Difference between revisions of "Appealing a Workers' Compensation Decision"

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{{REVIEWEDPLS | reviewer = [https://www.ascentemploymentlaw.ca/about-us Richard Johnson], Ascent Employment Law and [https://www.mooreedgarlyster.com/lawyers/sara-hanson Sara Hanson], Moore Edgar Lyster LLP|date= August 2021}} {{Dial-A-Law TOC|expanded = work}}
If you disagree with a decision on a workers’ compensation claim, you can request a review of the decision. If you’re still not satisfied, you can '''appeal to a tribunal'''.


{{Dial-A-Law TOC|expanded = employment}}
==Common questions==
If you think that the Workers’ Compensation Board, now called WorkSafeBC, made the wrong decision in your case, or if you don’t understand the decision, ask the WorkSafeBC officer handling your claim to explain it. Ask for a decision letter, if you didn’t already get one. If you are still not satisfied with the decision, you may request a review, and if you are not satisfied with the decision on the review, you may file an appeal.
===If my claim for workers’ compensation is denied, can I appeal?===
Yes. You can ask WorkSafeBC (the agency that operates BC’s workers’ compensation program) to review a decision on a workers’ compensation claim. If you’re unhappy with the outcome of the review, you can appeal to a tribunal.


==Reviews==
The [https://www.wcat.bc.ca/ Workers’ Compensation Appeal Tribunal] hears appeals of workers’ compensation decisions. We explain the process in our guidance [https://www.peopleslawschool.ca/appealing-a-workers-compensation-decision/ on appealing a workers’ compensation decision].
Before you can ask for an appeal, you first have to ask [http://worksafebc.com/claims/review_and_appeals/review_division/default.asp WorkSafeBC’s Review Division] to review the decision.


'''Time limit to ask for review'''—you have to ask for a review within 90 days of the date of WorkSafeBC’s decision letter or, in some cases, within '''90 days''' of the date that WorkSafeBC told you its decision orally or stopped paying you. An employer who wants to ask for a review of a decision or an order issued by WorkSafeBC on an occupational health and safety matter, has only '''45 days''' to ask for a review.
===Can any workers’ compensation decision be appealed?===
No. Only certain types of decisions can be appealed to the Workers’ Compensation Appeal Tribunal. Among those that can be appealed are decisions on:


Because WorkSafeBC routinely issues some decisions orally, the Review Division accepts review requests from oral decisions. After you request a review, you will receive a letter setting a time to make written submissions. The Review Division does not normally hold oral hearings.
* whether a certain type of injury or illness is covered by workers’ compensation
* whether a workers’ injury or illness arose out of and during the course of employment
* whether someone was a worker when they were injured


The Review Division considers the written submissions and WorkSafeBC’s file and gives its decision, usually within 150 days. The [http://worksafebc.com/claims/review_and_appeals/default.asp WorkSafeBC website] has more information on [http://worksafebc.com/claims/review_and_appeals/workers_and_dependants/default.asp reviews and appeals]. The phone numbers for the Review Division are 604.214.5411 in the lower mainland and 1.888.922.8804 elsewhere in BC. At the same time, if you feel that WorkSafeBC has treated you unfairly, you can also complain to its Fair Practices Office and the [https://www.bcombudsperson.ca/ Ombudsperson of BC]  (1.800.567.3247).
Some WorkSafeBC decisions that can’t be appealed include:


==Appeals==
a decision regarding vocational rehabilitation benefits
If you disagree with the decision of the Review Division, you can usually appeal to the [http://www.wcat.bc.ca/ Workers’ Compensation Appeal Tribunal]. But you cannot appeal decisions of the Review Division on specific issues, such as vocational rehabilitation, commutations, prevention orders (other than penalties), and certain types of disability awards.
a decision about whether or not to refer a decision back to WorkSafeBC
a decision not to give you more time to bring your review


'''Time limit to appeal'''—if you want to appeal, you have to do so within '''30 days''' of the date of the decision by the Review Division. Contact the Tribunal in writing (see address below) or phone 604.664.7800 in the lower mainland and 1.800.663.2782 (toll free) elsewhere in BC.
We explain this in greater detail in our guidance on [https://www.peopleslawschool.ca/appealing-a-workers-compensation-decision/ appealing a workers’ compensation decision].


