Benefit explanation provided

A worker experienced a three-month delay in the implementation of a WSIAT decision awarding him a retroactive NEL benefit. When he did receive his cheque, he contacted the WSIB because he questioned the award date. Over the course of six months the worker tried to reach the claims adjudicator , eventually escalating his concerns to the manager. However, he still did not receive the written explanation of the calculation he was seeking so he contacted the Commission.

Since the series of process problems that contributed to the delays in the worker’s individual claim had the potential to affect other claims in the sector, the Commission contacted the director. The director:

  • reviewed the worker’s entire file to look into the concerns about process
  • reviewed the file with the adjudicator, who called the worker to apologize for the delay and promised a written explanation within one week
  • wrote a memo to the sector managers requesting that they remind their teams of the importance of using the correct protocol and mechanisms for referring matters to the NEL area to prevent delays like this one.