My WSIB claim was denied
My claim was denied, what can I do?
There are only 4 reasons the WSIB can use to justify denying your claim. 1-there was a discrepancy in the reporting of your injury, 2- in the case of an occupational disease the medical doesn't support the diagnosis, the decision maker did not properly consider all of the evidence. The decision was arbitrary and had no legal basis to support it. Believe me, this happens more often than it should and there are many reasons for that.
What do you do to address it? That part is simple. Use your Loss of Earnings benefits Settlement Kit.
Why is this Kit so effective?
- The Kit specifically states the WSIB policy and legislation governing LOE benefits.
- It compels the decision maker to specify any and evidence considered in the review of the entitlement decision, thereby eliminating the possibility of an arbitrary decision and,
- It compels the decision-maker to outline any information that could be obtained to reverse the decision.
The Kit is prepared in such a manner as to ensure accountability on the part of the decision maker and ownership of his/her decision. It also sets the stage for a reconsideration request which will elevate the matter to the decision maker's manager.
Our Reconsideration of Decision Request Kit would be used to pursue that avenue in the event that the decision maker maintains their position. I our experience, decision makers are much more thorough in their decision making process when there is the prospect of having their decision scrutinized by their manager.