Review process

Steps in processing an application for review

First, the office that rendered the decision checks to ensure that the decision in question was made correctly. At this point, the decision can be amended if your application is justified.

If the dispute cannot be settled at this stage, your application will be forwarded to a review office, which will study your application for review and render a decision.

If your application involves a limited capacity for employment due to health reasons, it will be forwarded to the medical review office and examined by:

• A committee made up of a physician and a professional in the social sector (in the case of a severely limited capacity for employment)
  or
• A physician only (in the case of a temporarily limited capacity for employment).

The purpose of the review of your application by the committee or physician is not to question the diagnosis provided by the attending physician in the medical report you provided. The purpose is to help us fully understand your condition and the resulting limitations in order to make a decision that complies with the Individual and Family Assistance Act.

Review offices are completely independent from the office that rendered the initial decision. Your application for review will be processed fairly and confidentially.

Can I take part in the review process?

Yes. You will have the opportunity to be heard in a telephone interview, provide documents to complete your file, and supply any information you deem necessary to defend your point of view.

You have the right to be represented by a layer and to be accompanied or assisted by this person or any other person or organization of your choice.

When and how will the review decision be made?

Applications for review are processed diligently. For instance, in matters related to the social assistance or social solidarity programs, if the decision you are contesting caused your regular benefit to be cancelled or reduced by more by than 50%, the review office must hand down its decision within 10 business days of receiving the review application or no later than 10 business days after you express your point of view or produce your documents, if you have asked for additional time to do so. If not, the original benefit amount will be reinstated pending the decision.

All review decisions will be mailed directly to you. A copy will also be sent to your attorney or, if you so request, to the person or organization that helped you file the application for review. The office in charge of your file will also receive a copy of the review decision and must apply it and pay any amounts owing, if applicable.