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Issues in Dealing with the Board
Background
Issues about the Board itself usually centre on:
- dealings with the adjudicator
- the Board “losing” documents
- having to “report” to the Board
- the effect of slow decision-making by the Board
- appealing decisions
42. My adjudicator is really rude to me and I can't seem to get anything through to her. She never returns my calls.
- really no practical way to change adjudicators
- can complain to adjudicator's manager
- might be something for Fair Practices Commission to investigate
43. I fax stuff to my adjudicator but she says she does not have it yet.
- dealing with the Board's mail room requires understanding how they work
- all documents other than for pre-1990 claims are scanned in - can take 3 weeks to show up on adjudicator's computer screen
- if you want the adjudicator to get the hard copy quickly, put "hand-deliver before scanning" or "personal and confidential" on fax cover sheet
- be sure to keep the fax transmittal sheet so that you can prove the information was sent (see next question)
- mail in copy as well, so that it does eventually get scanned into file
44. Do I really have to tell the Board that I got _______(better; CPP-D; another job, etc)?
- requirement to report material change in circumstances is now in the Act
- not applicable to pre - 1990 claims
- must report a material change within 10 days
- what to report is “any change that affects entitlement” which is a very broad policy
- there is a provincial offence as well as a possible overpayment recovery; they do charge workers
- obligation is arguably ongoing given that even the final (6 year) review is not entirely final
45. It is now 8 weeks since I got hurt at work but I still haven't got any money from the Board. What am I supposed to live on in the meantime until I get paid?
- "timely" decision making by WSIB is slow at best (eg. can take 12 weeks)
- can apply for other benefits in interval
- assignment of benefits required with OW, ODSP, EI, LTD, STD
- important to document "work-relatedness" when claiming through other benefit schemes - make sure that other carriers are aware that worker is making a WSIB claim
46. I got this decision a long time ago that I didn't like and I want you to fix it.
- as of January 1, 1998, time limits to appeal came into force
- At the WSIB - 30 days for Labour Market Re-Entry & Return To Work disputes, 6 months all other types of issues
- can use "book mark" appeal
- Have 6 months to appeal a final decision of the Board to the Workplace Safety And Insurance Appeals Tribunal
- The Board or Appeals Tribunal can allow extensions of time to file appeals
- WSIB extension requests - see "Appeals System Practices and Procedures" on website
- Workplace Safety And Insurance Appeals Tribunal extension requests - see Practice Direction Time Extension on the Workplace Safety And Insurance Appeals Tribunal website
47. I appealed a decision from my adjudicator and now I got this form that says "60 day decision option". What am I supposed to do with it?
- have a choice of hearing route – gives option whether to have appeal decided based on file review only or oral hearing
- considerations of oral vs. written process:
- Does the worker feel too intimidated to go in-person to present their evidence?
- Does the worker’s side really come across in the documents or does it need to be explained in person?
- Is this purely a legal argument where the facts are not in dispute?
- Written process is faster, but more likely to lead to a “no” answer
- great pressure to give up right to oral hearing but generally not recommended
- the Board has already said "no" based on a review of the file, so don't give them another opportunity to do so again
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