Three-part Series: Appeal Decisions on your WCB Claim

There are two levels of appeal, but mind the time limits! Always carefully read the decisions your case manager makes and that you make an informed decision to appeal your WCB claim before the deadline.

We conclude our three-part series with appealing decisions on your WCB claim. In this blog, we also cover the importance of medical evidence and why you should seek out an employment lawyer for your case. Read on below.

At WorkSafeBC, it’s 90 days on most matters to appeal something your case manager decides. If you request a review, another WorkSafeBC employee, called a Review Officer, will review your claim with fresh eyes.  Most WorkSafeBC Review Officers are lawyers.  Almost all of these appeals are done through written arguments you submit to the Review Officer; very few are decided at a hearing.  That said, Review Officers can and often do reach out to workers or employers themselves to ask questions or get more information.

Instead of going to the Review Division right away with a decision you disagree with, you can ask your case manager to “re-consider” a decision on your claim. I don’t recommend taking this extra step. However, it may be a good idea if you have some evidence they didn’t know about. If you do ask for a re-consideration, remember that if the case manager takes too long to reconsider your claim, you may run out of time to appeal to the Review Division.  And if that happens, you’re likely out of luck and won’t be able to get a new decision!

If you don’t get the decision you want from the Review Division, you can appeal to the Workers Compensation Appeal Tribunal, or “WCAT.”  There is a time limit of 30 days to do so. WCAT will look at your matter and make a decision.  Although most of these matters are dealt with by written argument, having actual hearings with witnesses are more common than at the Review Division.

Evidence

Decision-makers will almost always prefer medical evidence and medical opinions to your own.  Because of this, you may have to get a second medical opinion on your claim.  While these often cost money, the Review Division and WCAT can reimburse you a certain amount, whether you win or lose, if they think that the medical opinion was reasonably necessary for your appeal.

If you think you will need more medical evidence to win your case, it’s an extremely good idea to retain a lawyer to ensure that a medical expert providing evidence for you a) reviews the right information, and b) answers the right questions.  Remember: the quality of the answers a medical professional gives are often only as good as the quality of the questions asked. An expert will do you little good if they’re answering questions that don’t squarely address your issue.

Consider retaining a lawyer

While you don’t need a lawyer to make an appeal in the workers compensation decision, it’s always a good idea to at least talk to a lawyer to see if the stakes are high enough that you could benefit from hiring one. Lawyers are much better equipped to argue your case than you are.  But, if you come to a lawyer too late, there may be very little that a lawyer can do for you.

Labour Rights Law represents workers on workers compensation appeals

I helped advise the Board of Directors at WorkSafeBC, including the rules and regulations that decision-makers at WorkSafeBC are bound to follow, and worked with folks there in many departments. From my time at WorkSafeBC, and my time working with case managers to help get my clients the benefits they’re entitled to, I know how hard WorkSafeBC employees work.  I also know, however, how WorkSafeBC can unintentionally confuse workers, not tell workers about benefits they’re entitled to, and make incorrect decisions on entitlement that, if left unchallenged, can have a devastating impact on the worker and their family.

If you’re an injured worker, get in touch for a consultation so we can review your claim and ensure that you’re getting all that you’re entitled to. We take pride not only in helping ensure our clients get every benefit and dollar you’re entitled to under law and policy but in giving them the confidence and peace of mind that comes with knowing what they can expect at every step of the workers compensation process.