You can appeal by phone or letter, or you can use the Notice of Appeal form on the Tribunal’s website. If you appeal by phone, you have to follow it up with the form within 21 days. If you use a letter or the form, fax them to 604.664.7898 or mail them to:
===How can I get a copy of my claims file?===
On the [https://www.worksafebc.com/en/claims/manage-claim/view-submit-claim-information WorkSafeBC website], you can view all the information associated with your claim. You can also request a copy of your claim, and WorkSafeBC will send the information to you.


:'''WCAT'''
To request a copy, complete and send a [https://www.worksafebc.com/en/resources/claims/forms/request-for-disclosure-form-25m13?lang=en '''request for disclosure''' form] to this address:
:150 – 4600 Jacombs Road
:Richmond, BC V6V 3B1
 
==What the Tribunal does==
The Tribunal will send you a letter to confirm that it got your appeal and give you an appeal number. You should always include this appeal number, and your WorkSafeBC file number, in any material you submit. The Tribunal will ask you to make your submissions in writing or tell you the date for your oral hearing. Normally, the Tribunal decides a case within 180 days of when it receives your claim file from WorkSafe BC.
 
The Tribunal must apply the law and the policies of the WorkSafeBC Board of Directors that apply to your appeal. You should find out what policies apply to your case. You can see previous Tribunal decisions on its website.
 
==Preparing for reviews and appeals==
Before you start, see the [http://www.wcat.bc.ca/research/wcat_publications/appeal_guides/index.html information guides] on the [http://www.wcat.bc.ca/ Tribunal’s website] for detailed information. Decide whether you want to handle your own appeal or have someone help you. If you are a union member, discuss your case with the union. They may have a representative who can help you, or they may hire a lawyer for you in a serious case. You may want to hire your own lawyer anyway. Make sure the lawyer has experience in workers’ compensation.
 
If you don’t get help from a union or lawyer, you should contact the [http://www.labour.gov.bc.ca/wab Workers’ Advisers Office] of the BC Ministry of Jobs, Tourism and Skills Training. Workers’ Advisers are separate from WorkSafeBC and there’s no charge for their service. They can help workers apply for reviews and appeals, and they have detailed information on their [http://www.labour.gov.bc.ca/wab website]. Their phone numbers are 604.713.0360 in Vancouver and 1.800.663.4261 elsewhere in BC.
 
If you are an employer, you should contact the [http://www.labour.gov.bc.ca/eao Employers’ Advisers]. They provide independent advice, assistance, representation and training to employers, potential employers and employer associations concerning workers' compensation issues. There is no charge for their service. They have detailed information on their [http://www.labour.gov.bc.ca/eao website]. 
 
==What you need to show==
Reviews and appeals are serious. You need to show clearly what’s wrong with the decision. You may need new evidence to support your appeal. You may need more evidence than you had when you first made your claim, such as medical evidence from doctors and specialists. It’s important to get all the evidence you need, as soon as you can.
 
It is not the role of the Review Division or the Tribunal to tell you what evidence you need.
 
==Check the Information Guides and your WorkSafeBC file==
To prepare your case, in addition to looking at the Tribunal’s Information Guides, you should also look at your WorkSafeBC file. You have the right to see it and you should automatically get it when you ask for a review. You will automatically get updated disclosure when you appeal a Review Division decision.
 
Even if you don’t have an active review or appeal, you can request disclosure of your claim file by sending a written request, using a form on the [http://www.worksafebc.com/ WorkSafeBC website], to:


:Disclosure Department
:Disclosure Department
:WorkSafeBC
:WorkSafeBC
:PO Box 4700 Stn Terminal
:PO Box 4700 Stn Terminal
:Vancouver BC V6B 1J1  
:Vancouver, BC V6B 1J1
:Fax: 604.233.9777 or toll free 1.888.922.8807


All your personal information is usually in your claim file, but sometimes other WorkSafeBC records also have personal information. To see these records, under the ''[http://www.bclaws.ca/civix/content/complete/statreg/1198514681/96165/292428220/?xsl=/templates/browse.xsl Freedom of Information and Protection of Privacy Act]'', send a written request to:
All your information is usually in your claim file, but sometimes other WorkSafeBC records have personal information too. To see these records, send a written request to:


