Making a claim
How and when do I file a claim for benefits with the WSIB?
- When can I make a claim for WSIB Benefits?
- What is a Worker's Report of Injury/Disease (Form 6)?
- How do I file a claim for benefits?
- What are my reporting obligations?
- What happens if I accidentally get stuck with a used needle?
A worker who is injured at work or becomes sick because of his/her job should:
- Get first aid immediately, or health care if needed
- Tell your employer about the accident or illness as soon as possible
When can I make a claim for WSIB benefits?
As a worker, you can claim benefits for a work-related accident or illness if you have:
- received health care, and/or
- lost time or wages from work beyond the day of accident/illness, or
- continued to work but on partial hours only
If you had to do different work due to the accident/ illness for more than seven days and did not see a health professional, you can also make a claim.
Policy 15-01-02 Employers' Initial Accident Reporting Obligations contains more details.
Often called just the Form 6, this is a WSIB form that the worker completes and sends to the WSIB after a work-related injury or illness. It is a way for you to tell us the details of what happened to cause the injury or illness. It also provides us with information we need to make decisions about and process your claim. This form is different from the one you may have filled out at work for your employer.
When you complete and submit the Form 6, it tells us that you are claiming for benefits for a work-related accident.
There is a time limit for you to report. It is important to claim benefits as soon as possible. You have six months from the date of the accident to claim benefits or, for occupational diseases, from the time you learn of the disease.
How do I file a claim for benefits?
To file a claim for benefits you must:
1. Report your injury or illness to the WSIB
You should complete, sign and return Form 6 (337k, pdf) as soon as possible following a work related injury/awareness of illness. It's best to complete this form soon after the accident or awareness of illness, while all the details are still fresh in your memory.
There is a deadline. A claim must be filed within six months of an accident or, in the case of an occupational disease, within six months of a worker learning of the disease. The claim may be filed after six months, if the worker can show "exceptional circumstances" existed at the time of the deadline. For further information, call 1-800-387-0750.
2. Consent to release of your functional abilities information to your employer
Your functional abilities information is non-medical information from the health care professional treating you. It tells you and your employer what kinds of work activities your illness or injury permits. Without this consent, you cannot claim benefits.
What are my reporting obligations?
You must notify the WSIB, within 10 calendar days, of any significant change in the status of your claim and eligibility for workplace disability insurance benefits (known as material change). Failing to report a significant change could result in reduction or suspension of your WSIB benefits.
Significant changes include:
- returning to work
- beginning to receive other income or government benefits
- significant changes in your medical condition.
What happens if I accidentally get stuck with a used needle?
Accidents with used needles can expose you to infectious disease. We treat these accidents like other possible exposures to infectious disease in your workplace. Your employer must report these incidents to the WSIB unless there is a surveillance protocol in place.
A surveillance protocol is a formal procedure a health care practitioner follows to test and monitor a person exposed to an infectious disease to see if the person develops that disease.
If there is a surveillance protocol, your employer must report the incident if you test positive or need any treatment relating to the incident.