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British columbia form 6a

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The document is a 'Worker’s Report of Injury or Occupational Disease to Employer' form, which workers must complete and submit directly to their employer when they experience an injury or occupational disease. It outlines the necessary information required from the worker, including personal details, incident specifics, and medical treatment received. The report is mandated by Section 149(4) of the Workers Compensation Act and should not be submitted to WorkSafeBC. Assistance for completing the form is available through WorkSafeBC's Claims Call Centre.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the 'Worker’s Information' section. Fill in your last name, first name, date of birth, and other required fields such as your WorkSafeBC claim number and social insurance number.
Next, provide details about your employer in the 'Employer’s Information' section. Include the organization name, type of business, and contact information.
In the 'Incident Information' section, accurately record the date and time of the incident. Specify if you received first aid and provide details about any medical attention received.
Complete the remaining fields regarding witnesses, protective equipment used, and a detailed description of how the incident occurred.
Finally, sign and date the report at the bottom before submitting it directly to your employer.

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