Review of Decisions by the Decision Review Office Policy 46-500 | Effective Date: November 24, 2022

Policy

WorkSafeNB is committed to an internal review process that ensures decisions are in compliance with legislation, policies, and considers the merits of each case. To that end, WorkSafeNB has established a Decision Review Office (DRO). While the DRO is a department within WorkSafeNB, those who review decisions do not work directly with operational staff. This ensures decisions are reviewed independently and without bias.

Legislation requires that a request for a decision review must be made within 90 days of the date of the decision, order, or ruling. Unless it is a review of an administrative penalty imposed under subsection 82.1 of the Workers’ Compensation Act, which must be made within 14 days after the notice of administrative penalty is served. Further, the decision review is a required step before an appeal may be made to the Workers’ Compensation Appeal Tribunal (WCAT).

Interpretation

Initiating a review

1. A client affected by a decision, order or ruling may request a review in writing, providing:

• The date of the WorkSafeNB’s decision;
• Identifying what is being disputed;
• Clear reason(s) for the review; and
• All facts relative the request for review.

  If insufficient reasons are provided, the DRO will return to the request form to the applicant for further clarification.

  When a written request has been submitted within the legislated timeframes, the DRO will review a decision if:

• It is a specific case and type decision that the DRO is allowed to review under the WHSCC & WCAT Act.

Decisions not eligible for review

2. Not all WorkSafeNB decisions are able or allowed to be examined or reviewed. Examples of non-reviewable decisions include the following situations:

• There is a previous DRO or WCAT issue on the same matter being disputed and there is no new decision point following the decision implementation;
• There is new information included with the request that first needs to be actioned at the initial decision-making level;
• There is no reviewable decision identified that has been made under the WC Act, FC Act, or WHSCC & WCAT Act. For example, the matter may pertain to a decision rendered under the Occupational Health and Safety Act, privacy complaint, service issue, human rights issue, labour standards complaint, etc.
• A notification letter that does not provide a decision. This may be a letter that communicates how a DRO or WCAT decision was implemented; recommunicates a decision made in the past; outlines pending policy changes that may impact a service or benefit received by the worker; communicates expectation for the level of service or benefit that will be provided, etc.
• Any other situation identified by the DRO that, when judged on its merits, is not reviewable. In these instances, detailed reasons will be provided as to why the decision is deemed to be non-reviewable.

 Extending the time limit

3. If the request for review is beyond the time limitation, the client must request an extension of the deadline that outlines the circumstances and reasons for the late application as part of their request for review. Each late application will be considered on its merits

4. The DRO may consider the list below, although not limited to, as reasonable explanations for the delay in filing the request for review:

• The client requesting the review was unaware of the decision, but upon becoming aware, took reasonable steps to advance the review;
• The client requesting the review retained the services of a representative, provided instructions, and reasonably relied on the representative to file a request for review, but no request for review was filed. Upon becoming aware of the representative’s inaction, took prompt and reasonable steps to pursue the review;
• The client requesting the review was misinformed as to the requirements to file a request for review within 90 days by any person who ought to have provided this information;
• The client requesting the review was incapable of applying sooner because of a severe or serious illness, injury, or mental health issue. This would need to be supported by file note entries or reason given in the DRO form;
• The delay was the responsibility of the WorkSafeNB (written decision was not issued in a timely manner, delayed responses, etc.); and
• Such other circumstances as the DRO deems just.

DRO decision

5. A DRO decision is the final decision of WorkSafeNB.  

6. The DRO decision will result in one of the following outcomes:

• Confirm - accepting, approving, verifying, or upholding the decision;
• Vary - changing or altering the decision, which includes the power to reverse the decision and to make the decision that the reviewer thought ought to initially have been made; 
• Revoke - annulling, repealing, rescinding, or cancelling the decision; or
• Suspend – stopping, interrupting, postponing, or staying the review, possibly temporarily, the effect of the initial decision. For example, when there was insufficient evidence to make the original decision and the reviewer cannot determine if the outcome is correct or not.

 Communicating the DRO decision

7. A written decision will be sent to the client who requested the review. A copy of the decision may also be sent to other individuals. For example, the worker will receive a copy of an employer appeal.

8. The decision review will be done in the official language of the client’s choice.

 Implementation

9. Decisions issued by the DRO must be implemented by the claim owner within 10 business days from the date of the decision providing the required information for implementation is available.

Application

This policy applies to all decisions made on or after the effective date.