Reconsideration

Overview

The ministry recognizes that assessing eligibility for assistance can be a complex and sensitive issue, and that differences of opinion may arise. The reconsideration process has been established to provide a person with an opportunity to have the ministry’s original decision reconsidered. The reconsideration decision is a new and final ministry decision and is a person’s last opportunity to submit new evidence.

Policy

Effective: October 1, 2005

For details about the reconsideration process, see the Reconsideration and Appeal brochure. [see Additional Resources]

The ministry prominently displays pamphlets, posters, and information about the rights of reconsideration in the reception area of each Employment and Assistance Office.

A copy of the ministry's Reconsideration and Appeal brochure must also be provided when a person makes an initial application for assistance.

Effective: November 3, 2006

A person may request that any of the following ministry decisions be reconsidered:
 

  • a decision that results in a refusal to provide income assistance, disability assistance, hardship assistance, or a supplement to or for someone in the person’s family unit
     
  • a decision that results in a discontinuance or reduction of income assistance, disability assistance, or a supplement provided to or for someone in the person’s family unit
     
  • a decision on the amount of a supplement provided to or for someone in the person’s family unit if the amount is less than the lesser of the following:
    • the maximum amount of the supplement under the regulations, and
    • the cost of the least expensive and appropriate manner of providing the supplement
       
  • a decision respecting the conditions (requirement to enter into or decision to suspend, amend, cancel, or specify conditions) of, or noncompliance with, an Employment Plan

A decision is made if one or more of the following apply:
 

  • the request relates to an issue of credibility
  • the request requires a choice between two competing interpretations of the legislation
  • the request requires a choice of how to apply the legislation to the particular facts in circumstances where the outcome is not automatic

The ministry has jurisdiction over determining whether there is a right to reconsideration.

There are some decisions that cannot be reconsidered, for example, a disagreement about administrative practices such as the method of payment.

Requests for reconsideration must be submitted and the decision reconsidered within the time limits and other requirements set out in the Employment and Assistance Regulation and the Employment and Assistance for Persons with Disabilities Regulation.

Reconsideration is not a review of the ministry’s original decision, but is a new and final ministry decision for the client. This is the client's last opportunity to submit new evidence to the ministry. The reconsideration is conducted based on the legislation and regulations.

An applicant or recipient who is dissatisfied with a reconsideration decision may appeal the decision to the Employment and Assistance Appeal Tribunal, subject to the time limits and other requirements set out in the Employment and Assistance Act and the Employment and Assistance for Persons with Disabilities Act and the regulations under the acts. The Tribunal has jurisdiction to determine appealability. [For more information, see Related Links – Appeal.]

No Change of Circumstances

If a person reapplies for income assistance, disability assistance, hardship assistance, or a supplement and a right of appeal has been exercised after the eligibility of the person’s family unit has been determined, and the Tribunal’s decision on the appeal has been implemented, no right of reconsideration exists for a second or subsequent application unless the circumstances relating to the determination of the eligibility have changed.

Effective: January 25, 2016

[see also Related Links – Appeal – Policy – Appeal Supplement]

[Section 54 of the Employment and Assistance Regulation and section 52 of the Employment and Assistance for Persons with Disabilities Regulation reference the “Reconsideration or Appeal Supplement.” In addition to the supplement’s full name, for the purposes of this topic, the term “reconsideration supplement” is referenced to reflect the stage the client is at in the reconsideration and appeal process at the time the supplement has been requested.]

A reconsideration supplement may be provided to a family unit for whom the ministry has made a decision to reduce or discontinue income assistance, disability assistance, or a supplement if the ministry receives a completed (signed) Request for Reconsideration (HR0100) form relating to that decision.

The reconsideration supplement is limited to the amount of the discontinued income or disability assistance or supplement, or to the amount reduced in respect of income or disability assistance or a supplement. (The intention of the supplement is to continue the level of income or disability assistance or supplement that existed prior to discontinuation or reduction, and not place the client in a better or worse position.) In addition, all rules of eligibility apply to provision of the supplement, and the supplement may be reduced or discontinued as appropriate if affected by factors that may not be related to the original reason for discontinuation or reduction.

To be eligible to receive the supplement, the recipient must agree in writing to repay the amount received if the final decision denies the recipient’s request. [For more information see Procedures – Reconsideration Supplement.] In the case of a couple, both the key player and spouse should sign the Promise to Repay – Benefit While Awaiting Reconsideration/Appeal Decision form (HR2737). However, if circumstances beyond the control of either recipient prevent both from signing the HR2737, the supplement may be issued on the basis of a single signature from either the key player or spouse.

