APPEALS OF DECISIONS REDUCING NEL AWARDS DUE TO A PRE-EXISTING CONDITION

In December 2017, the WSIB’s Operational Policy Branch and Permanent Impairment Program jointly released a memorandum regarding “Pre-existing Conditions and Permanent Impairments”. The purpose of the memo was to clarify the WSIB’s application of its policies on non-economic loss (“NEL”) benefits.

As set out in the memorandum, starting December 15, 2017, the WSIB will no longer reduce benefits for people with an asymptomatic pre-existing condition if it is non-measureable. In addition, the WSIB also confirmed that it would be reviewing approximately 4,500 decisions made between January 2012 and December 15, 2017 where there was a reduction because of an asymptomatic pre-existing condition. Information about the WSIB’s review for workers and employers is available on the WSIB’s website.

If one of the issues in your appeal at the WSIAT is the reduction of your NEL award due to a pre-existing condition, the WSIAT will be in contact with you to discuss the WSIAT’s proposed course of action with respect to your appeal.

Please contact the WSIAT if:

  • You receive notice from the WSIB that the decision regarding your NEL award is being reviewed and/or the WSIB has issued a new decision. We ask that you please inform the WSIAT of the WSIB’s review or decision as soon as possible.
  • As of March 1, 2018, you have NOT been contacted by the WSIAT about your appeal and one of the issues to be determined by the WSIAT concerns a reduction of your NEL award due to a pre-existing condition.

Employers are also encouraged to contact the WSIAT if they have any information with respect to appeals in which one of the issues to be determined concerns a reduction of a NEL award due to a pre-existing condition.

All updates and any questions about the WSIAT’s proposed course of action in these circumstances can be directed to the WSIAT’s Call Centre at (416)-314-8800 or 1-888-618-8846, 8:00 a.m. to 5:00 p.m., Monday to Friday.

We thank you for your cooperation.

Posted: February 8, 2018