Get Intent To Object Form

Filling out the Intent To Object Form online is a crucial step in contesting decisions made by the Workplace Safety and Insurance Board. This guide provides clear and supportive instructions to help you navigate the process with ease, ensuring that all necessary information is accurately submitted.

Follow the steps to complete your Intent To Object Form online

1. Click the ‘Get Form’ button to obtain the Intent To Object Form and access it for online completion.
2. In the 'Claim Identifiers' section, fill in the required information, including your name and claim number.
3. Specify the objecting party by selecting from the options provided: Worker, Worker Representative, Employer Representative, Employer, or Transfer-of-Cost Employer.
4. In the 'General Information' section, indicate whether the worker or employer's address and contact information is the same as stated in the decision letter. If not, complete the additional fields with the correct name, address, city/town, telephone numbers, language preference, and postal code.
5. Under 'Representation', indicate if you will represent yourself, have a representative, or are seeking representation. If you have a representative, be sure to include their name, organization, address, telephone numbers, and fax number.
6. In the 'Intent to Object' section, list the decision(s) you disagree with. Be sure to include the date of the decision letter and specify the issue(s) in dispute.
7. For the 'New Information/Reconsideration' section, determine if you have any new information to submit. If yes, check the corresponding box, and ensure to add the worker's name and claim number on each page of the attached information.
8. In the 'Reasons for the Objection' section, provide a detailed explanation of why you disagree with the decision(s). Be precise and refer to any new information you are attaching. If you require more space, you may attach additional pages.
9. Finally, remember to print and sign the completed form. You can then submit it to the WSIB by fax or mail as indicated in the instructions.

Complete your Intent To Object Form online today to ensure your objections are addressed.