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  • C504 Worker's Progressive Injury ... - Wcb Alberta - Wcb Ab

Get C504 Worker's Progressive Injury ... - Wcb Alberta - Wcb Ab

C504 WORKER 'S PROGRESSIVE INJURY QUESTIONNAIRE P.O. BOX 2415 EDMONTON AB T5J 2S5 Fax: (780) 4275863 18006611993 Claim Number Will you be off work due to this injury? Worker 's Name (Surname) Personal.

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How to fill out the C504 WORKER'S PROGRESSIVE INJURY questionnaire online

Filling out the C504 WORKER'S PROGRESSIVE INJURY questionnaire is an essential step in reporting a progressive injury to the WCB Alberta. This guide provides clear, step-by-step instructions to help you successfully complete the form online, ensuring that you provide all required information accurately.

Follow the steps to complete the form effectively.

  1. Press the ‘Get Form’ button to obtain the C504 questionnaire. This will allow you to access the form and prepare to input the necessary information.
  2. Enter your claim number and confirm whether you will be off work due to the injury by checking the appropriate box.
  3. Provide your personal information by entering your full name, personal health number, and date of birth.
  4. Indicate your job title and describe a typical workday you experience.
  5. Specify how long this has been your typical work day and describe any changes that may have contributed to your symptoms.
  6. Check all applicable symptoms you are experiencing, and indicate when these symptoms were first noticed.
  7. Identify the location of your symptoms and indicate which hand is dominant.
  8. List the tasks performed in your job and specify which of these tasks cause or increase your symptoms.
  9. Note if your tasks involve any specific movements such as twisting or gripping, and list any tools or equipment used.
  10. Document your break schedule and any medical treatments you have received for this condition.
  11. Indicate whether you have any existing medical conditions and list any current medications.
  12. If applicable, describe any previous injuries to the same body site, and share information about hobbies or activities affected by your injury.
  13. Provide additional information regarding your injury and your availability for further contact.
  14. Complete the form by signing it, and then determine how you wish to submit it: via fax or mail.
  15. Finalize the process by saving changes, downloading, printing, or sharing the completed form as needed.

Complete your C504 WORKER'S PROGRESSIVE INJURY questionnaire online today to ensure a swift response.

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Contact support

Report your injury in the myWCB worker mobile app, or by completing a report of injury [PDF, 0.24MB] form right away, containing the details of your injury/illness, will help us to make correct and timely decisions for you. You can get this form from your employer, here on our website or at any WCB office.

If your worker has been injured, you are required by law to submit the employer report of injury form within 72 hours after becoming aware of an injury or illness.

You should receive your first wage replacement benefit payment from WCB-Alberta within 14 days of WCB-Alberta registering your new claim. You will be paid wage replacement benefits as long as medical evidence shows you are unable to return to work due to your injury. Compensation benefits are not taxable.

The minimum annual premium on a WCB account is $200. It's important to base the coverage on your actual employment earnings (earnings before tax, CPP and EI deductions). This amount will be used to determine the amount you receive if you're hurt at work.

In Alberta, a worker must report an accident to the WCB within 24 months from the time an accident occurs or from the time they become aware of the accident.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232