Submit a claim document

Find the form you need, fill it in using your desktop or laptop computer, save it and submit it online.

Categories

• Claims
  • Report an injury, illness or exposure
  • Support your employee's recovery and return to work
  • Object to a claim decision
  • Re-open a claim
  • Accident cost statement
• Your account
  • Get WSIB coverage
  • Manage your premiums, rates and coverage
  • Annual reconciliation for monthly reporting businesses
  • Pay your premiums
  • Schedule 2 security requirement
  • Determine your independent operator status
  • Verify coverage when buying or selling your business
  • Authorize a third-party representative
  • Object to a decision about your account
  • Email us
• Order print materials

Claims

Report an injury, illness or exposure

Log in to your online services account to report a workplace injury or illness.  

• You can also fill out, save, and upload a
  report of injury/disease Form 7
  (0007A)
  • If you have questions about reporting, read the
    form 7 reference guide
  • If you are reporting a fatality, please report online call us at 1-800-387-0750, Monday to Friday from 7:30 a.m. to 7:45 p.m.
• Report an occupational noise-induced hearing loss claim
   (0137A)
• Report on needlestick injury or body fluid splash
   (2819A)

Report an exposure incident 

Support your employee's recovery and return to work

• Functional abilities form for early and safe return to work
  (2647A)
  • Guide to completing the functional abilities form
• Physical Demands Information Form
   (2828A, 2829A, 2830A, 2851A, and 2852A)
  • Example of Section 2: Duties and Physical Demands
  • Example of Section 3: General Physical Demands and Section 4: Additional Considerations
• Progress Report
   (0042A)
• Employer's subsequent statement
   (0009A)
• Treatment Memorandum
   (0156C)
• Long term rate earnings questionnaire
   (0717A)
• Modified earnings report
   (3146A)

Object to a decision about a claim

• Intent to object form - Employer
   (2399A)
  • Instructions for completing the form

Re-open a claim

• Continuity Report Post-1998
   (Form WRE07) / Re-open Claim Earnings Post-1998 (Form WRE07E) (PDF 3233A and 3524A)
• Continuity Report Pre-1998
   (Form RE07) / Re-open Claim Earnings Pre-1998 (Form RE07E) (PDF 2233A and 2235A)

Accident cost statement

• Accident cost statement code mapping

Your account

Get WSIB coverage

• Register online
• Employer by Application Form

  (0090A)
• Employer by Application Entertainment Industry
  (0095A)
• Optional insurance request/change for Schedule 1 employers
  (1574A)
• Optional Insurance Consent Form under Schedule 2  (1034A) ​
• Application for exemption from coverage for a Partner and Executive Officer in construction (1208A)
   
• Application for reduced premium rate for non-exempt partners and executive officers in construction (1209A)
• Schedule Transfer Request
   (3193A)

Manage your premiums, rates and coverage

• Application for Alternative Assessment Procedure for Interjurisdictional Trucking
   (2642A)

Annual reconciliation for monthly reporting businesses

• Complete your annual reconciliation online
• Reconciliation Form – working copy
  • Pre-January 1, 2020 with classification unit and rate group classification
     (1014A)
  • Post-January 1, 2020 with NAICS code and class/subclass classification
     (1014RA)

Pay your premiums

• Prepayment Request Form (3602A)
• Letter of Credit Schedule 1

Schedule 2 security requirement

• Letter of credit Schedule 2
• Continuous/Surety bond (10568A)

Determine your worker or independent operator status

• General - determining worker/independent operator status questionnaire
  (1158A)
• Logging industry - determining worker/independent operator status questionnaire
  (1168A)
• Transportation industry - determining worker/independent operator status questionnaire
  (10687A)

Verify coverage when buying or selling your business

• Purchase Certificate Worksheet
  (1238A)

Authorize a third-party representative

• Authorization for access to business account information
  (10371A)
• Authorization for claim-related information for legal representative
  (Direction of authorization 1824A)

Object to a decision about your account

• Objecting to an employer account decision
  (3363A)

Email us

• Email consent form

Order print materials

• Print material order form