Overpayment Recovery – Compensation
Effective date: November 1, 2016
Application: All claims.
Policy subject: Benefits - General
To establish guidelines for recovering overpayments.
Debtor means a person that receives an overpayment.
Overpayment means a compensation payment greater than what the debtor is entitled to receive under The Workers’ Compensation Act, 2013 (the “Act”), any other former Acts, or Workers’ Compensation Board (WCB) policy.
- The Act authorizes the WCB to collect overpayments (Section 112).
- Any money due the WCB may be set off against any compensation that may be or that may become payable to the person indebted to the WCB (Section 113).
- The Act permits WCB to issue an order for the payment of money owed under the Act and such order may be filed with the local registrar of the Court of Queen’s Bench and is enforceable as a judgment of the Court (Section 170).
- If a person knowingly provides false or misleading information to the WCB, the Act directs that the person is guilty of an offence and is liable on summary conviction to a fine of not more than $1,000 (Section 180).
- An overpayment is considered a debt owed to the WCB. Except as otherwise provided in this policy, all overpayments will be pursued for recovery, including overpayments made to the following:
- Earnings loss benefits.
- Travel and sustenance expenses.
- Annuity amounts.
- Former Act pensions.
- Permanent Functional Impairment (PFI) awards, and
- Any other payments made under The Workers’ Compensation Act, 2013 or The Workers’ Compensation Act, 1979.
- Overpayments resulting from the following circumstances are not normally subject to recovery; however, each situation will be decided on its individual merits and justice:
- A decision is reversed as the result of new information that was not available or which the debtor could not have known they were expected to provide at the time of the original decision (e.g., original decision made in good faith but new medical information received establishes a condition not known at the time of the original decision), or
- A decision originally based on best judgment or extension of the benefit of doubt is reversed (per POL 23/2014, Reversing Decisions) because that decision is subsequently seen to have been improper or unreasonable.
- Legal recovery efforts will follow the time limits set in the limitations of actions legislation in force when the:
- Overpayment occurs, or
- WCB discovers the overpayment.
- In all cases, the collection of overpayments will be pursued by every cost effective, legal means available, while treating all involved with dignity and fairness. WCB will consider the financial impact of the overpayment recovery on the debtor and will make reasonable effort to avoid creating undue financial hardship, except when alleged fraud or a breach of the Act is involved. For example, overpayments may be collected by installments to minimize hardship caused to the debtor.
- When an overpayment is being pursued for recovery, WCB staff will make every attempt to reach agreement with the debtor as to the methods and rates of repayment, but such agreement is not necessary to proceed with collection efforts.
- Where overpayment recovery efforts are unsuccessful, the WCB may set off overpayment debts against present and future entitlements.
- If there is an outstanding overpayment made to a worker on a claim and that claim is reopened or a new claim for the same worker is established, the overpayment will be recovered from that worker; or
- Overpayments may be recovered from the worker’s annuity. However, unless otherwise ordered by the Board Members, there will be no recovery from an annuity account until the annuity becomes payable (when the worker reaches age 65 or at the time of death if the worker dies prior to age 65).
- Decisions concerning the establishment of an overpayment are subject to reconsideration and/or appeal (POL 21/2013, Appeals – Claims and POL 22/2013, Appeals – Board Appeal Tribunal).
- If a worker knowingly provides false or misleading information that leads to an overpayment, POL 26/2013, Fines and Penalties may apply.
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