COVID-19

Your health and safety is our number one priority. To help prevent the spread of COVID-19, WSCC offices are closed to visitors. Visit our COVID-19 page for important service updates and to download Risk Assessments and Worksite Precaution Planning for COVID-19 for Employers.

Claims Forms for Workers

Please read each form carefully to ensure you accurately complete it.

Please contact us at 1-800-661-0792 if you need assistance.

Worker's Report of Injury

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Election to Claim Compensation

English | Français | ᐃᓄᒃᑎᑐᑦ

Electronic Fund Transfer

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Harvester's Report of Incident

English | Français | ᐃᓄᒃᑎᑐᑦ

Indemnity Guarantee

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Request for Disclosure

English | Français | ᐃᓄᒃᑎᑐᑦ

Statutory Declaration and Claim for Surviving Spouse

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Statutory Declaration for Dependents other than a Surviving Spouse

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Travel Expense Form

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Vocational Rehabilitation Job Search Contact Sheet

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Worker's Continuity Report

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Worker's Repetitive Strain Injury (Upper Limbs) Questionnaire

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Worker's Report of Noise-Induced Hearing Loss

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Worker's Report of Occupational Disease

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Worker's Report of Vibration Syndrome

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun

Forms

Request for Review

English | Français | ᐃᓄᒃᑎᑐᑦ | Inuinnaqtun