Social Security Tribunal of Canada

Notice of Appeal: Employment Insurance

Large-print version of official source
Notice of Appeal – Employment Insurance – General Division (PDF 594.49 KB)

 

Fill out and sign this form if you want to appeal a reconsideration decision from theCanada Employment Insurance Commission. We must receive your completed form within 30 days from the date you received your reconsideration decision.

We will share any documents you give us with any other parties to your appeal.

A community organization might be able to help you with your appeal. Find organizations that can help on our website here: https://www.sst-tss.gc.ca/en/your-appeal/help-other-people-or-organizations

We publish many Tribunal decisions online so that people can understand how the Tribunal works. If we publish the decision in your appeal, we will first remove any information that reveals your identity.

1. Appellant

I am (please select only one)

2. Appellant / contact person information

2A. Individual

(Optional) How would you like us to refer to you? We’re asking because we want to communicate with you in a respectful way.

2B. Employer

This appeal relates to the following employee/former employee (if applicable):

2. Contact information

3. Hearing

(Connect to the videoconference from a location convenient to you such as your home or your representative’s office. This option requires a high-speed internet connection.)
(You will travel to a Service Canada Centre near you and participate using their videoconference system. The General Division member will join from a different location.)
(Call from a location convenient to you such as your home or your representative’s office.)
(Your hearing will take place at a Service Canada Centre near you. The Tribunal member will be in the same room as you.)
(The General Division member will make their decision based on the written arguments and supporting documents that the parties (including you) send in.)

4. Language

(The Tribunal will get an interpreter for you.)

5. Alternate arrangements

Please tell us if you need any alternate arrangements for your appeal. We want to ensure that everyone can participate in our proceedings on an equal basis.

An alternate arrangement (or accommodation) is an arrangement to remove a barrier so you can participate fully in an appeal. We’ll accommodate you if you have needs related to a disability or any of the other grounds found in the Canadian Human Rights Act opens a new window. To request accommodation for a particular need, please contact us by phone, email, fax, or mail. All our contact information is at the end of this form.

You can find more information on our accommodation and accessibility policy on our website at www.sst-tss.gc.ca/en/decisions-laws-and-policies/social-security-tribunal-accommodation-and-accessibility-policy

6. Reconsideration decision

Please provide at least one of the following:

Please also provide the following information:

or

7. Reason(s) for your appeal of the reconsideration decision

8. Documents to support your appeal

Include any documents that could support your appeal.

Examples of supporting documents:

  • Pay stubs
  • Record of employment
  • Collective agreement
  • Employment contract
  • Bank statements
  • Medical reports or certificates (example, doctor’s report or specialist’s report)
  • Proof of residence
I am including copies of supporting documents

9. Late appeal (if applicable)

We must receive this completed form within 30 days from the date you received your reconsideration decision. If we receive your notice of appeal after the 30 days, you must explain why it is late. The Tribunal member will then decide whether your appeal can go forward. Please note that the Tribunal can’t accept an appeal filed more than one year from the date you received your reconsideration decision.

10. Representative information

You don’t need a representative. If you choose to have a representative, you are responsible for any costs.

Do you have a representative?

If you have a representative:

The Tribunal will share all information about your appeal with your representative. The Tribunal will normally communicate only with your representative and you will personally receive information only about the hearing and the final decision.

Please indicate which category of representative you have and fill out their information below.

(Optional) How would your representative like us to refer to them? We’re asking because we want to communicate with them in a respectful way.

I have confirmed with my representative that they want the Tribunal to send them correspondence and documents by email.

11. Signature of appellant

How to submit your appeal

Fill out, sign, and send us a copy of this form and copies of any supporting documents by email, fax, or mail. Keep all your original documents.

Email: info.sst-tss@canada.gc.ca opens a new window

Fax:
1-855-814-4117 (toll-free in Canada and the United States)
1-613-941-5121 (long distance charges may apply)

Mail:
Social Security Tribunal of Canada
PO Box 9812
Station T
Ottawa ON  K1G 6S3

Questions?

Email us at info.sst-tss@canada.gc.ca opens a new window or call us at 1‑877‑227‑8577 (toll-free in Canada or the United States) or 1‑613‑437‑1640 (from outside Canada and the United States – long distance charges may apply).

TTY – for those who are deaf or hard of hearing: 1‑866‑873‑8381 (toll-free in Canada and the United States) or 1‑613‑948‑8181 (from outside Canada and the United States – long distance charges may apply).

You can call us from 7:00 a.m. to 7:00 p.m. Eastern Time – Monday to Friday. Please leave a message if we can’t answer the phone and we’ll call you back.

Website: www.sst-tss.gc.ca/en

Privacy

We understand that parties may have privacy concerns. We try to respect those concerns. At the same time, the law requires us to be open about the Tribunal’s work. Learn more about how we balance open justice and privacy by reading our open justice and privacy statement on our website here: www.sst-tss.gc.ca/en/decisions-laws-and-policies/open-justice-and-privacy

Tips

  • Email is the fastest way to send us information.
  • Send one form for each decision you want to appeal.
  • You must tell us if your contact information changes. If we can’t reach you, we may proceed in your absence.
  • Keep all letters or documents we send you. They are numbered for easy reference and will be needed at your hearing.
  • If you change your representative, tell us right away.
  • Everything you send us must be in either English or French. If you need information about translation, visit our website here: www.sst-tss.gc.ca/en/your-appeal/interpreters-and-translation
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