WCB Procedures

Address a resolution submission or letter

Procedure summary

Published On

May 27, 2025

Purpose

To address a resolution submission from the Advisor's Office (AO)The AO is a program established by the Government of Alberta to help workers and employers appeal WCB decisions. Their services are offered free of charge. Call 1-866-427-0115 Email: advisoroffice@gov.ab.ca or a letter from a worker, employer, or their representative who disagrees with a decision, requests more investigation, or requests that a new decision be made on an issue and working to reach early resolution before proceeding with a formal request for review (RFR) of the decision.

Description

The decision maker reviews the resolution submissionA Resolution Submission is a document received from the Advisor's Office that identifies a disagreement with a decision. or letter from an interested partyThe interested party may be the worker, the employer, a dependant, a representative, or an Appeals Advisor. identifying a disagreement with a decision or requesting more investigation of a decision be made on a new issue.

The decision maker reviews the resolution submission from the AO or the letter from the worker, employer or one of their representatives and identifies the issue(s) to be addressed.

The decision maker discusses with the person who made the request, their representative or the appeals advisor. After the discussion, they decide whether to change the original decision, make a new one on a different issue or do more investigation.

The decision maker completes their review and responds to the resolution submission or letter within 30 days.

Key information

A resolution submission is sent by a worker advisor or employer advisor from the AO. A letter may also come from a worker or employer, a dependant or an authorized representative. It may include a request to:

Obtain information,
Make a decision on an issue that has not yet been addressed,
Review a decision that was previously made.

To address a concern with a decision or another issue, the worker, employer or dependant:

May contact the decision maker directly by phone or in writing to discuss and attempt to resolve their concerns.
May obtain help from the AO to help them resolve their disagreement. Workers and employers may contact the AO to learn how to access their services. An Advisor from the AO may submit a resolution submission to WCB.
May obtain a representative who can contact the decision maker by phone or in writing to discuss and attempt to resolve their concerns.

In addition, eligible employersAn employer is eligible for these services when the claim decision was made within the last 12 months and the employer does not have an authorized representative. may access the Employer Appeal Consulting (EAC) service. This service helps employers understand the facts, policies and legislation used to make a decision, with a focus on resolving the issue.

When the Workers' Compensation Board (WCB) receives a resolution submission from a worker or employer advisor or a letter from a worker, employer, dependant or representative, a written response must be sent within 5 calendar days to acknowledge receipt.

The decision maker has 30 calendar days from the date of the resolution submission or letter to issue and implement the outcome of the review, when the issue can be resolved. When resolution cannot be reached, the requester may ask that their submission or letter be converted into a Request for Review (RFR).

This procedure applies to concerns with claim related decisions. When the concern is related to:

A service issue that impacts the client's rights under the Code of Rights and conduct, acknowledge and address the service concern as outlined in the Code of Rights and Conduct in the Policy Manual.
A fairness concernThe worker, employer, or dependent of a deceased worker have a concern with being treated fairly by WCB., refer to the 10-4 Address a fairness inquiry procedure.

