Insufficient Notice of a Change in Benefits

An injured worker contacted the Commission with concerns about the WSIB reducing his LOE benefits and not providing him with sufficient notice before doing so. This worker had been unemployed for several years and had been receiving full LOE benefits.

When the WSIB conducted a final review of this worker’s loss of earnings, it was decided that he was capable of working and his benefits were reduced. The case manager advised the worker of this decision verbally, and followed up with a letter reducing his benefits retroactively, effective two weeks prior to the actual decision.

The Commission contacted the manager to discuss concerns about the decision-making process and the lack of sufficient notice. WSIB’s Process Guidelines with regard to LOE reviews states, in part “Any change in benefits is effective one week from the date of the decision letter…”.

After reviewing the claim and the guidelines, the manager advised the Commission that an error had taken place and that this worker’s LOE adjustment would be effective one week from the date of the decision letter. The worker received a letter from the case manager advising of this change, and apologizing for the error.