What is a Workplace Safety and Insurance Board (WSIB) claim file?
A claim file is created by the WSIB whenever a work-related injury or disease is reported to them. Your WSIB claim file will include all the documents related to your injury or disease claim. It can include documents submitted to the WSIB by you, your doctor, and your employer, as well as documents created by WSIB employees. Every claim file has a unique number. WSIB employees will request your claim number every time you talk to them. A claim file is divided into sections separated by blue title pages. Each section of the file starts with the most recent document and then goes back in time.
A claim file usually includes these sections:
- Memorandums (memos) – This section contains memos created by WSIB employees. These memos may include explanations of decisions made in your claim, WSIB doctors’ opinions, as well as notes of telephone calls and meetings with you, your employer, your doctor, and others connected to your claim. The memos are all numbered. You should refer to these numbers when you contact WSIB employees about specific memos in your claim file.
- Forms – This section contains the accident report forms from you, your doctor and your employer. If your file does not contain this section, the forms can probably be found at the front of the Medical Reports section.
- Medical Reports – This section contains the medical reports that your doctors sent to the WSIB.
- Correspondence – This section contains all the letters the WSIB has sent and received about your claim including decision letters. It does not contain medical reports.
- Work Transition, Labour Market Re-entry or Vocational Rehabilitation – If you received work transition, labour market re-entry or vocation rehabilitation services, your file will contain this section.
Some files also include other sections, like NEL, Payments and Health Care Benefits.
When can I get a copy of my claim file?
- You can get a copy of your claim file at any time by writing to the WSIB.
- If you file an Intent to Object Form with the WSIB, you will automatically receive a copy of your claim file and an Appeal Readiness Form. This is the preferable way of getting your claim file if you intend to proceed with an appeal.
How can I get a copy of my claim file?
- You can get a copy of your claim file by writing to the WSIB. In your letter, you should provide them with your claim number and request a copy of your file. Make sure your letter is dated and includes your signature.
- If you object to a WSIB decision and file an Intent to Object Form, the WSIB will send you a copy of your file. For more information on appeals, see Appeals at the WSIB.
How long does it take to get a copy of my claim file?
Usually, you will get a copy of your claim file about two months after you request it. Shortly after you submit your request, the WSIB should send you a letter confirming that they are preparing your copy of your file. If you do not receive any reply from the WSIB within three weeks of your request for your claim file, call the WSIB and follow-up.
Will I get everything in my claim file?
You will usually get your whole claim file. In rare cases, the WSIB may send some medical reports to your family doctor rather than to you. To determine if any part of your file is missing, look at the Access Memo. It should be one of the first pages in the file.
What should I do with my claim file?
- Your claim file is important if you want to appeal a WSIB decision. It will tell you what facts the WSIB used to make the decision.
- There are strict time limits for appealing WSIB decisions. You should seek qualified help immediately.
- When you get your claim file, read it carefully.
- It is important to keep the file in exactly the same order in which it came. If you ask someone to represent you, they will want to see the entire file in its original order.
- Do not remove anything from the file.
- Check to see if any information is missing from the file.
- Check that the information in the file is accurate.
- If you are asking someone to represent you, give that person the complete file in its original order. Also, do not return a WSIB Appeal Readiness Form without speaking to a qualified representative first.
Who can get a copy of my claim file?
You, or your representative on your behalf, can get a copy of your file.
If the employer you worked for at the time of your accident objects to a decision about your claim, the WSIB will send the entire file to the employer, except for the medical reports. You can object to the release of medical information by the WSIB to your employer. You should obtain advice before objecting to the release of medical information because it is often difficult to continue the objection successfully. For more information, see Employers and Claims.
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 below.
February 1, 2013