Workers’ Compensation Board forms
“Employer’s Report of Work-Related Accident or Occupational Disease” must be filed by employer within 10 days after the workplace accident occurs.
“Employee’s Claim for Compensation” must be completed by the injured worker and submitted to the Workers’ Compensation Board within two years following the accident or disability onset date (for occupational disease).
“Attending Doctor’s Report” provides information about work-related injury history, diagnosis, treatment, disability, causal relation of accident to disability, and degree of impairment. The form is to be filed by the treating physician within two days of initial treatment, with additional reports filed during continued medical treatment; ending with a final report.
“Notice that Right to Compensation is Controverted” must be filed by the insurance carrier or self-insured employer within: a) 18 days of the date the disability begins; or b) 10 days of the date the employer first had knowledge of the alleged injury, whichever is later. This form contains information identifying reasons why right to compensation is controverted.
“Notice that Payment of Compensation for Disability has been Stopped or Modified” must be filed by insurance carriers within 16 days following the date on which benefit payments are stopped or modified due to new medical evidence.