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WSIB Intent to Object — Notice and Grounds (Ontario)
The single most expensive mistake an injured worker in Ontario makes is the calendar: a return-to-work decision must be objected to within thirty days, while most other WSIB decisions allow six months — and the short clock catches people who assume they have time. Our Canadian template files the Intent to Object that preserves your appeal rights and sets out the grounds the decision is wrong, built for the exact decision you received. It maps the medical evidence, points you to the free Office of the Worker Adviser, and frames the WSIAT escalation — so the objection lands inside the deadline and on the merits.
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WSIB Intent to Object — Notice and Grounds
Objection To A Workplace Safety And Insurance Board Decision — LOE Reduction · June 11, 2026
Raymond T. Boucher
226 Wilson Avenue, Hamilton ON L8H 1S5
+1 (905) 555-0119
ray.boucher@email.ca
June 11, 2026
Workplace Safety and Insurance Board
Appeals Services
Re: Claim 90215447
Re: Claim 90215447
INTENT TO OBJECT — NOTICE AND GROUNDS
Claim 90215447 · LOE reduction
To WSIB Appeals Services,
I am writing to give notice of my intent to object to a decision of the Workplace Safety and Insurance Board on my claim, and to set out the grounds. The decision in issue is the reduction or termination of my loss-of-earnings (LOE) benefits, dated May 26, 2026. Please record this objection on claim 90215447 and treat this letter as the grounds accompanying my Intent to Object.
I am writing to give notice of my intent to object to a decision of the Workplace Safety and Insurance Board on my claim, and to set out the grounds. The decision in issue is the reduction or termination of my loss-of-earnings (LOE) benefits, dated May 26, 2026. Please record this objection on claim 90215447 and treat this letter as the grounds accompanying my Intent to Object.
1.
WORKER AND CLAIM DETAILS
Worker: Raymond T. Boucher
WSIB claim number: 90215447
Address: 226 Wilson Avenue, Hamilton ON L8H 1S5
Telephone: +1 (905) 555-0119
Email: ray.boucher@email.ca
Decision objected to: the reduction or termination of my loss-of-earnings (LOE) benefits, dated May 26, 2026
Benefit / context: Loss-of-earnings benefits following a 2025 shoulder injury (rotator cuff tear)
WSIB claim number: 90215447
Address: 226 Wilson Avenue, Hamilton ON L8H 1S5
Telephone: +1 (905) 555-0119
Email: ray.boucher@email.ca
Decision objected to: the reduction or termination of my loss-of-earnings (LOE) benefits, dated May 26, 2026
Benefit / context: Loss-of-earnings benefits following a 2025 shoulder injury (rotator cuff tear)
2.
THE DECISION AND MY OBJECTION
I object to the reduction or termination of my loss-of-earnings (LOE) benefits. In summary, the decision is wrong because: The Board reduced my LOE benefits on the basis that I can earn full wages in "suitable" modified work, but the job it relied on requires overhead reaching my surgeon has restricted, and it was never actually offered to me.
What I ask the Board to decide instead: Reinstatement of full LOE benefits from the date of the reduction, and a reassessment of suitable work that respects the overhead-lifting restriction.
What I ask the Board to decide instead: Reinstatement of full LOE benefits from the date of the reduction, and a reassessment of suitable work that respects the overhead-lifting restriction.
3.
TIME LIMIT FOR THIS OBJECTION
The time to object to this decision is six months from the decision date. This decision is dated May 26, 2026, which places the objection deadline on or about November 26, 2026. This Intent to Object is given within that period. The date stated in the WSIB decision letter governs, and I have relied on it.
4.
GROUNDS FOR THE OBJECTION
A loss-of-earnings decision turns on what I am actually able to earn and whether suitable work is genuinely available to me. The objection below addresses the functional restrictions the decision underweighted, the suitability and availability of the work it assumed, and the earnings figure it used.
