Income and Employment Supports Act, sections 43-48
Income Support, Training and Health Benefits Regulation, sections 73-74 , 93-94 and 97

INTENT

The process to obtain a Review of Decision or to appeal a decision to an Income and Employment Supports Appeal Panel is transparent and conducted in a fair and timely manner.

POLICY

The Government of Alberta (GoA) is required to inform an individual when a decision is made that affects their eligibility, income support, training benefits, and/or other benefits. Specifically, the GoA in the delivery of Learner Benefits, is required to:

• Provide details of the decision and rationale explaining why the decision was made;
• Advise the learner of their right to appeal the decision to the appeal panel within 30 days of receiving notice of the Department’s decision;
• Explain the process involved in appealing a decision to the appeal panel;
• Inform the learner that they must initiate the appeal process by submitting a written Notice of Appeal to the Learner Income Support Office (LISO) or to the Appeals Secretariat;
• Explain that benefits under review and/or appeal are not issued pending the outcome of an appeal hearing; 
• Advise an individual with eligibility for the same benefit(s) under another department and/or a non-government program, that he/she must pursue these alternate options, (including appeal), prior to initiating an appeal with the appeal panel, and
• Document all eligibility decisions and issues that are under appeal in Mobius Notes..

Notification:

LISO, representing the ministries of Advanced Education and Labour, makes a decision regarding eligibility for assistance under Part 2 of the Income and Employment Supports Act (IESA), based on information contained in the Learner Income Support Application. After determining eligibility for assistance, LISO issues a Funding Decision letter to notify the individual of:

• The details of a decision (with supporting rationale) that affects eligibility for assistance under Part 2 of IESA;
• Their right to appeal this decision; and
• The appeal process and the 30-day time limit to appeal the decision to the appeal panel.

Informal Review

Individuals who do not agree with a decision regarding eligibility for assistance under Part 2 of IESA, are advised to contact LISO for clarification. A consultant at LISO can explain applicable sections of IESA, associated Regulations and policy used to make the original decision. The consultant may also discuss potential alternatives and other resources available to the individual.

LISO will attempt to resolve the situation (if possible) prior to an appeal being initiated with the appeal panel. If an individual is not satisfied with LISO's explanation, the individual has a right to appeal the Department’s decision to the appeal panel.

Initiating the Appeal Process

To initiate the appeal process, an individual must submit a completed EMP0547A Notice of Appeal form, (or any type of written notice requesting an appeal), to LISO or to the Appeals Secretariat. The EMP0547A Notice of Appeal can be obtained from LISO, the Appeals Secretariat’s website, or by contacting the office of the Appeals Secretariat directly.

When submitting a Notice of Appeal, the individual must identify the decision that is being appealed and the reason for the appeal. The written Notice of Appeal must be submitted to LISO or to the Appeals Secretariat within 30 days of first receiving notification of a decision and the right to appeal.

In situations where LISO receives an appeal, the EMP 0547A Notice of Appeal is registered and uploaded into the Appeals Information Management System (AIMS) within two business days of being received. LISO documents in Mobius Notes that a Notice of Appeal has been received and entered in AIMS. LISO notifies the Appeals Secretariat by sending an email to CSS.Appeals@gov.ab.ca or sending a copy of the form to the regional office of the Appeals Secretariat.

In situations where an EMP 0547A Notice of Appeal form is received by the Appeals Secretariat, the form is registered and uploaded in AIMS. The Notice of Appeal is then scanned and emailed to LISO.

Extension to 30-Day Time Limit to Submit an Appeal

The Minister’s authority to grant an extension beyond the 30-day time limit to appeal a decision is delegated to the Appeals Secretariat.

In circumstances where a Notice of Appeal is filed after the 30-day time limit has expired, LISO is required to send an EMP0003 Request for Appeal Extension letter to the individual. The Request for Appeal Extension outlines how to request an extension to the 30-day time limit to appeal a decision.

Requests for an extension to appeal must be submitted in writing and must indicate the date that notice of the decision was received and the reason(s) why the Notice of Appeal could not be submitted within the 30-day time limit. Appeal extension requests must be forwarded to:

Appeals Secretariat
2nd Floor, Agronomy Centre
6903 116 Street
Edmonton, AB T6H 5Z2

The Appeals Secretariat may contact LISO to verify the nature of the decision under appeal, to clarify any information provided, as well as the timeframe and method in which the individual was notified of the decision.

An extension may be approved, if the Appeals Secretariat is satisfied that there are apparent grounds for appeal and reasonable grounds for extension.

The Appeals Secretariat will advise the individual and LISO whether an extension is granted. If granted, the appeal will proceed to the appeal panel for review and decision.

