How to File a WSIB Claim

 

What should I do first?

If you suffer a workplace accident or illness, you should:

  • Tell your employer about your accident or occupational disease. If you need more than first aid, your employer should send a report of your accident or disease (Form 7) to the WSIB within three days.

  • Get medical attention right away (for example, first aid, hospital emergency, family doctor).

  • Tell the person treating you to send a Health Professional's Report (Form 8) to the WSIB.

  • Report the accident to your union or your health and safety representative, if you have one.

 

How do I file a WSIB claim?

To apply for WSIB benefits you should complete and sign the Worker's Report of Injury/Disease (Form 6). You can get this form on the WSIB website or you can phone the WSIB toll-free at 1-800-387-0750.

In order to receive WSIB benefits, you must agree to allow your doctor (or other treating health professional) to release information about your “functional abilities” to your employer. Functional abilities information describes what you can and cannot do at work because of your work-related injury. Functional abilities information does not include details about your medical condition. By signing a Form 6, you allow your doctor to complete the functional abilities form and provide a copy of the completed form to you, your employer, and the WSIB.

Generally, the WSIB will pay no more than two weeks of benefits to a worker who has not signed a Form 6.

When you are completing a Form 6, you need to provide the WSIB with detailed information about your accident. You must provide your employer with a copy of the completed Form 6.

 

What is e-filing?

If your employer filed an Employer's Report of Injury/Disease (Form 7) and the WSIB has assigned a claim number to your accident, the WSIB will send you a letter asking you to file a Form 6. You may complete and file an electronic Form 6 (eForm 6) on the WSIB website. You must print the electronic Form 6 before filing it as you are required to give a copy to your employer.

Your employer must provide you with a copy of the Form 7 that they sent to the WSIB.

 

What happens after I file a Form 6?

You should receive a letter from the WSIB providing you with a claim number. A claim number does not mean that your claim has been approved. It only means that the WSIB knows about your claim and has started a file. You should refer to the claim number every time you contact the WSIB about your claim.

If you do not receive a claim number, it may mean that the WSIB does not know about your claim. You should contact the WSIB right away to check. The WSIB will tell you how to establish a claim if you do not have a claim number.

 

What if my benefits are delayed?

You could experience a delay in benefits if the WSIB has not received all the information required to make a decision. (For example, your doctor's report or employer's report may be missing.) A delay could also mean that the WSIB is still in the process of reviewing your claim and that a decision has not been made. If you do not receive a letter of explanation within a few weeks, call the WSIB and ask about the delay.

 

What if my claim is denied?

You should receive a letter from the WSIB explaining why they are denying your claim. If you disagree with the reasons provided, you have six months from the date of the WSIB decision to file an appeal. For more information on appealing a WSIB decision, see Appeals at the WSIB.

 

February 2013

IMPORTANT INFORMATION

This publication contains general information only. It is not legal advice about a particular situation and is not intended to replace advice from a qualified representative. This publication was last updated on the revision date listed above.