The reconsideration supplement may be provided for the shorter of the following:
 

  • the period between the date a request form is delivered and the date that the reconsideration is determined, and the period between the date that the income assistance, disability assistance, or supplement was reduced or discontinued and the date that the reconsideration is determined

Repayment of a Reconsideration Supplement

If the reconsideration decision is that the person is eligible for the discontinued or reduced income assistance, disability assistance or supplement, they do not need to repay the reconsideration supplement.

If the reconsideration decision is that the person is eligible for part of the discontinued or reduced assistance, the person must repay only that portion of the reconsideration supplement which the reconsideration decision confirmed they were not eligible to receive.

If the reconsideration decision is that the person is not eligible for the discontinued or reduced income assistance, disability assistance or supplement, the person must repay the full amount of the reconsideration supplement.

[For more information, see Related Links – Recoveries – Policy – Promise to Repay – Recovery of Repayable Benefits at a Future Date.]

If the client requests an appeal to the Employment and Assistance Appeal Tribunal in relation to a decision to reduce or discontinue income assistance, disability assistance, or a supplement by submitting the applicable completed forms, an appeal supplement may be provided. [For more information, see Related Links – Appeal – Policy – Appeal Supplement]

Effective: October 1, 2005

The duty to act fairly is the most basic component of administrative law. For the reconsideration process to meet the principles of fairness, it is essential that:
 

  • clients are informed of their right to have their case reviewed
  • clients have the opportunity to present their case and hear the case against them
  • both parties (the ministry and the appellant) have the same information available to them about the case being reconsidered
  • the person reviewing the matter is not a party to the original decision being reconsidered
  • the person reviewing the case is impartial and independent of the outcome
  • clients are informed of all reasons a decision was made

Effective: November 9, 2012

At any time before a request for reconsideration is made, a person may request and will be provided copies of all documents and information on which the ministry decision was based. The information will be severed in accordance with Freedom of Information and Protection of Privacy legislation. A formal request under Freedom of Information and Protection of Privacy legislation is not required by the client. Where the person requesting the information is not the client, proper authorization by the client will be required prior to its release.

[For more information on Freedom of Information and Protection of Privacy see Related Links – Information Security and Privacy (FOIPPA).]

Effective: February 27, 2017

When a person requests a reconsideration, the ministry must provide the person with an Employment and Assistance Request for Reconsideration (HR0100) form or message as soon as possible. The HR0100 must be provided in response to every request for reconsideration, even if the request is made outside the 20 business day timeline and/or the case is closed. A separate HR0100 is completed for each decision being reconsidered. A Reconsideration Officer will determine if reconsideration is available. A person who wishes to request reconsideration of a decision must deliver a completed and signed HR0100 to a local ministry office (or message if sent via My Self Serve) within 20 business days after the date the person was notified of the decision. A person who wishes to request reconsideration of a decision must deliver a completed and signed HR0100 to a local ministry office (or sent via My Self Serve) within 20 business days after the date the person was notified of the decision. If a request for reconsideration is not received within 20 business days after the person was notified of the ministry decision, the ministry decision is deemed to be accepted. If an HR0100 is received after 20 business days have elapsed, it should be sent to the Reconsideration and Appeals Section with a description of any extenuating circumstances which prevented its timely return. The Reconsideration Officer will determine whether or not the decision may be reconsidered.

[For more information on responding to a request for reconsideration on a closed case, see Procedures – Completing the Request for Reconsideration.]

If a person wishes to reapply for income assistance, disability assistance, hardship assistance, or a supplement within the 20 business days after a decision was made, where the decision is open to the reconsideration process, the person must exercise the right to request a reconsideration or allow the 20-business-day time period to lapse prior to reapplying.

Any person can request a reconsideration. The right to request a reconsideration is not restricted to applicants or recipients, but can also include persons such as advocates or trustees.

A person may request the assistance of an advocate in completing the HR0100.

A person making a reconsideration request must ensure that all information and documentation they wish the ministry to consider is with the ministry at the time of reconsideration. This is the final opportunity to introduce new information or documentation relating to the decision being reconsidered. No new information can be accepted after the reconsideration decision has been made.

After the ministry receives the completed HR0100,signed by the applicant or recipient:
 

  • a reconsideration decision must be made and mailed (or sent via My Self Serve) within 10 business days.
  • a person can request an extension of 10 additional business days if more time is needed to obtain and submit information before the reconsideration decision is made. The ministry can request an extension of 20 additional business days if more time is needed to clarify any of the information provided before the reconsideration decision is made.

After the reconsideration decision has been made, no new information can be accepted by the ministry and the ministry has no authority to grant a request for an extension.

