Document name
Appeals – Employer Accounts
Document number
PRO 20/2013

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

Purpose:

To outline the appeals process for employer account decisions.

BACKGROUND

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  1. POL 20/2013, Appeals – Employer Accounts has been approved by the Workers’ Compensation Board (WCB), which provides employers or their representatives with the guidelines for reconsideration or review of any decision made regarding their employer account.
  2. The following guidelines ensure that staff apply WCB policy and the appropriate provisions of The Workers’ Compensation Act, 2013 (the “Act”) when reviewing a decision.

PROCEDURE

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Employer Services Staff Member Review

  1. The first step employers (or their representatives) should take is to discuss their concerns with the Employer Services staff member responsible for the initial decision. The staff member will consider any new information provided by the employer, and gather any additional information necessary, to ensure there is sufficient information available to make a well-informed decision.
  2. The Employer Services staff member will provide a written response with full reasons for the decision.
  3. Where the original decision is upheld, the employer will be advised of the subsequent appeal process and will be provided with the Employer Appeals Fact Sheet.

Assessment Committee

  1. The Assessment Committee consists of:
    1. Chairperson – Director, Employer Services
    2. Member – Manager, Employer Services (Employer Service Representatives).
    3. Member – Manager, Employer Services (Account Registration and Data Processing)
    4. Member – Manager, Employer Premiums, and
    5. Member – Manager, Financial Services.

Of which any two are required for a quorum to consider an appeal. A decision of the majority of the members is the decision of the Assessment Committee.

  1. The Assessment Committee will determine whether the decision has been reviewed by the original decision maker. Where this has not been done, the appeal will be returned for review at this level prior to being heard by the Assessment Committee. The Assessment Committee will monitor the development and where the decision is not changed by Employer Services staff, review by the Assessment Committee will proceed in a timely fashion.
  2. The Assessment Committee will acknowledge the appeal in writing and provide an approximate time frame to review the decision.
  3. The employer may request a meeting or telephone conference with the Assessment Committee. The purpose of such a meeting is to allow them the opportunity to provide additional information or clarify certain issues related to the appeal.
  4. The Assessment Committee will provide a written appeal decision to the employer. The appeal decision will explain the issue(s) under consideration, the final decision and the detailed reasons for the decision, including the applicable authority as set out in the Act and/or WCB policy.
  5. Where the employer disagrees with the decision of the Assessment Committee, they may request a further review by the Board Appeal Tribunal as outlined in policy POL 22/2013, Appeals – Board Appeal Tribunal.

Policy references

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Legislative Authority

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The Workers’ Compensation Act, 2013

Sections 14, 15, 18, 20, 21, 22, 23, 29, 73, 80, 100, 169, 171, 173, 174

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Document History

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(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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Complements

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