WSIB - Ontario Nurses' Association

Time limits to notify ONA• Within one week of the date of the adverse decision if it is a 30-day appeal.• Within four weeks of the date of the adverse decision if it is a six-month appeal.• Within one week of receiving notice of an employer appeal.• It is the usual practice of WSIB Case Managers to call a worker to informhim/her of a decision on the same day the written decision is mailed. You donot have to wait for the written decision before contacting ONA.• If you want ONA to represent in an appeal, you do not send any letters toWSIB or advise them you will be appealing the decision. Contact ONAWSIB Intake first (1-800-387-5580, press 0 for Toronto office, ask for WSIBIntake or dial extension 7721).ONA WSIB Case Representation CriteriaUnlike grievances, there is no legal obligation for ONA – or any union – to providerepresentation in WSIB appeals to its members. The ONA Board of Directorsapproved the development of criteria to enable us to provide this representationto the most vulnerable of our injured members. The criteria is applied on a caseby-casebasis by the Labour Relations Officers on the ONA WSIB Team as towhether your case meets ONA’s Representation Criteria. There may be unusualor mitigating circumstances in your case that would permit us to waive criteria,therefore, even for the “Issue-Specific” criteria you must contact a WSIB LROvia the ONA WSIB Intake line – ext. 7721 – to determine if we can represent youin an appeal.When you contact ONA about an adverse WSIB decision you wish to appeal, andyou have contacted us within the above ONA time limits, an LRO with expertisein WSIB matters will determine if your case meets our criteria for representation.These criteria will be revised on an ongoing basis based on experience, newlegislation, regulations and WSIB policies. Each individual case will be assessedon an ongoing basis for meeting the criteria, including the merits. For example,if it is initially determined your case meets our criteria, and then a medical reportobtained later through our investigation contradicts or does not support your case,we may review the merits again and decide not to proceed further.In most cases where ONA decides there is no merit to continue with the appeal,self-help kits are provided to the worker to proceed on her/his own if s/he sochooses. The worker may utilize an outside representative, however, ONA doesnot pay this cost. ONA also does not pay the cost of obtaining medical assess-26