Effective: February 27, 2017

Reconsiderations for all original ministry decisions are conducted by the Reconsideration and Appeals Section, SDSI-CFD Legislation, Litigation and Appeals Branch.

The reconsideration is conducted based on the legislation and regulations. A reconsideration decision must be made and mailed (or sent via My Self Serve) within either:
 

  • 10 business days after receiving the completed HR0100, or
  •  when a person has requested or agreed to an extension, within 20 business days after receiving the completed HR0100, signed by the client.

A copy of the reconsideration decision (HR0101) will be sent to the applicant or recipient. In the case of a denial, the package sent to the client will also include all other submissions, information, and records that were before the ministry when the decision was being reconsidered  This package constitutes the appeal record. In the event of an approval, this additional information will not be automatically included, but may be obtained upon request. [For more information, see Related Links – Appeal – Employment and Assistance Appeal Tribunal – Appeal Record.]

The reconsideration decision does not uphold or reverse the original decision. Rather, the reconsideration decision is a new decision based on a full review of all the information, and will do one of the following:
 

  • approve
  • deny
  • or rescind (in the case of a person with persons with disabilities designation only).

Reconsideration Decisions Made Outside of Timelines

When the ministry has made a reconsideration decision outside of legislated timelines as indicated below:
 

  • 10 business days after receiving the completed HR0100, or
  • where a person consents to an extension requested by the ministry or the ministry consents to an extension requested by the client, within 20 business days after receiving the completed HR0100,

staff must ensure the client does not experience any loss as a result of the late decision. This includes reconsideration denials made outside of legislated timelines which are rescinded at appeal.

Example

  • The client submitted a request for reconsideration of the decision to deny PWD designation. The reconsideration decision was due September 25, 2012, and no extension was requested. Legislation provides that applicants for PWD designation are eligible to receive disability assistance on the first day of the month after the date of the reconsideration decision.

    A decision to approve PWD was not made by the Reconsideration Officer until October 10, 2012, which would result in the effective date for PWD designation being November 1, 2012. The client would lose a month of PWD eligibility due to the late decision. The effective date of the reconsideration must be the date the decision was due – September 25, 2012, and the effective date of eligibility for PWD designation is October 1, 2012 – the date the client would have been eligible if the decision had been made within legislated timelines.

Effective Date of Eligibility – Reconsideration Decision

[see also Additional Resources – Effective Date of Eligibility – Workflow Chart]

When the reconsideration decision approves the client’s eligibility, the effective date of eligibility is dependent on the type of assistance applied for.

In cases where the reconsideration decision is not completed within legislated timelines, the effective date of eligibility would be determined using the effective date of eligibility had the decision been made within timelines. [For more information, see policy above – Reconsideration Decisions Made Outside of Timelines.]
 

  • New applicants for income assistance are eligible for income assistance retroactive to the date of their application.
  • Applicants for disability assistance, who were already designated as a person with disabilities and are re-applying for disability assistance, are eligible for disability assistance retroactive to the date of their application for disability assistance.
  • Recipients who have had income assistance or disability assistance discontinued or reduced are eligible for assistance retroactive to the date of the reduction or discontinuance. If an appeal supplement has been issued, this is not repayable and must be considered to have been paid in place of the discontinued assistance or the amount by which the assistance was reduced.
  • Applicants who qualify as a person who has persistent multiple barriers to employment (PPMB) are eligible to receive income assistance at the PPMB rate on the first day of the month after the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the first day of the month after the date the reconsideration decision was due.
  • Recipients who have their PPMB status rescinded are eligible to receive income assistance at the PPMB rate on the first day of the month after the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the first day of the month after the date the reconsideration decision was due.
  • Applicants for disabilities designation are eligible to receive disability assistance on the first day of the month after the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the first day of the month after the date the reconsideration decision was due.
  • New applicants for a supplement are eligible for the supplement as of the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the date the reconsideration decision was due.
  • Recipients who have had a supplement discontinued or reduced are eligible for the supplement as of the date of the reconsideration decision. If an appeal supplement has been issued, this is not repayable and must be considered to have been paid in place of the discontinued supplement or the amount by which the supplement was reduced.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the date the reconsideration decision was due.

Procedures

Effective: February 27, 2017

Timelines for Delivering a Request for Reconsideration

A person who wishes to request reconsideration of a decision must deliver the HR0100 within 20 business days after the date the person was notified of the decision.

If the HR0100 is received outside this timeline the ministry must still accept the HR0100 and forward it to the Reconsideration and Appeals Section, SDSI-CFD Legislation, Litigation and Appeals Branch. A Reconsideration Officer will determine if reconsideration is available. The person should be advised that they may wish to include an explanation of any extenuating circumstances surrounding the delay in submitting the HR0100.