What the decision got wrong: The decision treats a "clerk/dispatch" role as suitable and available. My operative report and my surgeon’s restriction prohibit repetitive overhead reaching and lifting over 5 kg above shoulder height. The dispatch role at my employer includes pulling stock from high racking. No written offer of the role was ever made.
The correct decision, and why: My deemed earning capacity should reflect the actual restrictions. Until genuinely suitable, available work is identified, my LOE benefits should continue at the pre-reduction rate; the deeming applied here is not supported by a real, offered, restriction-compliant job.
The basis for my position: Surgeon’s functional restriction letter (overhead and weight limits), the operative report, and the job description showing high-racking duties — together they show the assumed work is neither suitable nor available.
What the decision got wrong: The decision treats a "clerk/dispatch" role as suitable and available. My operative report and my surgeon’s restriction prohibit repetitive overhead reaching and lifting over 5 kg above shoulder height. The dispatch role at my employer includes pulling stock from high racking. No written offer of the role was ever made.
The correct decision, and why: My deemed earning capacity should reflect the actual restrictions. Until genuinely suitable, available work is identified, my LOE benefits should continue at the pre-reduction rate; the deeming applied here is not supported by a real, offered, restriction-compliant job.
The basis for my position: Surgeon’s functional restriction letter (overhead and weight limits), the operative report, and the job description showing high-racking duties — together they show the assumed work is neither suitable nor available.
5.
MEDICAL AND FUNCTIONAL EVIDENCE
An objection is decided on the medical and functional record. The evidence supporting this objection is scheduled below:
1. Surgeon’s functional restriction letter (May 4, 2026) — No repetitive overhead reaching; no lifting over 5 kg above shoulder height
2. Operative report (rotator cuff repair) (November 2025) — Surgical repair and expected permanent limitation
3. Dispatch role job description (obtained May 2026) — Routine pulling of stock from high racking — inconsistent with restrictions
Reports still to come / to be obtained: A follow-up functional abilities evaluation is scheduled for July; its report will be filed when available.
Some records are still being obtained — including records held by the Board or by the employer — and will follow. I ask that the file not be decided until the medical evidence is complete, and that any report in the claim file relevant to this objection be considered.
1. Surgeon’s functional restriction letter (May 4, 2026) — No repetitive overhead reaching; no lifting over 5 kg above shoulder height
2. Operative report (rotator cuff repair) (November 2025) — Surgical repair and expected permanent limitation
3. Dispatch role job description (obtained May 2026) — Routine pulling of stock from high racking — inconsistent with restrictions
Reports still to come / to be obtained: A follow-up functional abilities evaluation is scheduled for July; its report will be filed when available.
Some records are still being obtained — including records held by the Board or by the employer — and will follow. I ask that the file not be decided until the medical evidence is complete, and that any report in the claim file relevant to this objection be considered.
6.
PRESERVING TIME AND THE APPEAL PROCESS
This Intent to Object is filed to preserve my appeal rights within the six months limit. After it is recorded, I understand the file moves to an Appeals Readiness stage and then to an Appeals Resolution Officer, and I will complete the Appeal Readiness steps and identify the issues and evidence as required.
Representation: I am a non-unionized worker and I am seeking the assistance of the Office of the Worker Adviser, which advises and represents injured workers at no cost; please copy correspondence to me in the meantime.
Representation: I am a non-unionized worker and I am seeking the assistance of the Office of the Worker Adviser, which advises and represents injured workers at no cost; please copy correspondence to me in the meantime.
7.
ESCALATION, THE BAR AND RELATED CLAIMS
If the objection is not resolved: a final WSIB decision — usually a decision of an Appeals Resolution Officer — can be appealed to the Workplace Safety and Insurance Appeals Tribunal (WSIAT), the independent appeal tribunal, by filing a Notice of Appeal within six months of that final decision. WSIAT is separate from the Board; I reserve that route.
8.
