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Expected to Work/Barriers to Full Employment Policy & Procedures

Published Date: January 18, 2021
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13 Appeal and Decision Review

Informal and Administrative Review 

AUTHORITY
Income and Employment Supports Act (IESA), sections 43-48
Income Support, Training and Health Benefits Regulation, sections 73-74, 93-94 and 96-97

INTENT
To describe the review processes that occur prior to an appeal.

POLICY
The Supervisor completes the Informal Review and/or Administrative Review and discusses the issue with the individual to attempt to resolve it (if possible) prior to scheduling the appeal hearing.

Informal Review

Clients who do not agree with a decision regarding eligibility for assistance under Part 2 of IESA, are advised to contact a Supervisor (or designate) at the Alberta Works Centre where the original decision was made.

The Supervisor is able to informally review the decision and may vary or reverse it. If the Supervisor upholds the original decision, he/she can provide clarification by explaining applicable sections of IESA, associated Regulations and policy used to make this decision. The Supervisor may also discuss potential alternatives and other resources available to the client.

The Supervisor should attempt to resolve the situation (if possible) prior to an appeal being initiated. If a client is not satisfied with the Supervisor’s explanation, the client can submit a Notice of Appeal and have the decision reviewed by the appeal panel.

Administrative Review

Upon receipt of an EMP 0547A Notice of Appeal, (or any form of written notice requesting an appeal), the Supervisor (or designate) completes an Administrative Review and enters this information into AIMS.

The Supervisor conducts an Administrative Review by examining the information:

  • On the individual file,
  • Provided by the worker,
  • Provided by the individual appealing, and
  • Provided in the EMP 0547A Notice of Appeal and/or the written submission prepared by the individual, requesting an appeal.

The Supervisor completes a Review of Decision document on AIMS and records this activity in Mobius Notes.

Timeline for Administrative Review

The Supervisor should not delay more than two business days to complete the Administrative Review. Supervisors must document (in AIMS and Mobius Notes) any delays and must notify the individual.

If an individual submits an incomplete Notice of Appeal, the Supervisor contacts the individual to clarify concerns or confirm facts of the decision. The two business day deadline starts once the Supervisor clarifies the appeal issue with the individual.

Outcome of Administrative Review

The Supervisor may confirm, vary or reverse the original decision.

  • If the Supervisor confirms or varies the decision, the appeal proceeds to the appeal panel (unless the individual withdraws the appeal request, either verbally or in writing).
  • If the Supervisor reverses the decision, the appeal status on AIMS is changed to ‘completed’, after the Supervisor submits the Review of Decision.

Documenting the Administrative Review

The Supervisor completes and records the Administrative Review in the Review of Decision within 14 calendar days of receiving the individual’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 individual appealing more than one decision; or
  • The individual is providing additional information that may impact the calculation of an overpayment.

The Supervisor must share with the Appeal Secretariat and record in AIMS and Mobius Notes if there is a delay in completing the Administrative Review and more than 14 calendar days is required.

Benefits Not Regulated by Legislation

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

  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 that are Specifically Regulated or Legislated

If the decision under appeal is legislated (addressed in the IESA or Regulations), the Supervisor:

  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. (If applicable) Records on the Review of Decision if they believe the appeal panel does not have authority to make a decision. See Overview and Authority section to identify which decisions are subject to appeal.

NOTE: If an individual appeals the denial of a benefit that is issued under Director’s Approval, the Supervisor:

  1. Includes a summary of the Area Manager/Regional 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 that these are not within the appeal panel’s jurisdiction to rule upon.