INTENT

To describe protocols for situations that may occur after an Appeal Hearing.

POLICY
A number of outcomes can occur as a result of a Citizen’s appeal panel hearing. The individual and/or the Department may have further actions to complete once a hearing is concluded.

The Appeal Panel may confirm, reverse or vary (change) the decision under appeal.

After the appeal hearing, the Appeal Panel:

• Prepares and issues a Panel Decision on the matter under appeal.
• Prepares the Appeal Report, including:
  • Facts and/or evidence on which the appeal panel based its ruling, as presented by the individual, witnesses who attended the hearing, and the department representative;
  • Justification for the decision; and
  • Authority for the decision by citing the appropriate section(s) of the Act or Regulations.
• Sends the Appeal Report to the District Office and to the individual with a written decision of the appeal panel (usually within 10 business days after the appeal hearing date).
  
  

If the Appeal Panel reverses or varies the original decision, the Panel Decision document:

• Records an itemized list of the specific benefits, goods and/or services awarded to the individual; and
• Records any restrictions pertaining to cost, frequency, time limitations, etc.
  
  

If the Appeal Panel reverses or varies the original decision, the Department:

• Schedules payment of benefits; and
• Updates Mobius Notes.
  
  

Challenge of Community and Social Service Appeal Panel Decision
The appeal panel’s ruling on a decision under appeal is final. However, if the individual is not satisfied with the appeal panel’s ruling, they may:

• Ask the Ombudsman’s Office to review the process used by the appeal panel to make its decision; or
• Request a ruling from Court of Queen’s Bench by filing a Judicial Review of the decision.
  
  

If the Department believes that the appeal panel has exceeded its authority, the Department may present the matter to, and request a ruling from, Court of Queen's Bench. This is done by filing a Judicial Review of the decision. Staff are asked to raise these concerns according to the IS-2021-D002 directive.

Benefits authorized by the appeal panel must be issued to the individual, pending outcome of the Department’s challenge of the appeal panel’s ruling.

Recovery of benefits authorized by the appeal panel can occur if Court of Queen’s Bench quashes or sets aside the Panel Decision.

Note

Should the Department make application to have the appeal panel’s ruling on the decision under appeal quashed, only documentation presented at the appeal hearing can be introduced as evidence at Court of Queen's Bench.