Digest of Benefit Entitlement Principles Chapter 17 - Section 4
17.4.0 Amendment (EIA 111)
Section 111 of the EIA allows the Commission to amend or rescind a decision. An amendment under section 111 of the EIA differs from reconsideration under section 52 of the EIA . Retroactive decisions made under section 52 of the EIA addresses issues of entitlement, qualification, underpayment and overpayment. Section 111 of the EIA addresses decisions that require correction because new facts are presented, a material fact was not considered, or was incorrectly considered when the original decision was made and can also result in an overpayment or an underpayment.
17.4.1 Limitations under EIA 111
Section 111 of the EIA has no defined timeframes. A decision can be changed either retroactively or currently at any time if:
- there are new facts on the file; or
- the decision was made without knowledge of a material fact; or
- the decision was based on a mistake of a material fact.
17.4.2 New facts
For the purpose of section 111 of the EIA , a new fact is a fact that either happened after a decision was rendered or had happened prior to a decision but could not have been discovered by a claimant acting diligently. In both cases the new fact must have some fundamental impact on a decision.
It is important to note that reviews under section 111 of the EIA will only occur because a Commission decision is being disputed and new facts are presented in support of that dispute.
17.4.2.2 Diligence
Black's Law Dictionary defines diligence as that degree of care which people in general exercise in respect to their own concerns. Therefore; a decision may be amended if all circumstances show the claimant, the employer, or the Commission acted as a reasonable person to protect their rights. Otherwise there can be no amendment. Jurisprudence has held that it is not possible to apply a standard to diligence, as each case must be judged on its own facts.
In order to meet the test of due diligence, the claimant must demonstrate that they exercised the degree of care, diligence and skill that a reasonably prudent person would have exercised in comparable circumstances to protect their right to benefits.
17.4.3 Material facts
Black’s Law Dictionary defines a material fact as a fact that is significant or essential to the issue or matter at hand. Therefore, a material fact is any information that does, or may, influence the outcome of the decision making process.
[ June 2014 ]
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