Form 5A - Application for accessibility-related complaints

 
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Page 1 of 7: Background

Purpose

This form is to be used when you (the Applicant) experienced an incident or issue related to a disability while travelling and the complaint has not been resolved by facilitation or mediation and needs to be adjudicated. Adjudication is a formal and legally binding process and submitting this application is the first step.

You must provide information and evidence that:

  1. you are a person with a disability; and,
  2. you encountered a disability-related barrier to your mobility while travelling on an airplane, train, bus or passenger ferry that crosses a provincial or Canadian border.

The transportation service provider, i.e. airline, railway company, bus operator or ferry operator (the Respondent) must explain:

  • how it intends to remove the barrier
  • or why it believes it cannot do so without experiencing undue hardship.

You and the Respondent will be given the opportunity to ask questions and reply. This is usually done in writing. In some cases there may be oral hearings. The Agency will then issue a decision that is final and binding, just like a decision from a court.

When should you file this form?

You should file your application as soon as possible after failing to resolve your dispute with the respondent to ensure that all relevant documents and options for relief are still available to you.

For more information, see:

Supporting documents

At the end of this form you will be able to upload copies of any documents related to your application, such as tickets, claim forms, receipts of expenses for reimbursement, correspondence between you and the respondent. This will speed up the review of your application.

What happens next?

If your application is complete, the proceedings will be started.

If your application is incomplete, you will be notified in writing and you must provide the missing information within 20 business days after the date of the notice. If you fail to provide the missing information within the time limit, your file will be closed.

Time to complete the form

Approximately 20 minutes if you have all supporting documents listed above with you.

Personal information collection statement
Statement

We are collecting your personal information to help us respond to your application for alternative dispute services. Providing documents and information is voluntary. Your personal information is protected under the provisions of the federal Privacy Act.

By submitting your personal information, you are authorizing us to collect, use, hold and, with your consent, share your file with staff, transportation providers and any other party involved with your case. We will do this with authority from the Canada Transportation Act. For more information about how your personal information will be managed, please refer to these Personal Information Banks (PIBS):

We want to protect you, so please do not include sensitive personal information including your Social Insurance Number, personal financial data and credit card numbers.

Inclusivity statement

The Agency is committed to providing dispute resolution services that are inclusive and respectful of gender diversity. Gender refers to current gender which may be different from sex assigned at birth and may be different from what is indicated on legal documents. In communications for the purpose of facilitation, mediation and adjudication, and in Agency decisions published on its website, the Agency will refer to individuals using the personal pronouns provided in the complaint form or application.

Security of Your Information

Our online form uses a secure method to encrypt and send your information electronically to the Agency. We will retain your information in an encrypted folder on a secure server hosted on our internal network until 30 days after we close your file. The Agency securely stores the information in its Corporate Repository and Case Management System, retains it for 10 years upon file closure, and then destroys it, as described in the PIB above.

If after reading this statement, you prefer not to submit your form via the Internet, you may use one of the following methods:

By courier or in person: Canadian Transportation Agency, 15 Eddy Street, Gatineau, Quebec, J8X 4B3

By Teletypewriter: 1-800-669-5575

All of the information on this form is required. If you do not provide it , the Agency will not process your application.

Privacy Inquiry

If you have any questions, comments, concerns or complaints regarding the collection, use and disclosure of your personal information and our administration of the Privacy Act, please contact our Access to Information and Privacy Coordinator by emailing otc.aiprp-atip.cta@otc-cta.gc.ca, by calling 613-316-4474 or by writing to: Access to Information and Privacy Coordinator, 15 Eddy Street, Gatineau, Quebec, J8X 4B3.

You may contact us anytime to request access to your information and to ensure that it is accurate. Please use the Personal Information Request Form to contact us.

If you are not satisfied with our response to your privacy concern, you may wish to contact the Office of the Privacy Commissioner by e-mail at info@priv.gc.ca or by telephone at 1-800-282-1376.