Laim filed with the Workplace Safety and Insurance Board as a result of this accident? additional sheets attached No Does or did the applicant contribute to the Canada Pension Plan or a similar plan? Employment Details Yes Is the applicant a member of a union? Part 6 No No Yes year Date of Employment Employer Information day year month day Latest Job Title To: year Last Date Worked: month day Date of Return to Work (if applicable) year Full-Time Part-Time Casual Season.

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How to fill out the FSCO OCF-2 online

Filling out the FSCO OCF-2 form correctly is crucial for processing your accident benefits claim efficiently. This guide provides comprehensive, step-by-step instructions on completing the form online, ensuring you understand each component and requirement.

Follow the steps to accurately complete the FSCO OCF-2 form.

  1. Press the ‘Get Form’ button to access the FSCO OCF-2 form and open it in your preferred online editor.
  2. In Part 1, enter the applicant's information by filling in the last name, first name, address, gender, date of birth, home telephone, work telephone, name and address of the insurance company, and the name of the policyholder.
  3. For Part 2, provide your authorization by printing your name or the name of your substitute decision maker, and signing the section to permit your employer to disclose necessary employment information.
  4. In Part 3, indicate your salary information needed for your claim. Select whether you were employed or self-employed at the time of the accident and detail the relevant period for salary calculations.
  5. Part 4 will require your employer or former employer to fill in the applicant's income details, including gross income for the last 52 weeks, gross weekly income for the last 4 weeks, and whether there were any absences from work.
  6. Move to Part 5 to confirm any other types of compensation from the employer. Indicate if the applicant is eligible for various benefits and whether a claim has been filed with relevant bodies.
  7. In Part 6, your employer should fill out employment details including the date of employment, job title, last date worked, and additional relevant information.
  8. For Part 7, your employer will need to certify the information provided by signing and printing their name and title, along with the date.
  9. Once all sections are completed, you can choose to save your changes, download the filled form, print it, or share it as necessary.

Begin completing your FSCO OCF-2 form online today!

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