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The attached Employers Exposure Incident Reporting Form (form 3959A) is intended for voluntary use when an unplanned workplace incident exposure has resulted from a leak, spill, explosion, release, or an unexpected contact with a chemical or other substance.
The WSIB pays for health care provided, in Quebec, to Ontario residents at the WSIBs treatment rates. Services provided in Quebec to residents of Quebec or other provinces are paid at the Quebec provincial health care rates or at rates paid by Quebecs workers compensation board.
report of injury/disease Form 7.
From your computer, tablet, or smartphone: Log in to your online services account. If you dont have an account, sign up. Enter the claim information. Select the documents that you want to submit. Confirm if they are WSIB forms. Get a confirmation.
Claims for benefits The worker must complete and submit an Election To Claim Benefits Form - Injury/Death or Exposure Outside Ontario, Form 0038, if electing to claim benefits from the Ontario WSIB. Although workers have a choice of claiming benefits in either jurisdiction, they may claim benefits in only one.
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The health professional (e.g., doctor, physiotherapist, or other licensed health care professional) who is treating the worker completes the form at the employers request or at the workers request. The health professional will provide the employer and/or the worker with the completed form.
If your claim is allowed, you may be eligible for WSIB benefits, including benefits for lost pay and help to recover and return to work. Benefit for loss-of-earnings: If you miss time from work because of a work-related injury or illness we may pay for your loss of wages.
Remember to complete an Employers Report of Injury (Form 7) through connect within three days of the injury. The worker will also have to complete a Workers Injury Report (Form 6).

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