6.10 Appeals

6.10.1  DENYING INCOME ASSISTANCE

• the value of their non-exempted financial resources is greater than the cost of their basic necessities (for more on financial eligibility, see section 6.1.4); or
• they are applying for general assistance, are childless, and have unreasonably terminated a job or refused a reasonable job offer (see section 6.5.4).

Under section 9(3)(b) of The Employment and Income Assistance Act, applicants who are denied assistance are to be notified of that decision in writing, stating the reasons and advising applicants of their right to appeal to the Social Services Appeal Board. If an applicant is denied assistance, the intake worker produces a letter to that effect to give to the applicant at the conclusion of the intake interview.

6.10.2 DISCONTINUING, REDUCING, SUSPENDING OR INCREASING INCOME ASSISTANCE

A written order by the director or designate must be on file where income assistance to a participant will be discontinued, reduced, suspended or increased, as per section 9(1) of The Employment and Income Assistance Act. The letter must state the reason for the decision, the effective date when the individual has the right to appeal, and notification of the right to be represented by legal counsel at the appeal.

Where the participant is being advised of a reduction by letter, the written order may be in the form of a notation, signed and dated, on the file copy of the letter.

Notification of Denial, Discontinuance, Reduction or Suspension of Assistance

It is normally adequate for written notice to be forwarded to the individual by regular mail, such as in cases when the participant requests closure of the file or is known to be out of the province. However, in cases where the decision to deny or vary income assistance is likely to be disputed, the notice should be forwarded by registered or certified mail.

When notification was not sent by registered mail and the participant indicates that sufficient notification was not received, the participant should be notified a second time by registered mail and allowed another 30 days in which to submit an appeal.

Right of Appeal
Letters to participants indicating that their assistance has been denied, discontinued, reduced or suspended should contain the following paragraph:

"You have the right to appeal this decision to the Social Services Appeal Board within 30 days of receipt of this letter. As well, you may be represented at the appeal by legal counsel or another person of your choice. Should you wish to appeal, please contact:

Social Services Appeal Board
7th Floor - 175 Hargrave Street
Winnipeg, Manitoba, R3C 4S6
Telephone  (204) 945-3003 / 1-800-282-8069

If you have any questions or concerns regarding this decision or the appeal process, please contact your Employment and Income Assistance counsellor."

6.10.3 PREVIEW OF APPEAL NOTICES

The director or designate is required to personally review each appeal notice which is received and, where possible, initiate action to rectify the problem in advance of the appeal hearing. Although the pre-screening of appeal notices may result in the cancellation of some hearings, this procedure is not intended to interfere with the right of appeal.

6.10.4 PREPARATION FOR APPEAL HEARINGS

1. a copy of the application form;
2. particulars regarding the appellant's financial resources; and
3. proof that written notice of the decision under appeal was provided to the appellant.

1. Case summary including:
   1. name of applicant and spouse;
   2. file number;
   3. number and age(s) of dependent children;
   4. date of application and date assistance issued;
   5. reason for enrollment; and
   6. if the basis of appeal relates to medical eligibility or continued eligibility of an existing disability case, all medical information relevant to the appeal must be provided to the board as well as to the applicant, including the individual's Medical Assessment and Medical Assessment Summary Forms, the dates of previous medical reviews and whether the disability is of a physical or mental health nature.
2. All issues raised in the Notice of Appeal should be listed and individually addressed.
3. A copy of the participant's income assistance budget, if applicable.

The report to the SSAB normally must be signed by the director but may be signed by the designate in exceptional circumstances.

In accordance with section 9(6) of The Employment and Income Assistance Act, the above documentation must be forwarded to the Secretary of the Social Services Appeal Board (SSAB) in advance of the hearing. The case counsellor, or in exceptional cases, a well-prepared staff person, is required to represent the director at every appeal hearing.

NOTE: Only information relevant to a given appeal should be provided to the appeal board for consideration.

