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Process steps

As a rule, the Accident Appeal Board seeks to process matters in the order they are received, but obtaining additional accounts or statements of expert opinion and other reasons may prolong the process. 

The average processing time at the board is currently just over eight months. Individual matters may take a shorter or longer time than that. The processing time is calculated from the moment the matter becomes pending at the appeal board to the moment the appeal board decision is sent by mail.

When the letter of appeal with the appropriate appendices has arrived at the appeal board, it is first recorded as pending. After that, the appeal progresses at the appeal board through different steps of the process which each take time.

First, the documents are checked, and any necessary additional accounts are obtained; more such accounts may also have to be obtained at later stages of the process. The appellant may also submit additional accounts to the appeal board until the matter has been solved. In order to allow processing the matter to progress as smoothly as possible at the appeal board, it is better if the parties submit any additional accounts during the early stages of the process. This is, in particular, because the counterpart will be heard following any new submissions. If such a hearing has to take place in the final stages of the process, it will lengthen the process.

After drawing up the process memorandum and its associated actions, the matter is, in most cases, referred to the physician member who answers any questions posed that require special medical expertise. After that, the referendary makes a decision proposal and draws up a draft decision. After that, the decision proposal and draft decision are circulated through each member of the section.

After circulation, a section meeting takes place where the appeal is decided.

After the meeting, the matter is finalised and typed out. Finally, the decision is sent by mail to the parties concerned. The document sheets are numbered and bound into document folders at the appeal board, and then sent to the insurance institution for archiving. The appeal board archives the decision, the process memorandum and minutes (decision list).

The decisions of the Accident Appeal Board are divulged to all parties concerned. The decision is only sent to the parties (the appellant and the insurance institution) and also for information to the appellant’s agent, if any. To the extent that the decision of the appeal board is confidential, no information about it is divulged to third parties.

No information is given regarding the appeal board decision until it has been mailed.

An outline of the process steps:

1. the matter is recorded as pending;
2. the documents are checked and any additional accounts obtained;
3. the process memorandum is drawn up;
4. the physician member gives an opinion (when required);
5. the referendary makes a decision proposal;
6. it is circulated through the members;
7. the decision is made at a section meeting;
8. the decision is typed out and finalised;
9. the decision is mailed;
10. the documents are mailed to the insurance institution for archiving;
11. the decision is archived at the appeal board.

Page last updated 6/24/2015 4:31 PM