Get Employer ''s Initial Report Of Injury Wcb Claim No

Filling out the Employer's Initial Report of Injury WCB Claim No online is a critical step in reporting workplace injuries. This guide provides concise and supportive instructions to help you complete each section of the form with confidence.

Follow the steps to successfully complete the report online.

1. Click ‘Get Form’ button to access the form and open it in your preferred PDF editor.
2. Complete Section A: Employer Information by entering your organization's name, address, postal code, type of business, phone number, contact person, email, fax number, and WCB Firm No. Ensure all information is current and accurate.
3. Fill out Section B: Worker Information by providing details about the injured worker, including specific division (if applicable), occupation, name, address, postal code, social insurance number, personal health number, date of birth, hire date, and gender.
4. In Section C: Injury Information, record the injury date, date the incident was reported to the employer, area of the body injured, and name of the healthcare provider. Explain how the injury occurred and provide the province where the injury took place. Indicate if the injury resulted in a fatality and whether the worker lost time from work due to the injury.
5. If the worker lost time from work, complete question #8 by recording the first day off and the time the employee left work due to the injury. Specify if the employee has returned to work and, if yes, the date of return. Also, clarify if you believe the incident is work-related.
6. In Section D: Wage and Employment Information, describe how the employee is paid and provide gross earnings for the 12 months preceding the first day off due to the work injury. Document any time lost during this period due to unpaid sickness, prior WCB claims, or other reasons. Specify the normal working hours and regular days off.
7. Finally, complete Section E: Declaration by providing your name, title, and the date. Ensure you sign the form to declare that all provided information is true and correct to the best of your knowledge.
8. Once all sections are completed, you can save your changes, download the form, print it, or share it as needed.

Complete and submit your documents online to ensure a smooth claims process.