Forms: Injured or ill people

Upload a claim document

Find the form you need, fill it in, save it and submit it online. 

Categories:

• Report an injury, illness or exposure
• Set up direct deposit
• Update us on your recovery and return to work
• Submit expenses
• Object to a decision
• Authorize a third-party representative
• Request your claim file

Report an injury or illness

Reporting an injury, illness or exposure incident? Submit online.  

• You can also fill out and save a
  Worker’s Report of Injury/Disease (Form 6)
   and upload it.
• If you're under 16 years old, your parent or guardian must sign the
  Worker’s Report of Injury/Disease (Form 6)
  before you upload it. 
• For help filling out your report, check out our reference guide (PDF)

Report a work-related, noise-induced hearing loss claim

Report an exposure incident

Set up direct deposit

Direct deposit enrollment (PDF 3072A)

• Please note: Do not upload the form online. 

Update us on your recovery and return to work

• Worker's Progress report
  (0041A)
• Continuity report (PDF 2232A)
• Functional abilities form for early and safe return to work
  (2647A)
  • Guide to Completing the Functional Abilities Form (PDF)

Submit expenses

• Medication reimbursement (PDF 0806A)
• Health care travel expense
  (2721A)
• Health care travel expense - Occupational disease and specialized services (PDF 2719A)
• Work transition travel expense application
• General expense (PDF 3164A)
• Clothing allowance application
• Vision care claim (PDF 3585A)

Object to a decision

• Intent to object
  (2397A)
  •  
    Instructions for the Intent to object form

Authorize a third-party representative

• Authorization for claim-related information for legal representative
  (1824A) This is not a request for access or an appeals form.
• Power of attorney for property/guardianship of property(PDF 3074A)

Request your claim file

• Request for copy of claim file (PDF 2144A)