Note
Under IESA, section 45(3), the Income and Employment Supports Appeal Panel has authority to hear an appeal submitted beyond the 30-day time limit, without involvement from the Appeals Secretariat, if the individual satisfies the appeal panel that:

• They did not receive notice of the Department’s decision; or,
• Notice was received later than when it was deemed to have been received.

Administrative Review

LISO is required to complete an Administrative Review upon receipt of an EMP0547A Notice of Appeal, (or any form of written notice requesting an appeal), and enter this information into AIMS.

LISO conducts an Administrative Review by examining information provided in the EMP0547A Notice of Appeal and/or the written submission prepared by the individual, requesting an appeal. LISO is also required to complete a Review of Decision document on AIMs.

Note
If the appeal deals with Health Benefits as defined in section 73 of the Income Support, Training and Health Benefits (ISTHB) Regulation, LISO advises that “the Income and Employment Supports Appeal Panel does not have authority to rule on the decision”, and explains how to submit the matter to the Health Benefits Exception Committee for consideration.

As part of the Administrative Review, LISO is advised to discuss the matter with the individual and attempt to resolve it (if possible) prior to scheduling the appeal panel hearing. In situations where an incomplete Notice of Appeal is received, contact with the client may be necessary to clarify concerns or confirm facts of the decision being appealed.  Completing the Administrative Review should not be delayed more than two business days while awaiting this confirmation.  Any delay is documented in AIMS and Mobius Notes, and communicated to the client.  If the Notice of Appeal is not clear, the time limit to complete the Administrative Review does not begin until the issue being appealed is clarified.

LISO may confirm, vary or reverse the original decision. If the decision is confirmed or varied, the appeal will proceed to the appeal panel, unless the individual withdraws the appeal request, either verbally or in writing. If the decision is reversed the appeal status on AIMs changes to completed, after LISO completes the Review of Decision.

If the appeal request is not withdrawn, LISO schedules the appeal hearing date using AIMS. If none of the dates/times shown on AIMS are suitable, LISO contacts the Appeals Secretariat to arrange a hearing date.

When the appeal panel hearing is scheduled, an Appeal Hearing Letter is generated by AIMs and forwarded by the Appeals Secretariat to:

• Notify the individual of the date, time and location of the hearing, and 
• Instruct the individual to submit copies of any new information to the Department in advance of the hearing.

The Administrative Review is completed and recorded in the Review of Decision within 14 calendar days of receiving the client’s Notice of Appeal.  In exceptional circumstances where the issue being appealed is complex, up to an additional seven calendar days may be required to complete the Administrative Review.  Examples of complex appeals include:

• The client appealing more than one decision; or
• Providing additional information that may impact the calculation of an overpayment.

If there is a delay in completing the Administrative Review, and more than 14 calendar days is required, the reason for the delay must be recorded in AIMS and Mobius Notes.

If the Notice of Appeal is filed after the 30-day time limit has expired, LISO is required to:

• Inform the individual that the Department will be challenging the appeal panel’s jurisdiction to hear an appeal submitted beyond 30 days;
• Explain the process to request an extension to appeal to the appeal panel; and,
• Forward an EMP0003 Request for Appeal Extension letter to the individual.

PROCEDURE

Notice of Appeal Submitted Beyond 30-Day Time Limit

In order for the Department to challenge the appeal panel’s jurisdiction to hear an appeal submitted more than 30 days after the individual was informed of the original decision; the right to appeal; and the 30-day time limit to submit a Notice of Appeal, LISO staff:

1. Note on the Review of Decision that the appeal panel may not have jurisdiction to hear the appeal, as per IESA, section 45(1).
2. Include evidence verifying that the individual did, in fact, receive notice of the decision more than 30 days prior to submitting the written Notice of Appeal.
3. Forward an EMP0003 Request for Appeal Extension letter to the individual.

Benefits Not Regulated by Legislation

If the decision under appeal is not legislated (not addressed in the Act or Regulations), LISO:

1. Specifies the applicable policy or directive in the Review of Decision.
2. Includes a summary of the applicable policy or directive to substantiate the decision.

Benefits Regulated by Legislation

If the decision under appeal is legislated (addressed in the Act or Regulations), LISO:

1. Specifies the applicable section of IESA or the Regulation in the Review of Decision.
2. Includes a summary of the applicable IESA or Regulation section to substantiate the decision.
3. Records on the Review of Decision that the appeal panel does not have authority to make decisions that exceed limits specified by IESA or the Regulations.

Appeal of Benefits Issued under Director’s Approval

If an individual appeals the denial of a benefit that is issued under Director Approval, LISO:

1. Includes a summary of the Director’s rationale for denying the benefit.
2. Records on the Review of Decision that benefits issued by Director’s Approval are under the authority of the Minister as provided by IESA and associated Regulations; and are not within the appeal panel’s jurisdiction to rule upon.

Appeal Process for Learners

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