Making a claim for noise-induced hearing lossWSIB 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Worker Information section. Enter your last name, first name, address, city/town, telephone number, province, email address, postal code, date of birth, and Social Insurance Number. Ensure all details are accurate for smooth processing.
3. In Section 1, indicate when you first noticed your hearing loss and whether it was gradual or sudden. Provide the date you sought medical attention and answer questions regarding ringing in your ears.
4. Proceed to Section 2 to disclose if you have a hearing aid and any assessments by an Ear, Nose and Throat specialist. Include relevant dates and contact information.
5. Continue with Section 3 by detailing your current employment status and any hazardous noise conditions you've worked in. Provide employer details as required.
6. Complete Section C with your entire work history. List employers chronologically along with job titles, exposure hours per day, and equipment used.
7. Finally, review the Declaration and Consent section before signing. Confirm that all information is true before submitting the form.

Start using our platform today to fill out your claim form easily and for free!