Mike Pretsell and David Little have been practicing Workplace Safety and Insurance Board (WSIB) law for a total of over 25 years. They have represented injured workers at all levels of WSIB appeals. We want to pass on some ideas about how the system works and how you can get the results you need. Remember that we offer a free telephone consultation in our areas of practice, including WSIB.
The WSIB has made a decision I disagree with – What can I do?
Almost every decision the WSIB makes in a claim can be appealed. When working with WSIB claims, to “appeal” means asking the WSIB to reconsider and change their decision. However, you can only appeal a decision that is in writing. If the WSIB has made a decision that you disagree with, but has not put it in writing, you have to request that the decision be put in a letter to you.
When the Board sends you a letter that goes against your interests, you have to appeal within a certain period of time. Generally, the time period is six months; however, some decisions have to be appealed within 30 days. The letter to you will explain which time limit applies.
It is critical that you send a written objection to that decision that you disagree with. Do not rely on a phone call!
To object to a WSIB decision, and to start an appeal, you should write to the person who wrote you the decision and tell them that you object. Here is a sample letter you can use:
Your name and address: . . . . . . . . . . . . .
Your claim number . . . . . . . . . . . . . . . . . .
Date of Letter: . . . . . . . . . . . . . . . . . . . .
Claims Manager
Workplace Safety and Insurance Board
200 Front Street West
Toronto ON M5V 3J1
Dear Sir or Madam:
Please be advised that I object to your letter dated [date of letter]. The decision is not in accordance with the evidence and Board policy.
Please send me an appeal form and a copy of my file as soon as possible. Details of my objection will be provided on the objection form.
Yours very truly,
[Your signature]
Here are some suggestions for your letter:
- If you have additional information you can send to the Board about your claim, you can send it with the letter. Make sure your claim number is on each page you send to the Board;
- You can either mail the letter to the WSIB office, or you can fax it toll-free to 1-888-313-7373;
- About a week after you send your letter, telephone the person that you are sending the letter to and make sure that they have received it. Ask them to confirm that they have sent your file to the “access” department, which is the department that photocopies files and provides appeal forms;
- Two weeks after that, you can telephone the access department and make sure your file has actually been sent to that department. One of the glitches at the WSIB is that your Case Manager must send the file to the Access department before you will actually get a copy of your file and an objection form.
- When you get the file from the WSIB, you should read it thoroughly. However – and this is very important – keep the file in order! People who work with the WSIB will want to see that file in exactly the order that it came in.
- The Board does not charge for a photocopy of the file, or for an appeal;
- If you want to get help with your file, it is a good idea to get assistance before the appeal form is filed. There is no time limit to filing the appeal form once you have it. The appeal form is a very important document because it is the first thing that is read by most Appeals Resolution Officers. Therefore, it pays to put considerable time and effort into preparing the appeal form