New Information Included with a Request for Reconsideration

As part of the reconsideration process, the ministry must accept any information submitted by the person in support of the decision being reconsidered by the ministry (subject to the time limits and other requirements set out in the acts or regulations).

Effective: February 27, 2017

When a person requests a reconsideration, the worker should initiate the reconsideration Service Request on the case in the system and generate the HR0100, or denial message. Section 1 of the HR0100 will be auto-completed at the time that the form or message is generated. The worker should review section 1 and complete section 2 of the HR0100, ensuring that all fields (e.g., client information, case number and office information) are filled in accurately, if not system generated. This includes describing the decision made by the ministry and citing the legislation and/or policy under which the decision was made. (It is important that in describing the decision, the worker fully states the decision and provides the substantive reasons for it – this does not mean simply stating a conclusion.)

Substantive Reasons

A substantive reason is a complete response that answers the following: what was requested, what was denied, what legislative criteria (criterion) were (was) not met and why not? The reasons must reference the specific legislated eligibility criteria (criterion) that are (is) not met and specify the circumstances/facts the client presented, or failed to present, that the ministry assessed and determined were the reason the person did not meet the legislated criteria.  

If the request is for a specific time period or a specific request, the decision should also include this specified time period or specifics of the request.

Example 1
A client's assistance is reduced in the month of January 2010. Any decision to reduce a client's assistance must include specific details regarding the information and/or documentation the ministry considered that led to that decision. The specific time period must be included as part of the decision if the assistance was requested for a specific time period. The decision must also include , the legislative authority for reducing assistance and the information/documentation the ministry considered in making the decision to reduce the client's assistance.

Example 2
If a client has requested 6 massage therapy visits and is denied, the decision should include the specific number of visits that were requested and denied. The decision must include a complete description of the legislated criteria that must be met to be eligible for massage therapy visits, the facts that were assessed, and the reasons (how or why) those facts support a denial, and the legislative criteria that were not met and therefore resulted in a refusal to provide 6 massage therapy visits.

When recording the date the requestor was informed of the decision, the worker must ask the person on which date he/she received the notification of the decision. That date will be the start date for the 20 business day timeline.

If the requestor had received written reasons for the original decision on the HR3318A/B decision letter template, the ministry worker must attach the HR3318A/B to the HR0100, and include copies of all information considered in making the original decision. In section 2 of the HR0100, the worker should identify that the HR3318A/B has been attached and provide the appendix number for reference. The worker should list all other attachments provided and then sign and date section 2.

Once sections 1 and 2 of the HR0100 have been completed, by either staff or system generated, a copy of all information on which the decision was based, including the relevant legislation, is attached and provided to the requestor. A separate HR0100 is completed for each decision being reconsidered.

The information will be severed in accordance with Freedom of Information and Protection of Privacy legislation. Third party information that does not impact the decision should not be included. Where the person requesting the reconsideration is not the client, proper authorization by the client will be required prior to its release.

[For more information on Freedom of Information and Protection of Privacy see Related Links – Information Privacy and Security (FOIPPA).]

The person must complete sections 3 and 4 of the HR0100 and return it to the ministry within 20 business days of being notified of the decision being reconsidered. MYSS users will complete these sections by replying to a questionnaire presented to them in MYSS.

The worker may provide the person with the names and addresses of local support agencies or non-governmental organizations that may be able to assist the person with completing the request for reconsideration.

Submissions and other documentation may be accepted, either with the completed HR0100 or after the HR0100 has been delivered, to support the request for reconsideration as long as the reconsideration decision has not yet been made.

After the ministry receives the completed HR0100, a reconsideration decision must be made and mailed (or sent via My Self Serve) within 10 business days. A person can request an extension of 10 additional business days if more time is needed to obtain and submit information. The ministry may request a 10 business day extension to seek clarification about information submitted at reconsideration by a person or on a person’s behalf. If the extension is granted, the reconsideration decision must be made and sent within 20 business days of receiving the completed HR0100.

After the reconsideration decision has been made, no new information can be accepted by the ministry and the ministry has no authority to grant a request for an extension. 

Effective: February 27, 2017

The request for reconsideration may be delivered electronically, in person, by mail or by fax to the ministry or the Reconsideration and Appeals Section, SDSI-CFD Legislation, Litigation and Appeals Branch.

Upon receiving an Employment and Assistance Request for Reconsideration (HR0100) at a local office, the ministry will date-stamp it and review it for completeness, and will ensure it has been signed and dated. MYSS users will complete these sections by replying to a questionnaire presented to them in MYSS.

