have any questions, you may call the OEA for advice and/or representation.
Appeals at the WSIB’s ASD
Only certain types of appeals involving more complex issues, or credibility issues, will be decided by oral hearings. Most matters will be decided based on materials in the claim file, written submissions, and any additional documents submitted. When you are ready to proceed with your appeal, you must complete the ARF that will be sent to you. This form requires you to provide comprehensive information about your grounds for appeal, why you think you should win, and the outcome you are seeking from the WSIB once your appeal has been reviewed/heard by the ARO. Call the OEA for further advice or representation.
What happens if a worker appeals a WSIB decision
Employers will receive a Participant Form (PF) after the worker submits his/her ITO Form. The PF must be completed and returned to the WSIB as soon as possible, or you will not get any further information about the appeal until after a final decision has been made. The WSIB will send you the worker’s filed ARF, and the claim file.
Getting help to appeal a decision
The OEA provides representation at both the WSIB and the WSIAT, primarily to employers who have fewer than 100 employees.
Employers of all sizes can call the OEA’s Advice Centre any time to discuss concerns they have with workplace safety and insurance issues. Our staff are experienced workers’ compensation experts, and all information shared is considered strictly confidential.