Appealing a decision on your worker's injury claim

A: A worker can ask for a review of a decision made on their injury claim or an employer can ask for a review of a decision made on their worker’s claim at any time. There is no time limit in Saskatchewan.  The intent of the appeals process is to provide workers and employers with an easily accessible and independent review process of any decision made by the WCB regarding a worker’s claim for entitlement to WCB benefits and compensation. Any decision made on the claim file that a worker or employer disagrees with can be further reviewed through the appeal process. We encourage you to consider reaching out to the initial WCB decision maker to discuss and better understand the decision you disagree with before you appeal.

A: The first step is to discuss the decision with the original WCB decision maker to better understand the reasons for the decision you disagree with and to ask the original decision maker to review their decision before you appeal.

There are two types of employer appeals: appealing a decision on your worker’s injury claim and appealing a decision on your employer account.

If a discussion with the initial decision maker on your worker’s claim does not change the decision you disagree with and you still wish to appeal, you can ask the appeals department to independently review the disputed claim decision. Your appeal request must be in writing and addressed to the WCB appeals department. You can submit the appeal request by:

• email
• completing a web-based form
• fax
• regular mail
• delivering the appeal submission in writing in person to the WCB

If a discussion with the initial decision maker on your employer account does not change the decision (for example, a decision on employer registration, industry classification, payroll reporting, premium assessment and experience rating) you disagree with, and you still wish to appeal, you can ask employer services to independently review the disputed decision.

A: Include your name as the employer, your worker’s name, claim number, the date of the decision in dispute, the name of the original decision-maker, reasons why you disagree with the decision, and how you would like the matter resolved. Provide any additional information that you might have that is relevant to the decision you are appealing or why you disagree.

A: In Saskatchewan, there is no time limit on when you can submit an appeal on a claim decision. If you are considering an appeal of a WCB claim file decision, we encourage you to submit your appeal as soon as you are able and as close in time to the original decision you are disputing. With the passage of time the appeal review becomes more difficult and memories of the event and facts fade.

A:  Once you have submitted an appeal, here are the steps in the appeals department process.

A:  Appeals by the appeals department are conducted on a first-come, first-served basis to be fair to everyone submitting an appeal. When your appeal is registered, you will receive confirmation in writing of the registration and an estimate of the time required to complete your appeal review. You will generally not be contacted once it is assigned to an appeals officer unless the appeals officer needs further information or clarification. Once the appeal is completed, the decision will be sent to you in writing, along with the reasons for the decision, including the applicable WCB policy and legislation used in the appeal decision.

A: The total time to complete an appeal review is very much dependent upon the volume of incoming appeals at the time when you submitted your appeal and the complexity of the claim file. Appeals are conducted on a first-come, first-served basis to be fair to everyone submitting an appeal. The current estimated wait time at the time of registration will be provided in the confirmation letter sent to you once your appeal is registered.

A: The appeals officer reviewing your appeal request has access to all documentation and records on your claim file. The appeals officer will also consider all additional information that you may have provided in your appeal submission.

A: The Workers’ Compensation Act, 2013 (the Act) stipulates that the WCB may reconsider any matter it has dealt with and may rescind, alter or amend any prior decision it has made. The Act requires staff to base every decision on the real merits and justice of each particular case.

The WCB also recognizes that from time to time, workers and employers may desire an independent review made on an injury claim. Appeals officers are bound by WCB policy and have authority to confirm, change, or reverse any prior claim decision.

At all levels of appeal, all information relevant to the issue or decision under dispute is considered and given weight appropriate to its relevance and the ability to verify its accuracy. Facts and issues are determined on the basis of whether they are more likely than not. For example, if an appeals officer is given a particular statement of fact, they must look at all the evidence and determine on that evidence whether that fact is more likely than not to be true. Every appeal considers the merits and justice of each particular circumstance. Where evidence on both sides of an issue is approximately equal, the issue is settled in favour of the worker as directed by the Act.  

A: If your appeal is successful, the original decision you disagreed with is rescinded or reversed and appropriate WCB benefits or compensation that ought to have been provided are then given to you.

A: If you disagree with a decision of the appeals department, you have the right to further appeal to the Board Appeal Tribunal as the final level of appeal. The process around this last level of appeal is much the same as the appeals department process.

A: The Act provides for the setting aside of a special reserve fund to meet losses arising from any circumstance which would unfairly burden employers. The key purpose of the reserve is to provide employers cost relief on compensation claims that involve a work injury along with a worker’s pre-existing condition.

If the period of disability from a work injury is prolonged or extended due to the worker’s pre-existing condition, cost relief could be available to the employer. Cost relief is available if a pre-existing condition has extended the worker’s recovery time. The WCB does not cover the pre-existing condition, but covers only the work injury.

If a claim is eligible for cost relief, the employer will be provided the cost relief and costs are charged to the reserve. This process does not impact the worker’s benefits or compensation. Usually, the WCB will charge claim costs to the reserve if the recovery time from a work injury is prolonged because a worker’s non-work-related pre-existing condition is worsened by the work injury.

Learn more about cost relief.

A: The Board Appeal Tribunal is comprised of two or more members of the board. This is the last and final level of appeal at the WCB. The Board Appeal Tribunal is bound by the Act and has full discretionary authority in all matters delegated to it under the Act. Much like the appeals department, in reviewing a WCB decision, the Board Appeal Tribunal may rescind, alter, or amend a prior decision made on a claim file based on the real merits and justice of each particular case.

A: The FPO receives inquiries and questions about WCB practices in all areas of service delivery. However, it cannot review issues that are under appeal. Please visit the Fair Practices Office page for more information.