Case Summary : Decision-Making Process

Access to investigation documents

A worker complained to the Commission when the regulatory compliance officer (RCO) failed to respond to his request for access to his claim file, including all the notes, audio tapes and surveillance gathered by the WSIB investigator. The worker had received a preliminary decision to suspend benefits based on information from the investigator. The worker wanted that information so that he could respond before a final decision was made on his entitlements.

The worker did not receive the investigation record until after the RCO made the final decision four months later, which confirmed the benefit suspension. When the worker received the investigation record, he found many parts were missing. He wrote to the RCO eight times between November and March, asking for specific missing information.

The Commission spoke to the RCO several times and to the manager to review the access process.

To follow up on the systemic issues arising from this case, the commissioner and the specialist met with the directors of prosecutions and compliance to discuss the investigation and the decision-making process after an investigation. The directors agreed to rewrite the letter sent to workers after an investigation is done and a preliminary decision made to suspend benefits. The letter will now state clearly how workers can participate in the process. The WSIB also agreed to provide workers with automatic access to the investigation record.

The director of prosecutions also said he was reviewing the process and procedures in investigations.

(August 2006)