The complete HR0100, along with any attached submissions or additional documentation, must be attached to the reconsideration service request in the system and immediately forwarded to office 063 (Reconsideration Branch) to be reconsidered.

Ensure that a reconsideration initiation activity plan has been launched in the system, as it is crucial that the ministry is able to confirm the date the HR0100 was received and processed.

If the recipient has submitted the HR0100 to request reconsideration of a decision that discontinued or reduced assistance, the recipient should always be informed when a reconsideration supplement may be provided [see Procedures – Reconsideration Supplement].

Effective: February 27, 2017

The reconsideration is conducted based on the legislation and regulations. A reconsideration decision is made and sent within either:
 

  • 10 business days after receiving the completed HR0100, or
  • where an extension has been agreed to, within 20 business days after receiving the completed HR0100.

A person’s request for an extension may be made electronically, orally or in writing, and at the same time as, or after, a signed HR0100 has been delivered. However, the ministry must receive the request for extension before the reconsideration decision has been made. The HR0100 and request for extension must be immediately forwarded to office 063 (Reconsideration Branch) in the system. It is the responsibility of the Reconsideration and Appeals Section to review the request for extension and determine whether an extension will be granted. In the case of an electronic request, the extension will be immediately granted. Extension requests will generally be accommodated by the ministry.

In cases where an extension is granted, a note should be added to the reconsideration service request outlining the date the HR0100 and extension request were received, whether the extension was granted, and the decision due date.

There are two general situations in which an extension may be granted:

When the Person Requests Additional Time

After delivering the HR0100, a person or the person’s advocate may request an extension of 10 additional business days if more time is needed to obtain and submit information before the reconsideration decision is made.

Example 1
Many requests for reconsideration involve complex medical issues. A client may wish to submit new evidence from a medical practitioner to be considered at reconsideration, but is unable to meet with the medical practitioner to obtain and submit documentation within 10 business days after submitting the completed HR0100.

Example 2
A person wishes to obtain further information from an advocate, but the advocate is not available.

In both circumstances above, it would be appropriate for the ministry to grant the person’s request for an extension of an additional 10 business days, at the end of which time the reconsideration decision must be made and sent.

When the Ministry Wishes to Seek Clarification

When the ministry wishes to seek clarification about information submitted at reconsideration by a person or on a person’s behalf, an extension of 10 additional business days may be granted when the person provides consent.

The Reconsideration Officer should seek consent of the person requesting the reconsideration if clarification is required in order to make a fair and fully informed reconsideration decision.

The person or the person’s advocate must provide their consent, electronically, orally or in writing, before an extension is available to the ministry. Without consent the ministry will be required to make and mail the reconsideration decision within 10 business days after receiving the completed HR0100.

Example 1
Where a person has submitted a new medical report, it may be necessary to contact the medical practitioner to seek clarification about that information in order to make a decision that fully considers the new medical report.

Example 2
While conducting the reconsideration, the Reconsideration Officer may be uncertain if there is documentation missing from the submission (ie. pages appear to be missing) or some of the relevant information provided with the request for reconsideration is not legible.

In both circumstances above, it would be appropriate for the ministry to ask that the person requesting the reconsideration consent to extending the deadline by an additional 10 business days, at the end of which time the reconsideration decision must be made and sent.

Effective: January 25, 2016

[Section 54 of the Employment and Assistance Regulation and section 52 of the Employment and Assistance for Persons with Disabilities Regulation reference the “Reconsideration or Appeal Supplement.” In addition to the supplement’s full name, for the purposes of this topic, the term “reconsideration supplement” is referenced to reflect the stage the client is at in the reconsideration and appeal process at the time the supplement has been requested.]

A reconsideration supplement is only available when income assistance, disability assistance or a supplement is either discontinued or reduced. It is not available when income assistance or disability assistance has been denied. It is also not available when hardship assistance is denied, discontinued or reduced.

The supplement enables a recipient to continue to receive assistance on the same basis as before it was discontinued or reduced while the decision is being reconsidered. The reconsideration supplement can be issued up to the time that the reconsideration is determined unless the client requests an appeal, in which case it may be continued until the appeal has been decided [for more information on appeal supplements see Related Links – Appeal – Procedures]. The purpose of providing the supplement is to put a recipient in the same position that the recipient would have been in had it not been for the decision to discontinue or reduce assistance. The amount of the supplement is limited to the amount of the assistance that was discontinued or the amount by which it was reduced.

Before issuing the supplement, ensure the recipient has completed and returned the HR0100.