6.10.5 ATTENDANCE AT HEARINGS AND PARTICIPATION OF LEGAL COUNSEL

To determine if the participation of legal counsel is necessary at SSAB hearings, the following practices are recommended:

1. Depending on the nature of the appeal, the director will designate a staff person to represent the Department at an SSAB hearing.

2. When the director or designate is advised that the appellant will be represented by legal counsel, the director or designate should review the case and determine:
   1. if the Department's solicitor should be consulted; and
   2. once consulted, if the solicitor should be present at the hearing.

1. determine whether to have the solicitor present at the hearing (if possible, prior to consulting with the solicitor); and
2. advise if the appellant will be represented by legal counsel and if the appeal may have implications to existing policy.

6.10.6 DISCLOSURE OF APPEAL DOCUMENTATION

6.10.7  DECISIONS OF THE SOCIAL SERVICES APPEAL BOARD

Allowed Appeals

The SSAB may allow an appellant's appeal or may allow it and vary the director's decision by making any decision that the director was authorized to make. When an appeal has been allowed by the SSAB the order of the SSAB must be implemented. The director must within five working days of the date of the order implement the order and report this to the Executive Director of Adult and Children's Programs, to the Executive Director, Employment and Income Assistance Programs and to the Team Leader, Service Delivery Support using the prescribed format.

Appeal Decisions with a Recommendation

The SSAB may refer the matter under appeal back to the Department for further consideration in accordance with a recommendation. The director must consider the recommendation and within three working days of the date of the order provide the Executive Director of Adult and Children's Programs, and the Executive Director, Employment and Income Assistance Programs and the Team Leader, Service Delivery Support with a proposal (using the prescribed format) as to whether or not the recommendation should be implemented. One of the Executive Director's will provide direction to the director who must notify the client of the decision within ten working days of the SSAB's order.

6.10.8 REQUESTS FOR REVIEW OF THE SOCIAL SERVICES APPEAL BOARD (SSAB) DECISION

The appellant or the director may request a reconsideration of an SSAB order, and the SSAB may reconsider its order on its own initiative.

Requests from an appellant for a reconsideration of an order will not be challenged by the Department. When advised by the SSAB that such a request has been granted, the director must provide a report to the SSAB, within its requested timeframe.

When an appeal has been allowed and the director proposes that the SSAB be asked to reconsider its order, the director should submit a recommendation, using the prescribed format, to the Executive Director of Adult and Children's Programs and to the Executive Director, Employment and Income Assistance Programs and to the Team Leader, Service Delivery Support within five working days of the date of the order. One of the Executive Directors will provide direction as to whether or not to proceed with the request to the SSAB.

Generally, a proposal for a reconsideration request should be based on one of the following reasons: (a) the decision appears to be clearly outside of the legislation, (b) the decision clearly seems to be contrary to EIA's written policy, (c) the discretion is outside of the normal range of discretion afforded the designated officer within the policy, (d) there is new evidence that was unavailable at the time of the original hearing, (d) it appears that the original panel did not permit relevant evidence to be heard, (e) it appears that an important aspect of evidence may have been factually misunderstood (this does not include a disagreement respecting interpretations or the weight given to the evidence), or (f) there is a question of the SSAB's jurisdiction.

For further information on the reconsideration of a SSAB order see section 22 of The Social Services Appeal Board Act and the SSAB's Information Bulletin on its procedures.

6.10.9 EXTENSION OF THE TIME LIMIT FOR FILING AN APPEAL

In accordance with section 12(3) of The Social Services Appeal Board Act, the Social Services Appeal Board (SSAB) may grant an extension to the 30 day time limit for filing an appeal. An extension may be granted either before or after the time limit expires. The appellant's request for an extension must provide the reason(s) the extension is required. The SSAB will provide the director with an opportunity to comment on the request for an extension. In most, but not all situations, the director will not challenge the request for an extension. However, situations in which the director may challenge the request for an extension include: when the appellant has filed but withdrawn an appeal on the same issue, when the same issue has been previously reviewed by the SSAB and there is no new relevant information, or when there has been a considerable passage of time (typically this would be in excess of 6 months) and there is no apparently convincing reason for the appeal not to have been filed.

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