Get File A Claim - Workers' Compensation Board

Filing a claim for workers' compensation benefits is a crucial step for individuals who have experienced a work-related injury or illness. This guide provides clear and detailed instructions on how to successfully complete the File A Claim - Workers' Compensation Board form online.

Follow the steps to complete your claim form online.

1. Press the ‘Get Form’ button to access the form and open it in the editor.
2. Begin by entering your personal information in Section A. This includes your name, date of birth, mailing address, social security number, phone number, and whether you require a translator for any hearings.
3. In Section B, provide your employer's information. Enter the employer’s name, address, phone number, and your work address. Include the date you were hired, your supervisor's name, and information about any other employers relevant to your claim.
4. Complete Section C with details about your job during the time of the injury or illness. Enter your job title, describe your typical work activities, specify your employment type (full-time, part-time, etc.), and include information about your gross pay.
5. Proceed to Section D to provide details about your injury or illness. Enter the date and time of the incident, the location where it occurred, and a comprehensive description of what you were doing at the time of the injury, as well as how the injury happened.
6. In Section D, continue to provide detailed descriptions of the nature of your injury, including the body parts affected, any objects involved, and whether a vehicle was part of the incident.
7. Move on to Section E and indicate whether you stopped work due to your injury and if you have returned to work, along with details about your current employer and your pay information.
8. Fill out Section F with information regarding any medical treatment received for your injury or illness. Specify the names of the healthcare providers, dates of treatment, and whether you are still receiving care.
9. Before submitting the form, carefully review all entered information to ensure accuracy. Sign and date the form appropriately, or have a legally authorized representative sign if necessary.
10. Once completed, save any changes made to the form, and ensure to download or print a copy for your records. Then, submit your form as directed to the designated address or online submission method.

Start your claim process today by filling out the File A Claim - Workers' Compensation Board form online.