Workers Compensation Board decisions — denied claims, stopped wage loss benefits, disputed medical coverage — can be appealed, first to the WCB Review Office and then to the independent Appeal Commission. Neil Kaplan represents injured workers and employers in WCB appeals across Manitoba.
If the Workers Compensation Board of Manitoba has made a decision about your claim that you disagree with — a denied claim, wage loss benefits refused or ended, a medical or assessment decision — the WCB’s own published process provides two levels of appeal: reconsideration by the WCB’s Review Office, and then an appeal to the Appeal Commission, an independent body that functions separately from the WCB. Neil Kaplan represents workers and employers through both levels.
As the WCB describes it, the first step is to ask the Review Office to reconsider the decision. The Review Office uses file reviews to decide appeals, working from the claim file, and it operates under the WCB’s Policy 20.10, Reconsiderations; the WCB states that the Review Office strives to complete the majority of its decisions within 60 days of the reconsideration being listed. If you receive new information that the Review Office has not previously considered, you can submit a new request for reconsideration along with that information.
If you are still not satisfied after the Review Office decision, the Appeal Commission is the final avenue of appeal. The Commission describes itself as the highest and final level of appeal for compensation and assessment decisions; although it is bound by The Workers Compensation Act, it functions separately and independently from the WCB. Two features of its published process matter:
The Appeal Commission’s published list of who may appeal includes: a worker; a deceased worker’s dependent; a deceased worker’s estate; an employer challenging a compensation decision; an employer challenging an assessment decision; and a third party with a direct interest in the matter. On timing, the Commission states that — except for appeals of administrative penalties, which must be filed within 30 days of being served with the WCB’s decision — there are no time limits to file an appeal. It adds practical advice worth following: if you intend to obtain further information, medical or otherwise, obtain it before appealing, because the appeal is decided on the record assembled.
The Worker Advisor Office is a free provincial service that assists workers with appeals. Workers and employers may also retain a lawyer. Neil’s role in a WCB appeal is to review the decision and the claim file behind it, identify what the Review Office or the Commission needs to see — the policy issue, the medical evidence, the earnings records — and present the appeal at whichever level decides it. The same file discipline runs through his MPI appeal practice before AICAC.
First, reconsideration by the WCB’s Review Office, which decides appeals by file review under the WCB’s Policy 20.10. Second, an appeal to the Appeal Commission — an independent body, separate from the WCB — which is the final level of appeal. The Commission can only decide issues the Review Office has already decided.
The Appeal Commission states that, except for appeals of administrative penalties — which must be filed within 30 days of being served with the WCB’s decision — there are no time limits to file an appeal. It advises obtaining any further information, medical or otherwise, before appealing.
The Commission’s list includes a worker, a deceased worker’s dependent or estate, an employer challenging a compensation or assessment decision, and a third party with a direct interest in the matter.
Either by file review or by an oral hearing; the Chief Appeal Commissioner or the appeal panel decides which. Hearings are not open to the public, interpreter services are free, and the Commission decides only the issues that were previously decided by the WCB’s Review Office.
Yes, at the first level: the WCB states that if you have new information that has not previously been considered by the Review Office, you can submit a new request for reconsideration along with the new information.
Yes. The Worker Advisor Office is a free service available to assist workers with appeals. Workers and employers may also hire a lawyer to prepare and present the appeal.
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