ACKNOWLEDGEMENT
Please acknowledge this Intent to Object, confirm it has been recorded on the claim within the time limit, and advise the next steps and any forms required to move the objection forward. I am available to provide further information and reserve all my rights under the Act.
YOURS TRULY,
Raymond T. Boucher
Worker
Date: ____________________
WORKER
Raymond T. Boucher
Date: ____________________
Available as a print-ready PDF or an editable Microsoft Word (.docx) file.
What Is a WSIB Intent to Object?
It is the notice that stops the clock. When the Workplace Safety and Insurance Board (WSIB) decides your claim — allowing or denying it, setting a benefit, cutting loss-of-earnings, rating a permanent impairment, or approving a return-to-work plan — you have a limited window to object, and the Intent to Object is how you preserve the right to appeal while the full grounds are still being assembled. Under section 120 of the Workplace Safety and Insurance Act, that window is just thirty days for a return-to-work or work-transition decision, but six months for any other decision. The template files the notice and the grounds together, so the deadline is protected and the case is started in one document.
The grounds are where objections are won or lost, and the right argument depends entirely on the decision type. A claim denial turns on whether the injury arose out of and in the course of employment. A loss-of-earnings (LOE) reduction turns on whether the "suitable" work the Board assumed is real, restriction-compliant and actually available. A return-to-work decision turns on the fit between the plan and your medical restrictions. A non-economic loss (NEL) rating turns on the medical assessment against the schedule. A health care refusal turns on medical necessity. The template writes the framework that matches your decision and drops your facts into it, so the objection meets an Appeals Resolution Officer (ARO) on the issue actually in dispute.
Two supports most injured workers in Ontario never hear about can change the outcome. The Office of the Worker Adviser (OWA) is a free government service that advises and represents non-unionized injured workers at both the WSIB and the appeal tribunal — no fees, no contingency, and you keep all the benefits you win. And the appeal does not end at the WSIB: a final decision (usually an ARO decision) can be taken to the Workplace Safety and Insurance Appeals Tribunal (WSIAT), the independent appeal body, within six months. The template signposts the OWA and frames the WSIAT route so you know the whole chain before you start.
What's Covered in This Template
The notice and grounds are structured the way the WSIB and an ARO read them — decision, deadline, grounds, evidence, process and escalation — so the objection is preserved in time and built on the medical record.
Decision-Type Selector
Claim denial, LOE reduction, return-to-work, NEL rating or health care — the selector sets both the deadline and the argument that fits.
The 30-Day vs 6-Month Trap
The section 120 split handled automatically: 30 days for return-to-work and work-transition decisions, 6 months for everything else, with your deadline computed from the decision date.
Grounds Built for the Decision
The work connection for a denial; the suitability and availability of work for an LOE cut; the plan fit for return-to-work; the assessment for a NEL rating; medical necessity for health care.
Medical Evidence Schedule
Each report named, dated and tied to what it proves — restriction letters, operative reports, functional abilities evaluations — the record an objection is decided on.
Request to Hold the File
Where reports are still coming, a request that the file not be decided until the medical evidence is complete, and that the Board obtain records it holds.
Deadline Preservation
The Intent to Object as the instrument that protects the appeal right while the grounds and evidence are finalized — the deadline cannot follow, but the grounds can.
Extension Request
Where the deadline may have passed, a written request to extend time that explains the delay — the only route once the window has closed.
Office of the Worker Adviser
The free OWA signpost for non-unionized workers — advice and representation at the WSIB and WSIAT, no charge, no contingency fee.
WSIAT Escalation Framed
The next step explained: a final WSIB decision can be appealed to the independent WSIAT within six months — the route reserved, not started here.
Statutory Bar and HR Overlap
The no-lawsuit trade-off acknowledged, and where workplace stress is tied to the employer’s own decisions, the human-rights boundary flagged.
How to Create Your WSIB Objection
Five steps from a decision you disagree with to an objection that is in time and on the merits.
