Case Summary : Decision-Making Process

Implementation of WSIAT decision

A worker representative complained that the claims adjudicator unfairly implemented a WSIAT decision by arbitrarily recalculating his client's short-term earnings along with the long-term earnings that WSIAT directed be recalculated. The effect was a lower benefit than the representative believed was intended by the WSIAT decision. The representative attempted to raise his concerns with the manager, but the claims adjudicator informed him that the manager had approved her action.

It appeared to the Commission that the WSIAT decision could have been interpreted according to the representative's expectation, however, there was no support for the representative’s belief that the WSIB acted arbitrarily. The claims adjudicator followed the WSIB internal consulting protocol on ambiguous WSIAT decisions. She consulted with the payment and operations managers about her interpretation of the WSIAT decision and they concurred. And, the operations manager instructed her to consult with a legal policy analyst before acting on her interpretation. The policy analyst apparently confirmed that the claims adjudicator's interpretation was reasonable.

The manager acknowledged that the claims adjudicator should have documented her consultation with the legal policy analyst. He accepted that without such documentation it could be perceived that the operations area acted arbitrarily. The manager undertook to speak to his team about the importance of documenting the file when consulting with a legal policy analyst about an ambiguous WSIAT decision.

(June 2005)