Poor communication leads to poor decision

Mr. T received a letter from the WSIB saying he had been overpaid and asking for the money back. The letter explained that the WSIB can recover benefit-related debts that arise from the duplication of benefits, a failure to report material changes in circumstances, fraud, and administrative errors where the worker was aware of the error. Mr. T spoke to a WSIB assistant director who told him the overpayment was created when the WSIB did not adjust his benefit payments when he got an increase of $0.50 an hour in his pay rate in July 2013. Mr. T thought this unfair since he had informed the WSIB of his pay increase and provided his tax returns confirming it.

Mr. T contacted the Commission, who reviewed his file and the WSIB policy on the recovery of benefit-related debts. The file showed that the first case manager failed to act on Mr. T’s information and the new case manager reviewed the file, noted the difference in the pay rate, and determined that an overpayment was due.

Commission staff asked the manager if the overpayment met the exception criteria under the WSIB policy. The manager found the overpayment had been created in error. She said Mr. T’s increase in pay was not a material change as it was less than 10 per cent. The case manager told Mr. T the WSIB would reimburse him for the earlier reduction in benefits. In addition, his ongoing loss of earnings benefits was restored to its previous rate.