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View from the Board: How to appeal a claims decision

Dave Baspaly
View from the Board: How to appeal a claims decision

Since 98 per cent of appeals are started by workers, you will more likely be in the position of being asked if you wish to respond to a worker’s appeal.

You will receive a notice from the appeal body – usually the Internal Review Department – advising you of the worker’s appeal.

Workers Compensation Board (WCB) legislation allows the WorkSafeBC adjudicator to change a decision, whether at the request of a worker or employer, or based on the adjudicator’s determination.

But, it is important to remember that the WCB legislation only allows this change of decision for up to 75 days.  After this time, the worker or employer must appeal to the Review Division (see below) to request a change in decision.

Remember that the clock is running from the date of any decision that you may want changed – and the maximum time to go back to the WorkSafeBC  adjudicator is 75 days. You may also choose to appeal directly to the Review Division.

A Review Division appeal can be done in two ways:

Read and Review – written submissions only  or an oral hearing,  in which the worker and the employer, with representatives if they chose, attend a hearing and present their respective cases.

If the worker appeals, the appeal form from the Review Division will tell you what issue is being appealed.

If you don’t agree with the worker’s position, you should take part in the appeal.

You may do this through a written submission, both for the read and review and for the oral hearing.

You need not attend the oral hearing, but it is recommended that you do.

Often, there will be statements made by the worker or the worker’s representative that will go unchallenged unless the employer or the employer’s representative is present.

The decision of the Review Division will have a financial impact on your business so you should try to take the time to attend. The employers’ adviser is available to help with these appeals at no charge.  You may also hire a private consultant to assist you.

You have 90 days following the date of the decision letter to appeal to the Review Division.

The Workers’ Compensation Appeal Tribunal is the final level of appeal after the Review Division.

The process with the Appeal Tribunal is similar to the Review Division, except that you have only 30 days from the date of the decision letter to appeal to the Appeal Tribunal.

The appeal is usually handled by written submissions.

An oral hearing may be granted if the Appeal Tribunal thinks that the hearing is necessary to determine the facts of the claim.

To get help from the employers’ advisers office, call 604-713-0303 or toll-free at 1-800-925-2233.

This column is part of a series on WorkSafeBC claims. Dave Baspaly is the president of the Council of Construction Associations (COCA) and a member of the JOC Editorial Advisory Board. Grant McMillan was the strategic advisor for this column. Send comments or questions to editor@journalofcommerce.com.

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