Appeals – Employer Accounts
Effective date: January 1, 2014
Approved date: December 18, 2013
Application: Applies to employers requesting reviews of decisions made by Employer Services staff.
Policy subject: Reconsiderations and appeals
To outline the appeals process for employer account decisions.
- Section 18 of The Workers’ Compensation Act, 2013 (the “Act”) allows the Board Members to delegate any of their powers or functions to WCB employees. Persons affected by delegate decisions can make appeals. This section also directs that the WCB must create policy to guide the appeals process.
- Section 20(5) of the Act states that the WCB can reconsider any matter that it has dealt with and any decision that it has made.
- Section 23 of the Act requires staff to base every decision on the merits and justice of each case. However, WCB recognizes that from time to time, employers may desire an independent review of a decision on their account.
- Section 171 of the Act clarifies that oral hearings are not a right under the Act.
- The intent of the appeals process is to provide employers with an easily accessible and independent process of review for decisions regarding their employer account.
- Employer appeals on worker claims issues are dealt with under POL 21/2013, Appeals – Claims.
- Employers (or their approved representatives) may appeal any decision made by WCB, related to their employer account. These decisions may include, but are not limited to employer registration, classification, assessment or experience rating.
- WCB has a three-level process for employers who wish to appeal a decision on their account:
- Review and/or explanation of the decision by the original staff member responsible for the decision.
- A review of the original decision by the Employer Services Assessment Committee. The Committee is bound by WCB policy and has authority to confirm, change or reverse any decision originally made by an Employer Services representative, and
- Final review by the Board Appeal Tribunal comprised of two or more members of the Board. The Board Appeal Tribunal is bound only by the Act and has full discretionary authority in all matters (POL 22/2013).
- All requests for appeals (by employers and their representatives) must be in writing to the chair of the Assessment Committee. The request should outline the specific issue(s) under dispute, why the appellant thinks the decision is incorrect, and their expected resolution to the appeal.
- Where the employer is appealing or contemplating an appeal regarding their assessment, classification or experience rating decision, access to the employer file or relevant claim cost information will follow the process outlined under PRO 06/2017, Authority for Disclosure.
- All appeals at the Assessment Committee level will be acknowledged in writing to all interested parties (employers and their representatives).
- At each level of appeal, the decision is made by the staff member(s) who review the documents and/or hear the evidence.
- Where the employer provides new information that was not available when the decision being appealed was made, this information must first be considered by the staff member responsible for that decision before progressing to the next level of appeal.
- Following each level of review, the decision will be communicated in writing to all interested parties, outlining:
- The issue(s) under dispute.
- The decision made, and
- The rationale for the decision, including the applicable authority as set out in the Act or WCB policy.
Standard of Proof
- At all levels of appeal, all information relevant to the issue(s) under dispute is considered and given weight appropriate to its relevance and level of verification. Decisions are based in accordance with the conclusion that is more likely, considering the merits and justice of the appeal. Where the evidence on both sides of an issue is approximately equal, the issue is settled in favor of the employer. POL 02/2019, Decision Making, will apply.
Burden of Proof
- There is no burden of proof on the employer submitting the appeal. However, the employer is expected to provide a reason for disagreeing with the original decision, and to cooperate in providing the information required by the Assessment Committee. The onus is on the WCB to ensure that there is sufficient information to make the appeal decision.
The Workers’ Compensation Act, 2013
Sections 14, 15, 18, 20, 21, 22, 23, 29, 73, 80, 100, 169, 171, 173, 174
(1) February 1, 2020. Procedure updated to note that the Manager of Financial Services replaced the Director of Strategic Planning and Performance Measurement on the Assessment Committee.
(2) January 1, 2014. References updated in accordance with The Workers’ Compensation Act, 2013.
(3) POL and PRO 32/2010, Appeals – Employer Accounts (effective December 1, 2010 to December 31, 2013).
(4) PRO 14/1977, Assessment Committee (effective March 15, 1977 to November 30, 2010).
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