Appeals at the WSIB

 

The first Workplace Safety and Insurance Board (WSIB) decision is made at the WSIB Operating Level. If you disagree with that decision, you can file an appeal to the WSIB Appeals Services Division within the time limit. If you discover that you have missed an appeal time limit, you should obtain help from a qualified representative as soon as possible. For information on appealing when a time limit has passed, see Appeal Time Limit Extensions: WSIB. 

 

Decisions made on or after January 1, 1998 

  • Return to work, labour market re-entry, or work transition decisions:  You have 30 days from the date of the WSIB decision to appeal. 

  • Access to worker’s file: You have 21 days to object to the release of medical information to your employer. See Employers and Claims. 

  • All other decisions: You have six months from the date of the decision to appeal. 

 

Decisions made before January 1, 1998 

Any WSIB decision made before January 1, 1998 had to be appealed by June 30, 1998. 

 

Who can appeal a WSIB decision? 

You can appeal a WSIB decision if you are:

  • an injured worker or an injured worker’s employer

  • the spouse, dependant, or estate of a deceased injured worker 

 

How do I start an appeal at the WSIB? 

Within the time limit, fill out and send an Intent to Object Form to the WSIB. It is helpful to read the Worker Instruction Sheet provided by the WSIB before completing the form. Both the Intent to Object Form and the Worker Instruction Sheet are available from the WSIB’s website or by phoning the WSIB at 1-800-387-0750.

On the Intent to Object Form, you must write the date of the WSIB decision you disagree with and you must list the issues you want to appeal. If you are not sure how to list the issues, you may write that you want to appeal “All issues not decided in my favour. The second page of the Intent to Object Form asks for the reasons for your objection. You are not required to complete the second page.   

Once it is complete, send your Intent to Object Form by fax, courier or registered mail so you have proof that you sent it within the time limit. Keep the receipt or fax confirmation sheet in your records. Even if you are not sure whether you agree with the decision, it is wise to file an Intent to Object Form right away, so you don’t lose your right to appeal. 

When the WSIB receives your Intent to Object Form, they will send you a letter confirming that you have met the time limit to appeal.   The WSIB should also send you an Appeal Readiness Form and a copy of your claim file. For information on how to read your claim file, see Getting Your WSIB File.

 

What should I do when I am ready to go ahead with my appeal? 

If you will be asking someone else to represent you, do not send the Appeal Readiness Form to the WSIB. Give the Appeal Readiness Form to your representative. There is no time limit for submitting the Appeal Readiness Form to the WSIB. 

If you will be representing yourself, you must be sure that you are ready to go ahead with your appeal before you send the Appeal Readiness Form to the WSIB. This means you should have already gathered and sent the WSIB any new information or documents about your case, including any additional evidence you have to support your claim, such as medical documents. If you disagree with your employer accessing your health care documents, that issue must be resolved before you send in your Appeal Readiness Form. It is also a good idea to read the WSIB’s Worker Instruction Sheet about the Appeal Readiness Form.    

If you will be representing yourself, you should include the following information on your Appeal Readiness Form: 

  • the reasons why you feel the decision is wrong

  • a list of the additional WSIB benefits and services you are expecting

  • the type of hearing you are requesting (hearing in writing or oral hearing)  

If you want a hearing in writing, you must send your written submissions with your Appeal Readiness Form. A submission is an explanation of why you think the decision is wrong and how the appeal should be decided. For suggestions on written appeals, see Submissions. 

If you want an oral hearing, you must put the following information on the Appeal Readiness Form: 

  • the reasons why an oral hearing is needed

  • a list of your witnesses and an explanation of what they will say

  • whether you need an interpreter

  • your agreement that you are able to attend a hearing within 90 days   

Keep a copy of the completed Appeal Readiness Form, as well as any other documents you send to the WSIB, for your own records. 

 

What happens after I send in my Appeal Readiness Form? 

The Objection Intake Team will review your Appeal Readiness Form to decide if your appeal is ready to move ahead. This review should be completed in about two weeks. If your appeal is ready, it will be forwarded to the Appeals Services Division to be decided by an Appeals Resolution Officer (ARO).  

If your appeal is not ready because you included new issues or evidence, your file will be returned to the original decision-maker so he or she can consider the new information. Any new medical information that you provide may be sent to a WSIB doctor for review. This process can take some time. If the original decision-maker does not change the decision, your file will then be referred to the Appeals Services Division. 

 

How does the appeal process work? 

Once your appeal is sent to the Appeals Services Division, the WSIB will choose whether you will have a hearing in writing or an oral hearing. 

Hearing in writing: In these cases, you and your employer will provide the WSIB with written explanations of why the decision is wrong and how the appeal should be decided. After reviewing those submissions and the other documents in your WSIB file, the ARO will write a decision. You will be sent a copy of the decision.  You will not have an oral hearing or speak to the ARO.   

Oral hearing:  If you are granted an oral hearing, an Appeals Scheduler will schedule your oral hearing within 90 days. At a hearing, you and your employer will have a chance to explain why the decision is wrong and how the appeal should be decided. The ARO may also hear from witnesses necessary to the appeal. After the hearing, the ARO will issue a written decision. For information on presenting your case at an oral hearing, see Hearing Tips.   

 

How do I appeal a final WSIB decision? 

Final WSIB decisions (ARO decisions) can be appealed to the Workplace Safety and Insurance Appeals Tribunal (WSIAT). See Appeals at the WSIAT for more information. 

February 2013

IMPORTANT INFORMATION

This publication contains general information only. It is not legal advice about a particular situation and is not intended to replace advice from a qualified representative. This publication was last updated on the revision date listed above.