WSIAT: Appealing your WSIB decision

August 15, 2017 at 12:15pm

Workers Comp Claims & Appeals: Appealing your Decision at WSIATInformation adopted from the Ontario Worker Adviser (OWA) website. Used with permission.

The Workplace Safety & Insurance Act Tribunal (WSIAT or the Tribunal) is an independent organization and is separate from the WSIB. The Tribunal is the final level of appeal for workplace insurance matters. A single Vice-Chair or a three-person panel makes decisions at this level. Appeals often include an oral hearing, but may be dealt with through written submissions alone.

The WSIAT is the final level of appeal to which workers and employers may take disputes. Even though it is separate from and independent of the WSIB, it is required to apply WSIB policy when deciding appeals. The Tribunal can only hear an appeal when there is a final decision from WSIB.

Time Limits for Appeals to WSIAT for Decisions Made On or After January 1, 1998

You have 6 months from the date of a final WSIB decision to appeal that decision to WSIAT. But there are certain types of WSIB decisions that you cannot appeal. This includes decisions about employer-requested health exams and some commutations. Following a negative decision from an Appeals Resolution Officer (ARO), your Worker’s Compensation Representative will guide you through the process of appealing.

Who Can Appeal to WSIAT?

You can appeal if you are:

  • an injured worker or an injured worker’s employer
  • the spouse, dependent, or estate of a deceased injured worker

How Do I Appeal a Final WSIB Decision?

Appeals of final WSIB decisions are made to the Tribunal. Final WSIB decisions are usually decisions made by an Appeals Resolution Officer (ARO). Your Workers’ Compensation Representative will send you a Notice of Appeal (NOA) to be signed and completed so that the 6 month time limit is met to appeal to WSIAT.

What Happens Next?

WSIAT will send a Readiness Form acknowledging receipt of the NOA form. By signing the Readiness Form, it confirms that we are prepared to tell WSIAT everything they need to know to schedule your case for a hearing. Once WSIAT receives your Readiness Form, they will prepare the Case Record.

What Is the Case Record?

The Case Record is the written evidence that WSIAT will review when hearing your appeal. The Case Record should contain all the relevant WSIB files. Once the Case Record is prepared, WSIAT will send it to your representative along with a Confirmation of Appeal (COA) form.

Your appeal will remain on a WSIAT Notice of Appeal List until such time as WSIAT receives your completed Confirmation of Appeal (COA) form. A case can remain on the Notice of Appeal List for up to two years from the date WSIAT received first contact. At that time, WSIAT will decide whether to consider the appeal abandoned and close the file.

Then, after WSIAT receives the Case Record, it will review the contents to make sure the Record includes all the necessary documents from your file(s). Send any missing or additional information to WSIAT along with the COA form. Also, submit any new evidence to the Case Record at least 3 weeks before the scheduled hearing date.

Completing the Confirmation of Appeal

The Confirmation of Appeal (COA) form needs to advise WSIAT of the following:

  • Whether you want your hearing held in English or French.
  • If you need an interpreter at your hearing and the language of preference.
  • Whether you would rather have a hearing in writing. The Tribunal will accept a written hearing if the matter is fairly simple and straightforward and if you do not have to prove you are telling the truth. If, for example, your employer insists the accident did not happen the way you said, then you need to attend an oral hearing so that WSIAT can decide who to believe.
  • Whether you want to try alternative dispute resolution (ADR). Under this option, also known as mediation, Tribunal staff will attempt to resolve your appeal without the need for a full hearing. If you and your employer cannot come to an agreement at mediation, you will then proceed with a written or oral hearing.
  • If you have any other WSIB claims.
  • Whether you have any new evidence and, if so, include a copy of it.
  • Witnesses (other than you) that will testify on your behalf at your hearing and what each witness will say.
  • Whether you need a summons for any witness. A summons is an order from WSIAT demanding that a person appear and testify at your hearing. You only need a summons if the witness does not agree to come to the hearing and if the evidence the witness can give is necessary for the appeal.

Note: You must send the completed COA form and any additional evidence to both WSIAT and any other party. In most cases, the other party would be the employer or Employer Representative. If the accident employer is participating in the hearing, they need to complete a Response Form and identify any new evidence and/or witnesses.

What Is the Early Review Department?

The Early Review Department reviews all WSIAT appeals. It ensures your case is ready for hearing and decides whether WSIAT should:

  • hold an oral hearing,
  • try mediation, or
  • proceed with written submissions.

If the Early Review Department determines your case is not ready to proceed, they will contact your Workers’ Comp Rep. This is usually done by letter, advising how to prepare for the hearing. If the case is ready, we will receive a letter with the date, time and location of the oral hearing.