Policies and Procedures- Appeals

Apl-1 If a claimant is not satisfied with the final decision of the compensation panel, the claimant may appeal the decision to the appeal board (BCA Board of Directors).

Apl-2 The appeal must be submitted within 60 days of the communication of the panel decision to the claimant. The appeal board may extend the time limit for good cause.

Apl-3 If a claimant expresses a wish to appeal the compensation panel’s decision, the claims consultant will meet with the claimant to review the appeal process, the availability of the claims consultant to assist the claimant, and the possible costs involved. If the claimant decides to proceed with the appeal, they will sign a notice of appeal form (see BCA 18 & 19).

Apl-4 A letter (see BCA 20) to the claimant will be sent confirming our receipt of the appeal.

Apl-5 Upon receipt of the claimant’s intention to appeal the panel’s decision, the BCA staff will contact the BCA Board chair informing them of the appeal (see BCA 21) with a copy of the notice to Board members.

Apl-6 The claim file will be sent to each member of the Appeal Board (BCA Board Members) for their review at least one week previous to the meeting of the Appeal Board.

Apl-7 The Appeal Board may make the decision on the appeal based solely on the record of the claim and documents submitted with the appeal. The Appeal Board is not required to conduct a hearing or take testimony, but may do so if it so chooses.

Apl-8 The Appeal Board shall review the decision of the Compensation Panel and may overrule the decision only if the Appeal Board determines the decision of the Compensation Panel is arbitrary and capricious. The Appeal Board will refer to the BCA Compensation Panel Standards for Eligibility and Compensation in their appeal decision.

Apl-9 The Appeal Board shall complete its decision within 60 days of the filing of the appeal with the Appeal Board.

Apl-10 If the Appeal Board agrees with the Compensation Panel’s decision regarding eligibility, a letter informing the claimant of the decision will be sent to the claimant (see BCA 22). The Appeal Board will inform the claims consultant working with the claimant and the Program Director of their decision before the letter is sent to the claimant. The claims consultant and the Program Director will discuss what supports may be available for the claimant, and if the information should be provided directly to the claimant by the claims consultant or a support professional.

Apl-11 If the Appeal Board overturns the Compensation Panel’s decision regarding eligibility, a letter informing the claimant of the decision will be sent to the claimant (see BCA 23) and the claim will be referred back to the Compensation Panel to determine the amount of compensation to be awarded. The Appeal Board will inform the claims consultant and Program Director of their decision before the letter is sent to the claimant.

Apl-12 If the Appeal Board agrees with the Compensation Panel’s decision regarding the amount of compensation to be awarded, a letter informing the claimant of the decision will be sent to the claimant (see BCA 24). The Appeal Board will inform the claims consultant and Program Director of their decision before a letter is sent to the claimant.

Apl-13 If the Appeal Board overturns the Compensation Panel’s decision regarding the amount of compensation to be awarded, a letter informing the claimant of that decision and the amount to be awarded will be sent to the claimant (see BCA 25). The Appeal Board will inform the claims consultant and Program Director of their decision before a letter is sent to the claimant.

Apl-14 The decision of the Appeal Board is final and is not appealable to any court or other authority.