Case Summary : Decision-Making Process
Implementation of WSIAT decision
A worker representative complained to the Commission that the WSIB
unfairly implemented a decision from the Workplace Safety &
Insurance Appeals Tribunal (WSIAT) and denied the worker ongoing
benefits which the WSIAT decision stated he was entitled to receive.
Further, the representative perceived that the Claims Adjudicator
and Manager were unwilling to reconsider the implementation decision.
The FPC contacted the Manager to discuss the implementation process.
The Manager disclosed that the Claims Adjudicator (CA) had found
the WSIAT decision to be ambiguous and open to interpretation. The
Manager undertook to consult with a WSIB legal policy analyst about
the CA’s interpretation. When the Manager contacted the Commission
to report the outcome of the consultation, he advised that the policy
analyst recommended that, since the apparent intention of the WSIAT
decision was for benefits to continue following the decision, it
should be implemented on that basis. The Claims Adjudicator reconsidered
the decision to terminate benefits and the worker was allowed his
ongoing benefits to age 65.
The Manager acknowledged that the WSIB should have sought clarification
of the ambiguous WSIAT decision, before implementing it as the CA
had interpreted. He reported that he planned to raise this case
in his next team meeting in order to remind staff about the protocol
to follow when implementing an ambiguous WSIAT decision. In addition,
the manager reported he had referred the WSIAT implementation problems
to a member of the WSIAT Decision Implementation Team, which provides
feedback to WSIAT about problems with decision implementation.
The Commission and complainant were satisfied with the outcome
of the inquiry; no further investigation was conducted.