Addressing delayed decisions

Resolving an issue for one individual often causes WSIB staff, on their own initiative, to make changes to how they, or their team, handle similar cases.

A worker complained about a lack of communication and a four-month delay in initial adjudication of his claim.

When the Commission inquired into the reason for the delay, the WSIB manager said that case managers have the option of changing the pending status of a claim to “resolved” once they have given the decision verbally to the worker. The effect is that managers may be unaware of delays by their staff in releasing written decisions and thus cannot provide effective oversight.

The manager invited the worker in this case to call her to discuss the acknowledged service gaps. In view of the imminent implementation of the new service delivery model in the office, she also initiated a review of every claim that was six months old or older so that she would know the status of all pending decisions and could resolve any identified gaps.