The recipient must also sign and submit a Promise to Repay form (HR2737) [see Forms and Letters] prior to the supplement being issued. In the case of a couple, both the key player and spouse must sign the Promise to Repay - Benefit While Awaiting Reconsideration/Appeal Decision form (HR2737). However, if circumstances beyond the control of either recipient prevent both from signing the HR2737, the supplement may be issued on the basis of a single signature from either the key player or spouse. The Promise to Repay form must be signed every time the supplement is issued before it is issued. [see Extension of Reconsideration Decision Timeline]

When issuing the reconsideration supplement, the ministry worker should create a notification on the case to ensure that the debt is added to the case if the outcome of the reconsideration and appeal process is not in the client’s favor.

If the reconsideration decision does not approve the recipient’s reconsideration request and the recipient does not appeal the decision to the Employment and Assistance Appeal Tribunal, or the recipient appeals the reconsideration decision to the Employment and Assistance Appeal Tribunal and the Tribunal confirms the ministry decision, the recipient must repay the amount issued as a reconsideration or appeal supplement during the reconsideration and appeal processes. The recipient is required to sign a Repayment Agreement Appeal Benefit form (HR2749) [see Letters and Forms], whereby the recipient acknowledges the debt and agrees to begin immediate repayment of the debt by deduction from the recipient’s monthly assistance. In the case of a couple, both the key player and spouse should sign the Repayment Agreement Appeal Benefit form (HR2749). However, if circumstances beyond the control of either recipient prevent both recipients from signing the HR2749, one signature from either the key player or spouse is sufficient to complete the form

If the Tribunal confirms the ministry decision and, as a result, the recipient is no longer in receipt of monthly assistance, the ministry may recover the amount issued as a reconsideration or appeal supplement through other methods.

[For more information on other methods for recovery, see Related Links – Recoveries – Policy – Methods for Recovery of Assistance.]

Remember: if the recipient has submitted the HR0100 to request reconsideration of a decision that discontinued or reduced assistance, the recipient should always be informed that a reconsideration supplement may be provided.

[For more information on Promise to Repay, see Related Links – Recoveries – Policy – Promise to Repay – Recovery of Repayable Benefits at a Future Date.]

[For more information on Repayment Agreements, see Related Links – Recoveries – Policy – Repayment Agreements – Repayable Benefits by Deduction from Ongoing Assistance.]

Effective: January 25, 2016

Before conducting the reconsideration, the Reconsideration Officer will review the completed HR0100 by applying Part A and Part B as follows:

Part A

Step 1

Is the person's request concerning one of the following:
 

  • a refusal to provide income assistance, disability assistance, hardship assistance, or a supplement to or for someone in the person’s family unit
  • a discontinuance or reduction of income assistance, disability assistance, or a supplement provided to or for someone in the person’s family unit
  • the amount of a supplement provided to or for someone in the person’s family unit and the amount is less than the lesser of the following:
    • the maximum amount of the supplement under the regulations, and
    • the cost of the least expensive and appropriate manner of providing the supplement
  • the conditions (requirement to enter into a decision to suspend, amend, cancel, or specify conditions) of, or non-compliance with, an Employment Plan

Step 2

Has a decision been made? By applying the three-part test, a decision has been made if one or more of the following apply:
 

  • are you required to resolve an issue of credibility?
  • are you required to resolve two competing interpretations of the applicable legislation?
  • do you need to determine how to apply the legislation to the particular facts in circumstances where the outcome is not automatic?

Part B

Step 1

Is the person's request made within 20 business days and on a completed Employment and Assistance Request for Reconsideration (HR0100) form?

Decisions Open to Reconsideration

If the request meets both Part A (Step 1 and 2) and Part B (Step 1), the result being a positive response to both Part A and Part B, the request is reconsidered using the Employment and Assistance Reconsideration Decision (HR0101). [see Forms and Letters] The majority of requests will meet both Part A and Part B.

Decisions Open to Reconsideration but Submitted "Out of Time"

If the request meets Part A (Step 1 and 2), but not Part B, the Employment and Assistance Reconsideration Decision (HR0101) is used because Part A was met, but the request may not be decided because it was submitted outside the allowable time frame.  The Reconsideration Time Limits Exceeded Letter (HR3223) [see Forms and Letters] is to be mailed to the client along with the Employment and Assistance Reconsideration Decision (HR0101).

When determining Part B, consider any extenuating circumstances that may have contributed to the delay beyond legislated timelines. If there are extenuating circumstances, use discretion to determine if Part B is met.