Detailed Business Procedure

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1. Review the submission or letter Review the submission or letter and determine the steps needed to address and resolve the issue. The resolution submission or letter may contain more than one issue. Consider if the issue involves a decision that was previously made or if a new decision is required, and whether additional information needs to be gathered. Discuss the resolution submission or letter request with the supervisor for assistance, if needed.	Administrative tasks A resolution submission is scanned to the file as an AO 201A. Letters from interested parties are scanned to the file as LREP, LEMP or LWKR.
2. Call the requester or the appeals advisor Decision maker Discuss the requester's concerns. Ask questions to find out why they disagree with the decision, are requesting further investigation or a new decision be made. Listen to understand the requester's viewpoint and work together to find solutions. Discuss possible resolutions. Consider if: More investigation is needed. Explain the next steps (e.g., requesting missing medical reports, getting a medical opinion from an internal consultant, contacting a treatment provider or arranging medical assessments). A new decision is required because the issue was not previously addressed. Discuss the steps to make a decision (e.g., reviewing the claim information, medical reports, requesting an internal consultant review). A decision was previously made. Explain the information considered (e.g., objective medical informationObjective medical information means the data can be measured through physical examination findings, medical tests and/or reports from diagnostic procedures., medical opinions, assessments, etc.) and relevant policies. Confirm where the disagreement lies and if the original decision needs revisiting. If new evidence is submitted, refer to the 1-7 Reconsider a previous decision (new evidence) procedure. If the letter was from an employer, they may be eligible for the Employer Appeal Consulting (EAC) service, present the option to them and refer them to the WCB website to complete the necessary Employer Appeal's Consulting form to request their support. Confirm if the requester agrees with the action plan to resolve the issue. When they: Agree with the plan, continue to the next step. Do not agree with the plan or the issue cannot be resolved to their satisfaction, forward the issue to the supervisor for review and explain why the issue cannot be resolved. Supervisor After reviewing the decision maker's file note, contact the requester. Ask questions to clarify the issue and work with them to find solutions. If the issue is not resolved, consider discussing it with the AO manager or the Client Services (CS) manager, if needed. Following the discussion(s), advise the decision maker of the outcome and provide direction on how to proceed. Note: If the decision changes after discussions, consider if a service issue affected the worker's rights under the WCB Code of Rights and Conduct. If so, address the concern and discuss with the decision maker how to improve future service delivery.	Administrative tasks Document the conversation in a file note (Request for Review CS/Details). When the requester is not satisfied with the action plan to resolve the issue or the issue cannot be resolved, send a file note (Request for Review/Details-CS) to the supervisor.
3. Action the supervisor's recommendations, if required and send the response letter Review and action the supervisor's recommendations and/or direction on how to proceed. Send a response letter within 5 business days acknowledging receipt of the resolution submission or letter. Outline details of the review, discussions and the action required or agreed upon to resolve the issue. When: Further investigation is needed, outline the next steps and include the anticipated completion date. Notify the supervisor of the outcome of the review and continue to the next step. A decision is changed, or a new decisionWhen the original decision is changed it is considered a new decision. is made which resolves the issue(s) as agreed to by the requester, explain the new decision in the letter and how it resolves the issue(s). End this procedure and refer to the procedure that corresponds with the decision being made. A new decision does not resolve the requester's concern, or the original decision remains unchanged, determine if the requestor has asked for the issue to be forwarded to the Dispute Resolution and Decision Review Body (DRDRB) if the issue could not be resolved. If so, continue to step 5. If not, end the procedure. A new decision does not resolve the requestor's concern or the original decision remains unchanged, determine if the requester asked the issue to be forwarded to the DRDRB if the issue could not be resolved. If so, continue to step 5. If not, end the procedure.	Administrative tasks Send the Resolution Submission Response (GE201A) letter. Send a file note (Request for Review/Details-CS or Appeal) to the supervisor, including the outcome of the review and the plan to investigate the issue(s).
4. Implement the plan Implement the plan outlined in the response letter within 30 calendar days. Upon completion of the investigation, call the requester to discuss the outcome. Make a new decision based on the results of the investigation, if required. When a new decision is made, send a new letter outlining the decision. If the issue is resolved, end the procedure. If the issue is not resolved, continue to the next step. If the new decision does not resolve the requestor's concern or the original decision remains unchanged, determine if the requester asked the issue to be forwarded to the DRDRB if the issue could not be resolved. If not, end the procedure. If so, go to step 5.	Administrative tasks Send a new Resolution Submission Response (GE201A) letter.
5. Convert the resolution submission or letter into a request for review Review the resolution submission or letter to determine if it includes direction to forward the issue to the DRDRB if the issue is not resolved. If so, convert the resolution submission or letter to a RFR in the system and notify the supervisor.	Administrative tasks Send a file note (Request for Review/Details) to the supervisor indicating the submission or letter will proceed as an RFR. Send a task to the Document Modification, Team Desk requesting the resolution submission or letter form ID be changed to a G040G040 is the ID number of the Request for Review form.. Include the date the resolution submission or letter was received. Changing the form ID triggers the same tasks as when a new G040 is scanned to file. Follow the 13-2 Address a request for review (RFR) procedure.

Supporting Information

Employer Appeal Consulting (EAC) service

Eligible employers may access assistance from the Employer Appeal Consulting (EAC) service when the claim decision was made within the last 12 months, and the employer does not have an authorized representative. Employers can access the necessary form (Request for Employer Appeals Consulting (C1116) form) to request the services from the WCB website.

Upon receipt of the request for services, an industry specialist is assigned to determine the issue is valid (i.e., the issue is appealable). They contact the decision maker and/or supervisor to notify them the employer has requested assistance from Industry Support. The industry specialist will review and attempt to resolve the issue within 5 business days.

The industry specialist may attempt to resolve the issue by:

Educating the employer about any legislation/WCB policy that relates to the decision.
Discussing the decision with the decision maker and their supervisor to determine whether it can be changed or there is a possible resolution.
Requesting any additional information.
Providing the decision maker with any new evidence submitted by the employer.

If a resolution:

is reached or there is a change in the decision/a new decision is made, the decision maker or supervisor contacts the employer to discuss the outcome.
is not reached or there is no change in the decision/a new decision is not made, the industry specialist contacts the employer within 5 business days, to discuss their analysis of the issue and, when applicable, provide information about the formal review process and send the appropriate letter.

Supporting references

Policies

Workers’ Compensation Act

Applicable sections

Section 9.3 (Includes all subsections) - Review body
Section 9.4 (Includes all subsections) - Reviews
Section 13.1 (1) - Power of Appeals Commission
Section 13.2 (1) - Appeals
Section 13.3 (1) - Board is Bound by a Decision
Section 13.4 (1) - Appeal
Section 13.5 (1) - Consensual resolution process priviledged
Section 17 (2), (3), (4), (5), (6) - Jurisdiction of Board

General Regulation

Applicable sections

Related Legislation

Applicable sections

Compatibility Warning

WCB Procedures

Address a resolution submission or letter

Procedure summary

Detailed Business Procedure

Administrative tasks

Decision maker

Supervisor

Administrative tasks

Administrative tasks

Administrative tasks

Administrative tasks

Supporting Information

Supporting references

Policies

Related links

Workers’ Compensation Act

General Regulation

Related Legislation