Highlights of Noteworthy Decisions

Decision 556 06 R
R. Nairn - M. Christie - K. Hoskin
  • Fraud
  • Reconsideration (new evidence)

In Decision No. 556/06 (released in June 2008), the hearing panel found that the worker was entitled to a full FEL award from R1 in June 2003, until she reaches age 65 in July 2042. The Board applied for reconsideration of Decision No. 556/06.

The Board advised that, in 2011, the worker's file was referred to the Board's Regulatory Services Division. After investigation, the worker was charged with 10 counts of knowingly making false or misleading statements, in connection with claims for mileage for medical appointments between 2001 and 2008, and two counts of failing to report a material change in circumstances, in connection with the worker being employed and earning income from 2003 to 2006 and in 2009. As part of a negotiated settlement, the worker pleaded guilty to 10 counts of knowingly making false or misleading statements and one count of failing to report a material change in circumstances.
Tribunal decisions are meant to be final determinations of the matters on appeal and will be reopened only in very limited circumstances. One of the situations where it may be appropriate to reopen a decision is when a party introduces substantial new evidence that was not available at the time of the original hearing and which would likely have resulted in a different decision had the evidence been introduced at the original hearing.
The Panel found that the evidence submitted by the Board satisfied the requirement of being substantial new evidence. Had the hearing panel in Decision No. 556/06, which found that the worker could not return to work in any capacity, known that the worker had actually been employed between 2003 and 2007, it may well have reached a different conclusion.
The application to reconsider was granted. A new hearing will be scheduled on the merits.