Requests Not Open to Reconsideration

If the request does not meet Step 1 and Step 2 of Part A, the Employment and Assistance Reconsideration Decision (HR0101) is used to respond to the request, but the request will not be decided on its merits as reconsideration is not available.

If Part B is also not met, this should also be addressed in the HR0101 to indicate how the request does not meet the legislated timelines and that the time limit for filing the request has expired.

When responding to a management issue (e.g., an operational issue or matter of practice, policy or procedure), a reference will be included in the HR0101 to refer the matter to the respective Service Quality Manager for review of the management issue and further follow-up.

Example 1
A person's request may concern an operational issue or matter of practice, policy or procedure rather than an eligibility matter, for example, a disagreement about administrative practices such as the method of payment,  a case closure or third party administration of assistance. A request concerning a management issue will not meet Step 1 of Part A, and therefore reconsideration will not be available.  

Example 2
A client has been discontinued from assistance because the ministry has stated that a required form was not submitted. The client states that the form was in fact submitted, but the ministry has no record of this.  The ministry is questioning the client's credibility. As the request concerns a discontinuance of assistance and an issue of credibility must be resolved, this will meet both Step 1 and 2 of Part A, and reconsideration will be available if Part B is also met.

Example 3
The outcome would be automatic, for example, if a recipient of income assistance, who is a family unit size of 1, requests $500 for monthly shelter. The ministry has no choices to select from to make a decision; the monthly shelter amount is $ 375 for a family unit size 1. The result is automatic when one looks at the monthly shelter allowance table set out in Schedule A. The ministry is not required to interpret the regulation to make a determination. In this case, even though the request will meet Step 1 of Part A, it will not meet the three part test – no decision is made – in Step 2 of Part A and reconsideration will not be available.

However, the ministry must review the request carefully, as the request may be to receive a shelter allowance for a family unit size of 2 or more. Where the ministry determines family unit size based on a choice made after reviewing the circumstances, this is not an automatic outcome – the decision was reached either by applying a particular interpretation of the regulation to the facts or by deciding an issue of credibility. In this latter half of the example, under these circumstances both Step 1 and Step 2 of Part A would be met, and if Part B is also met then reconsideration would be available.

Effective: November 9, 2012

When a person submits a request for reconsideration of an eligibility decision involving trusts, and the submission includes new or amended trust documentation, the Reconsideration Officer must forward the documentation to the Litigation Section of the SDSI-CFD Legislation, Litigation and Appeals Branch (LLAB). The documentation will be forwarded to Legal Counsel for an expedited review. The Reconsideration Officer will be notified of the outcome of the review.

[For more information on trusts see Related Links – Trusts.]

Effective: September 1, 2016

There are some types of decisions that cannot be reconsidered. These include, for example, disagreements about administrative practices such as the method of payment. As with all decisions, applicants and recipients should still be offered the opportunity to request a reconsideration and be provided with the HR100, Request for Reconsideration Form. Reconsideration and Appeals Section staff will determine eligibility for reconsideration.

The Community Volunteer Supplement and Camp Fees are not provided under either the authority of the Employment and Assistance for Persons with Disabilities Act or the Employment and Assistance Act. Therefore, the reconsideration and appeal provisions of Section 16 of the Employment and Assistance for Persons with Disabilities Act or section 17 of the Employment and Assistance Act do not apply. The ministry is therefore not able to provide a new decision; however, the case will be reviewed. Applicants and recipients should still be offered the opportunity to request a reconsideration and be provided with the HR100, Request for Reconsideration Form.

Effective: July 29, 2013

Follow these steps when adjudicating Persons with Persistent Multiple Barriers (PPMB) Requests for Reconsideration:
 

  1. Determine that the client has been denied.
    • Ensure that the Denial Letter or message is present in the Request for Reconsideration.
       
  2. Review the completed HR0100 by applying Part A and Part B as indicated in Conducting the Reconsideration
     
  3. Review the case and determine whether or not all relevant documents are included.
    • Relevant documents include:
      • PPMB Checklist
      • PPMB Checklist – Appendix 1
      • Employability Screen
      • Client Employability Profile
      • Employment Readiness Information Questionnaire, if completed
      • Employment Plans
      • Voluntary Participation Plans
      • Medical Report – Persons with Persistent Multiple Barriers
      • Any other relevant information provided from the client’s file or provided by the client unsolicited. Examples include:
        • A letter from a social worker, probation officer, health professional with whom the recipient is involved, which describes circumstances of the client that could impact employability
        • Proof of earnings declared in the last 12 months
      • If all relevant documents are not included, refer the file to the Reconsideration Administrator to request the missing documents from the Employment and Assistance office.
      • Once all documents are included, continue with adjudication of the Request for Reconsideration.
         
