Document name
Reversing Decisions
Document number
PRO 23/2014

Effective date: January 1, 2015

Application: Claim and employer account decisions

Policy subject: Reconsiderations and appeals

Purpose:

To provide administrative guidelines for reversing decisions.

DEFINITION

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Customer means an injured worker, surviving dependent spouse, or employer.

BACKGROUND

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POL 23/2014, Reserving Decisions establishes the process for reversing decisions.

PROCEDURE

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General

  1. WCB staff will reverse decisions only after careful consideration.

Reviewing and Reversing Decisions

  1. If Case Management or Claims Entitlement staff decide to reverse or significantly alter a decision, they must get approval from one of the following:
    1. Team Leader.
    2. Assistant Director of Operations, or
    3. Executive Director of Operations.
  2. If Employer Services staff decide to reverse or significantly alter a decision, they must get approval from one of the following:
    1. Manager, or
    2. Director of Employer Services.

Communicating Decisions

  1. If the WCB reverses a decision, the WCB staff member that made the reversal will:
    1. Discuss the reversal with the customer in person or by phone, and
    2. Send a letter to the customer that outlines the reasoning for the reversal.

Appeals – Reversed Decisions

  1. Customers can appeal reversed claim decisions. The following policies will apply:
    1. POL 21/2013, Appeals – Claims.
    2. POL 20/2013, Appeals – Employer Accounts
    3. POL 22/2013, Board Appeal Tribunal.

Policy references

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Section heading

Act Sec #

Section detail

18, 20(5), 100(1)

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Supersedes              

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PRO 51/2006 Reversing Decisions

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Complements

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