:'''Freedom of Information and Protection of Privacy Office'''
:Freedom of Information and Protection of Privacy Office
:WorkSafeBC
:WorkSafeBC
:PO Box 2310 Stn Terminal
:PO Box 2310 Stn Terminal
:Vancouver, BC V6B 3W5
:Vancouver, BC V6B 3W5
:Phone: 1.866.266.9405
:Fax: 604.279.7401
You can also see most of your claim file information online on the WorkSafeBC website. You will need your claim number and your personal access number.
For more on this, check script [[Freedom of Information and Protection of Privacy (Script 235)|235]], called “Freedom of Information and Protection of Privacy”. As well, check the ''[http://www.bclaws.ca/civix/content/complete/statreg/1198514681/96165/292428220/?xsl=/templates/browse.xsl Freedom of Information and Protection of Privacy Act]''.
==For more information==
*Check script [[Workers' Compensation (Script 285)|285]], called “Workers' Compensation”, and the Tribunal's website, including its Information Guides.
*Check the [http://www.labour.gov.bc.ca/wab Workers’ Advisers website] or the [http://www.labour.gov.bc.ca/eao Employers' Advisers website].
[updated November 2015]


----
==Who can help==
----
===With more information===
:'''WorkSafeBC'''
:Deals with complaints about unsafe working conditions and injuries on the job.
:Call 1-888-967-5377
:[https://www.worksafebc.com/ Visit website]


:'''Workers’ Advisers Office'''
:A government office that helps workers with claims for workers’ compensation benefits. They are separate from WorkSafeBC and there’s no charge for their services.
:Call 1-800-663-4261
:[https://www2.gov.bc.ca/gov/content/employment-business/employment-standards-advice/personal-injury-and-workplace-safety Visit website]


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Latest revision as of 00:24, 8 November 2023

This information applies to British Columbia, Canada. Last reviewed for legal accuracy by Richard Johnson, Ascent Employment Law and Sara Hanson, Moore Edgar Lyster LLP in August 2021.
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If you disagree with a decision on a workers’ compensation claim, you can request a review of the decision. If you’re still not satisfied, you can appeal to a tribunal.

Common questions

If my claim for workers’ compensation is denied, can I appeal?

Yes. You can ask WorkSafeBC (the agency that operates BC’s workers’ compensation program) to review a decision on a workers’ compensation claim. If you’re unhappy with the outcome of the review, you can appeal to a tribunal.

The Workers’ Compensation Appeal Tribunal hears appeals of workers’ compensation decisions. We explain the process in our guidance on appealing a workers’ compensation decision.

Can any workers’ compensation decision be appealed?

No. Only certain types of decisions can be appealed to the Workers’ Compensation Appeal Tribunal. Among those that can be appealed are decisions on:

  • whether a certain type of injury or illness is covered by workers’ compensation
  • whether a workers’ injury or illness arose out of and during the course of employment
  • whether someone was a worker when they were injured

Some WorkSafeBC decisions that can’t be appealed include:

a decision regarding vocational rehabilitation benefits a decision about whether or not to refer a decision back to WorkSafeBC a decision not to give you more time to bring your review

We explain this in greater detail in our guidance on appealing a workers’ compensation decision.

How can I get a copy of my claims file?

On the WorkSafeBC website, you can view all the information associated with your claim. You can also request a copy of your claim, and WorkSafeBC will send the information to you.

To request a copy, complete and send a request for disclosure form to this address:

Disclosure Department
WorkSafeBC
PO Box 4700 Stn Terminal
Vancouver, BC V6B 1J1

All your information is usually in your claim file, but sometimes other WorkSafeBC records have personal information too. To see these records, send a written request to:

Freedom of Information and Protection of Privacy Office
WorkSafeBC
PO Box 2310 Stn Terminal
Vancouver, BC V6B 3W5

Who can help

With more information

WorkSafeBC
Deals with complaints about unsafe working conditions and injuries on the job.
Call 1-888-967-5377
Visit website
Workers’ Advisers Office
A government office that helps workers with claims for workers’ compensation benefits. They are separate from WorkSafeBC and there’s no charge for their services.
Call 1-800-663-4261
Visit website
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