  4. Review the reasons for original denial.
    • Identify the denial reasons in the Denial Letter
       
  5. Examine legislative criteria and the Request for Reconsideration, including all relevant information available, to determine whether or not the applicant meets all points of the legislation, and if not, why.
  • The application must meet section 2(2) and either 2(3) or 2(4) of the Employment and Assistance (EA) Regulation.
  1. If the information is unclear or contradictory, contact the appropriate parties (as long as there is client consent, if required, to do so).
    • Examples include contacting the:
      • The original decision maker to clarify denial reasons
      • Medical practitioner to clarify the duration of the medical condition or restrictions arising from the medical condition
         
  2. After making the decision based on legislation, and considering all relevant information available, write the decision.
     
  3. Fill out the decision cover letter, update the reconsideration service request in the system and forward the file to the Reconsideration Administrator for processing.

Effective: February 27, 2017

The reconsideration decision is to be recorded on the Employment and Assistance Reconsideration Decision (HR0101) [see Forms and Letters] and sent (or provided via My Self Serve) to the client in a package containing the HR0101, the Reconsideration Approval Cover Letter (HR3221) OR the Reconsideration Denial Cover Letter (HR3222) [see Forms and Letters] and all other submissions, information, and records that were before the ministry when the decision being reconsidered was made.

This package constitutes the appeal record. [For more information, see Related Links – Appeal – Employment and Assistance Appeal Tribunal – Appeal Record.]

The appeal record will be severed in accordance with Freedom of Information and Protection of Privacy legislation.

[For more information on Freedom of Information and Protection of Privacy see Related Links – Information Privacy and Security (FOIPPA).]

Where the reconsideration decision denies a person's request, the package will also include an Employment and Assistance Appeal Tribunal brochure, which provides information about appeal rights, and a Notice of Appeal to the Employment and Assistance Appeal Tribunal (EAAT001).

When the reconsideration decision is made, the Reconsideration Officer should document the decision on the reconsideration service request.

Effective Dates of Eligibility for Reconsideration Decisions Approving a Request

[see also Additional Resources – Effective Date of Eligibility – Workflow Chart]

When the reconsideration decision approves the client’s eligibility, the effective date of eligibility is dependent on the type of assistance applied for.
 

  • New applicants for income assistance are eligible for income assistance retroactive to the date of their application. Staff will determine eligibility for income assistance as of the date of the application and may need to pro-rate assistance as set out in section 26 and Schedule A of the Employment and Assistance Regulation.
  • Applicants for disability assistance, who were already designated as a person with disabilities and are re-applying for disability assistance, are eligible for disability assistance retroactive to the date of their application for disability assistance. Staff will determine eligibility for disability assistance as of the date of the application and may need to pro-rate assistance as set out in section 23 and Schedule A of the Employment and Assistance for Persons with Disabilities Regulation.
  • Recipients who have had income assistance or disability assistance discontinued or reduced are eligible for assistance retroactive to the date of the reduction or discontinuance. Staff will determine eligibility for income assistance or disability assistance as of the date of reduction or discontinuance. If an appeal supplement has been issued, this is not repayable and must be considered to have been paid in place of the discontinued assistance or the amount by which the assistance was reduced.
  • Applicants who qualify as a person who has persistent multiple barriers to employment (PPMB) are eligible to receive income assistance at the PPMB rate on the first day of the month after the date of the reconsideration decision. Staff will determine eligibility as of the first day of the month after the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the first day of the month after the date the reconsideration decision was due.
  • Recipients who have their PPMB status rescinded are eligible to receive income assistance at the PPMB rate on the first day of the month after the date of the reconsideration decision. Staff will determine eligibility as of the first day of the month after the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the first day of the month after the date the reconsideration decision was due.
  • Applicants for persons with disabilities designation are eligible to receive disability assistance on the first day of the month after the date of the reconsideration decision. Staff will determine eligibility as of the first day of the month after the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the first day of the month after the date the reconsideration decision was due.
  • New applicants for a supplement are eligible for the supplement as of the date of the reconsideration decision. Staff will determine eligibility for the supplement as of the date of the reconsideration decision.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the date the reconsideration decision was due.
  • Recipients who have had a supplement discontinued or reduced are eligible for the supplement as of the date of the reconsideration decision. Staff will determine eligibility for the supplement as of the date of the reconsideration decision. If an appeal supplement has been issued, this is not repayable and must be considered to have been paid in place of the discontinued supplement or the amount by which the supplement was reduced.
    • In cases where the reconsideration decision has been made outside of timelines, staff will determine eligibility as of the date the reconsideration decision was due.