Forms: Business

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
  • 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
• Health and Safety - Training and information
• Recognize a small business
• 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 call us at 1-800-387-0750, Monday to Friday from 7:30 a.m. to 5 p.m.
• Report a work-related, noise-induced hearing loss claim (PDF 0137A)
• Report on needlestick injury or body fluid splash (PDF 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 (PDF)
• Physical Demands Information Form (PDF 2828A, 2829A, 2830A, 2851A, and 2852A)
  • Example of Section 2: Duties and Physical Demands (PDF)
  • Example of Section 3: General Physical Demands and Section 4: Additional Considerations (PDF)
• Progress Report (PDF 0042A)
• The Subsequent Report is no longer available. Please use the Progress Report instead. 
• Treatment Memorandum (PDF 0156C)

Object to a decision about a claim

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

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

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

Manage your premiums, rates and coverage

• Application for Alternative Assessment Procedure for Interjurisdictional Trucking (PDF 2642A)
• Completing Your Premium Remittance Form (PDF 0976A)
• Reconciliation Form – working copy
  • Pre-January 1, 2020 with classification unit and rate group classification (PDF 1014A)
  • Post-January 1, 2020 with NAICS code and class/subclass classification (PDF 1014RA)

Pay your premiums

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

Schedule 2 security requirement

• Letter of credit Schedule 2
• Surety bond

Determine your worker or independent operator status

• General - Determining Worker/Independent Operator Status Questionnaire
  (1158A)
• Retail Industry - Determining Worker/Independent Operator Status
  (1155A)
• Courier Industry - Determining Worker/Independent Operator Status Questionnaire
  (1157A)
• Logging Industry - Determining Worker/Independent Operator Status Questionnaire
  (1168A)
• Taxi Industry - Determining Worker / Independent Operator Status
  (1152A)
• Trucking Industry - Determining Worker/Independent Operator Status Questionnaire
  (1149A)

Verify coverage when buying or selling your business

• Purchase Certificate Worksheet
  (PDF 1238A)

Authorize a third-party representative

• Authorization for access to business account information
   (PDF 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 (PDF 3363A)

Email us

• Email consent form (PDF)

Order print materials

• Print material order form