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Employer s Statement of Return to Work

Employer s Statement of Return to Work 2026

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The document is an 'Employer’s Statement of Return to Work' form, which collects detailed information about a worker's injury, their return to work status, and any impact on their earnings. It includes sections for the worker's personal details, employer information, specifics about the injury, and questions regarding the worker's ability to return to work and any financial implications. The form also provides instructions for submission and outlines the legal basis for collecting personal information.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the worker's information, including their last name, first name, and WorkSafeBC claim number. Ensure all personal details are accurate.
Proceed to fill in the employer's information, including the employer's name and contact details as registered with WorkSafeBC.
In the 'Details of Injury' section, provide specifics about the worker's occupation, date of injury, and any relevant circumstances surrounding the incident.
Answer questions regarding the worker's return to work status and earnings post-injury. Be sure to include dates and any opinions on their ability to return.
Complete any additional information required and ensure you add your electronic signature at the end of the form.

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