Forms: Injured or ill people

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:

• Report an injury, illness or exposure
• Noise-induced hearing loss
• 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 your Form 6.
• For help filling out your report, check out our reference guide

Noise-induced hearing loss

• Report a work-related, noise-induced hearing loss claim
• Report a declaration for lost, stolen or damaged hearing devices

Report an exposure incident

Set up direct deposit

You can sign up for direct deposit through our online services to get your benefit payments sent right into your account.

You can also fill out a 

(3072A)

and fax or mail it to us.

• Please note: Do not submit the form online.

Learn more about how to sign up for direct deposit.

Update us on your recovery and return to work

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

Submit expenses

• Medication reimbursement
  (0806A)
• Health care travel expense
  (2721A)
• Health care travel expense - Occupational disease and specialized services
  (2719A)
• Work transition travel expense application
• General expense
  (3164A)
• Clothing allowance application
• Vision care claim
  (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
  (3074A)

Request your claim file

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