Appeals Commision

Notice of Appeal

ATTENTION: Once you start to complete the Notice of Appeal application, you will NOT be able to save the information and come back to submit it later. It will not save or be submitted until you click the SUBMIT button.

Please see Practice Guideline #1 – Filing an Appeal for information that will help you complete your application.

Please make sure you have the items below before starting the application:

  • an email address; and
  • The Notice of Representation form if you have a representative, in either JPEG or PDF format.
    Note: The form must be signed and dated by the person being represented within two (2) years of being submitted to the Appeals Commission.

You have the option of representing yourself or finding someone to help with an appeal to the Appeals Commission.  

 A representative is someone who is authorized, in writing, to act on your behalf (preparing your appeal and making arguments during your hearing).

You will need to provide your representative with written permission to get a copy of your file and act as your representative.

Notice of Representation form:

The Notice of Representation form gives us permission to discuss your appeal with your representative.  

After you have a chosen a representative, you need to sign a Notice of Representation form and send it to the Appeals Commission.

Please submit a complete Notice of Representation form. 

  • The form must be signed by the person who is being represented.
  • The date on the form must be no more than 2 years earlier than the date the form is submitted.

Please complete the 'Notice of Representation' form. This form must then be signed and dated before uploading. The form must be signed and dated by the person being represented within two (2) years of being submitted to the Appeals Commission.

Upload the 'Notice of Representation' form in either PDF or JPEG format.

I am appealing the following Dispute Resolution and Decision Review Body (DRDRB) decision(s):

Claim/ Account #
Date of WCB Review Body decision/WCB determination
Attach a copy of the decision/determination

Enter the appeal issue(s) with the page number of the decision relating to the issue:

Issue #
Issue description*
Page # of decision issue found on*

Examples of accommodations can include but are not limited to the need for a chair fitted with a back brace, the support of a service animal, and/or extra breaks during the hearing. If you need any accommodations, please tell us in the space provided below, and you will be contacted to discuss any reasonable accommodation the Appeals Commission can offer.

Please use this section to provide any additional information you feel the Appeals Commission needs to process your Notice of Appeal.

You can type the information or upload a file in either PDF or JPEG format.

You may attach any additional documents or submissions you believe need to be included with your Notice of Appeal. Please note, you will be given additional opportunities to submit documents before your hearing. Your appeal will be assigned to an Appeals Officer who will contact you with further instructions

A representative may submit this application only if they are authorized as a representative in this appeal. The appellant can authorize a representative by completing the Notice of Representation section of this application form or submitting a Notice of Representation form to the Appeals Commission.

By my clicking SUBMIT on the online form, I appeal the issue(s) in the decision(s) or determination described in my application.