WSIB Appeals in Ontario: Internal Reviews & WSIAT

What the WSIB Covers

Eligible workers can receive:

• Loss of Earnings (LOE) benefits — 85% of pre-injury net earnings while unable to work
• Medical aid — treatment, medication, assistive devices
• Non-Economic Loss (NEL) award — lump sum for permanent impairment
• Labour Market Re-entry (LMR) — retraining if you cannot return to your job

Common Reasons for WSIB Denials

• Claim not reported within 6 months of the accident
• WSIB disputes the injury arose "in the course of employment"
• Pre-existing condition alleged as sole cause
• Medical evidence not sufficiently linking injury to work
• LOE benefits cut off after an alleged return-to-work offer
• NEL rating disputed — WSIB assigns a lower impairment percentage

Step 1 — Internal Objection / Reconsideration

You must first file an Objection with the WSIB within 30 days of the decision letter. Submit new medical evidence, a written statement, or a doctor's report supporting your claim. The WSIB Case Manager reviews the file and issues a new decision — often within 90 days.

Step 2 — Appeal to WSIAT

If the internal review is unsuccessful, appeal to the Workplace Safety and Insurance Appeals Tribunal (WSIAT) — an independent adjudicative body. File within 6 months of the internal review decision.

1. File Notice of Appeal: Complete the WSIAT appeal form and pay the $150 filing fee (waivable for financial hardship).
2. Disclosure: WSIAT sends you the full claims file. Review all documents for errors or missing evidence.
3. Pre-Hearing: A Vice-Chair may hold a pre-hearing to narrow issues and set a hearing date.
4. Hearing: Oral or written. You or your representative presents evidence, cross-examines any WSIB witnesses, and makes legal arguments.
5. Decision: WSIAT decisions are publicly available and binding on WSIB.

Key Evidence at WSIAT

• Independent Medical Examination (IME) reports supporting your injury
• Specialist reports (orthopaedic, neurologist, psychiatrist)
• Functional Abilities Evaluation (FAE) if return-to-work is disputed
• Employer health and safety records, incident reports
• Witness statements from co-workers

Can a Paralegal Represent Me at WSIAT?

Yes. Licensed paralegals can represent workers and employers at WSIAT hearings. WSIAT is an administrative tribunal, not a court, so paralegal representation is expressly permitted. Many workers achieve better outcomes with professional representation than self-represented.