September 2016

6.2 Internal Review and Regional Dispute Resolution

Summary of Directive

An internal review and regional dispute resolution process is available to ODSP employment supports applicants and clients if they disagree with a decision related to eligibility for or the suspension and/or cancellation of employment supports.

Legislative Authority

Section 36 (1), (2) and (3) of the ODSP Act

Intent of Policy

To ensure that applicants and clients have a fair and accessible mechanism for disputing decisions made regarding eligibility for or the cancellation and/or suspension of employment supports.

Application of Policy

Decisions That Can Be Disputed

Applicants or clients may request an internal review or regional dispute resolution review of the following decisions:

  • ineligibility for ODSP employment supports, and
  • cancellation and/or suspension of ODSP employment supports.

All other decisions, including the amount or level of goods and/or services to be provided, are not subject to the internal review and regional dispute resolution processes.

The Internal Review Process

An applicant or client must request an internal review, in writing, within 30 calendar days from the day the decision is received.
Written requests for internal reviews may be submitted by using the Request for Internal Review form 2878, or by a letter signed by the applicant or client.

When the applicant or client is unable to provide a written request within 30 days, the internal review process can be started based on a verbal request, which must be followed up in writing by the applicant or client.

Under exceptional circumstances, the ODSP office may extend the period for requesting an internal review. Exceptional circumstances include, but are not limited to, situations where the applicant or client:

  • has literacy or language difficulties and is unable to provide a written request without assistance;
  • was ill or hospitalized during the 30 day time frame;
  • received the notice of decision late because of circumstances beyond his/her control; or
  • other circumstances beyond his/her control.

Conducting the Internal Review

By policy, the reviewer must be authorized to conduct internal reviews and must have the same or higher level of decision-making authority as the original decision-maker.

ODSP caseworkers conducting the internal review must:

  • document the internal review process;
  • examine the case file;
  • where appropriate, communicate directly with the applicant or client in an effort to obtain any additional information which may resolve issues at this stage;
  • examine the original decision to determine if it was:
    • the appropriate decision based on all relevant facts (including additional information that the applicant or client may provide during the internal review process); and
    • consistent with legislation, regulations and policy directives;
  • make a decision to confirm or overturn the original decision and clearly summarize the reason(s) for arriving at that decision;
  • provide the applicant or client with written notice of the internal review decision, including information on the regional dispute resolution process.

The internal review is an informal, administrative process. Legal representation is not required during the internal review. However, if an applicant or client wishes to involve their legal representative or an advocate in the process, he or she may do so.

Withdrawal of Request for Internal Review

An applicant or client may at any time during the process notify ODSP staff that he/she wishes to withdraw the request for an internal review. The applicant or client can confirm the withdrawal using the Internal Review Withdrawal Form 2879. Once an applicant or client has withdrawn the request for internal review, no further dispute is possible.

The Regional Dispute Resolution Process

ODSP employment supports has a regional dispute resolution process for applicants and clients that do not agree with a decision related to ODSP employment supports. No appeal to the Social Benefits Tribunal is available on a decision regarding ODSP employment supports.

An applicant or client must request a regional dispute resolution review, in writing, within 30 calendar days from the day the internal review decision is received.

Upon receipt of the applicant’s or client's written request for a regional dispute resolution review, ODSP staff will forward, via their regional office, the request to a Regional Program Manager in another region to review the decision.

The Regional Program Manager in the other region may hear the dispute by telephone or may deal with the dispute through written correspondence from each of the parties, including the applicant or client, an ODSP caseworker, and/or the service provider, as appropriate. Applicants and clients have the right to appoint an advocate to gather or clarify information or to support them before the dispute resolution process.

The review must take place within 45 calendar days of receiving the applicant’s or client's request for a dispute resolution review.

The Regional Program Manager in the other region will make the final decision to either confirm or change the original decision and will advise the original Regional Program Manager of his/her decision. He/she must document the reasons for his/her decision.  The applicant or client must be advised of the final decision in writing, copying the original Regional Program Manager, and a copy of the letter placed on file. 

Timelines

There are four time frames relevant to the internal review and regional dispute resolution process:

  • the applicant or client must request the internal review within 30 calendar days of receiving the written notice of decision;
  • the ODSP office has 10 calendar days to complete the internal review and issue its decision,
  • the applicant or client has 30 calendar days from receiving the internal review decision to launch the regional dispute resolution process; and
  • the dispute resolution review must take place within 45 calendar days of receiving the applicant’s or client’s request for a review.

Related Directives

2.1 Program Eligibility
6.1 Client Progress and Cancellation/Suspension of Supports