- 1
Enter Your Claim and the Decision
Your name, claim number, and the date on the WSIB decision letter — the date the deadline runs from.
- 2
Pick the Decision Type
Claim denial, LOE reduction, return-to-work, NEL rating or health care — the template sets your deadline and the argument.
- 3
State Why It Is Wrong
A short ground now; the full, decision-specific grounds in Expert, with your position and the basis for it.
- 4
Schedule the Evidence (Expert)
Each report dated and tied to what it shows, with anything still to come flagged and the file asked to be held.
- 5
Preserve Time and Send
The Intent to Object recorded within the window, the OWA signposted if you want free help, and the WSIAT route reserved.
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Legal Considerations
WSIB objections are won on the deadline first and the medical record second — and free help exists for both.
This template provides general information for injured workers in Ontario and is not legal advice. The 30-day return-to-work deadline under the Workplace Safety and Insurance Act is short and easy to miss; if yours is near, file the Intent to Object immediately and consider the Office of the Worker Adviser (non-unionized) or your union. This template covers the Ontario WSIB system; British Columbia and Alberta use a different process. For serious or complex claims, get advice from a representative experienced in workers’ compensation.
Reviewed for Ontario workers’ compensation law
The Section 120 Time Limits
Under s.120 of the Workplace Safety and Insurance Act, the time to object is thirty days for a decision about return to work, work transition or the re-employment obligation, and six months for any other decision — a claim denial, an LOE reduction, a NEL rating, a health care decision. To preserve the right you file an Intent to Object (worker form 2394A) by the date in the decision letter. The template computes the deadline from the decision date and the decision type, so the short clock does not catch you.
WSIB and WSIAT Are Not the Same Body
The objection goes to the WSIB first, through its own appeal process: an Intent to Object, then an Appeals Readiness stage, then a decision by an Appeals Resolution Officer (ARO). The Workplace Safety and Insurance Appeals Tribunal (WSIAT) is a separate, independent tribunal that hears appeals from final WSIB decisions — usually ARO decisions — within six months. WSIAT is the last step in the chain, not where an objection starts, which is why the template addresses the WSIB and reserves the WSIAT route.
The Office of the Worker Adviser
The OWA is a free Ontario government service that advises and represents non-unionized injured workers and their survivors at both the WSIB and the WSIAT. There is no charge and no contingency fee, and you keep all the benefits you win. Unionized workers are usually represented by their union instead. Most injured workers never hear of the OWA — the template signposts it, because free expert representation changes outcomes.
The Statutory Bar and Mental Stress
Workers’ compensation is the worker’s remedy for the workplace injury — the historic trade-off bars a civil action against the employer for it. There is one boundary worth knowing: under s.13 of the Act, chronic and traumatic mental stress can be compensable, but s.13(5) excludes stress caused by the employer’s own employment decisions — discipline, a change of duties, termination. Those facts are not a WSIB claim; they may be a human-rights or other employment matter, which is a different route.
Related Canadian Templates
A workplace injury rarely sits alone. If part of your situation is discrimination — for example stress tied to the employer’s decisions, which the WSIB cannot decide — our HRTO application support builds the human-rights case, but the same issue cannot be run in both forums at once (Figliola). If you are in British Columbia or Alberta, the workers’-comp process is different — see our WCB review request (BC and Alberta). For a harassment problem behind the injury, our workplace harassment investigation request triggers the duty to investigate, and for a dismissal, our severance review demand letter and CLC unjust dismissal complaint cover the employment side.
Frequently Asked Questions
File the Objection Before the Clock Runs Out
Create your WSIB Intent to Object in minutes: the decision-specific grounds, the 30-day or 6-month deadline computed for you, the medical evidence scheduled, the free Office of the Worker Adviser signposted, and the WSIAT escalation framed — in formal notice format. Download the PDF free, or unlock Expert for the decision-type grounds, the evidence schedule and the appeal-process clauses.
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