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WSIB Form 7 Employer's Report of Injury Disease - Ontario, Canada
What Is WSIB Form 7?
WSIB Form 7, Employer's Report of Injury/Disease, is an official statement prepared by Ontario employers that need to inform the authorities about the occupational illness or injury. Once you learn about the workplace incident, find out what kind of healthcare was offered to the employee, whether they earn less now or require to work in a different capacity for a time. A WSIB Form 7 fillable version was released on January 1, 2011, and can be downloaded through the link below.
Alternate Name:
- WSIB Claim Form 7.
The Ontario Workplace Safety and Insurance Board (WSIB) will provide eligible workers with benefits after their employer completes Form 7 and the employee, in their turn, submits WSIB Form 6, Worker's Report of Injury/Disease, to share their own version of events.
How to Fill Out WSIB Form 7?
Follow these steps to complete WSIB Claim Form 7:
- Provide information about the employee - their job title, length of time they have worked for you, social insurance number, and worker reference number. Check the appropriate box to indicate whether they are an executive, elected official, company owner, or relative. Write down the employee's name, address, telephone number, date of birth, sex, preferred language, and date of hire. If they belong to a union, the form must confirm that fact.
- Describe the organization you represent - state its trade and legal names, contact details, business activity, and account number.
- Outline the details of the injury or illness - when and where it happened, who has learned about it first, which body part was injured. Use free space to elaborate on the incident - for instance, there might be other employees involved or there are witnesses who can confirm the accident actually took place. You can attach your personal statement to the report if you have any concerns about the claim.
- If the worker had any kind of medical treatment after the incident, state whether they went to a hospital or got help in the workplace.
- If the employee could not work for some time and lost earnings due to the injury or illness, indicate the amount of time they were unable to be present at work.
- Check the applicable boxes to describe the specifics of the employee's return to work.
- Provide the worker's wage information - state whether they are working full-time or part-time, how much money they receive per hour, day, or week, and what other earnings they receive from your organization.
- Write down the details of the current work schedule the worker maintains.
- Certify all the statements in your report are true and complete, record your name, title, and telephone number, sign and date the form. Make sure all the pages show the worker's full name and social insurance number. If you want to share additional information with the WSIB, you can do so using the last page of the document.
Download WSIB Form 7 Employer's Report of Injury Disease - Ontario, Canada
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