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First report of injury pdf

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WORKERS COMPENSATION FIRST REPORT OF INJURY OR ILLNESS EMPLOYER NAME ADDRESS INCL ZIP CARRIER/ADMINISTRATOR CLAIM NUMBER OSHA LOG NUMBER REPORT PURPOSE CODE JURISDICTION INSURED REPORT NUMBER EMPLOYER S LOCATION ADDRESS IF DIFFERENT INDUSTRY CODE LOCATION EMPLOYER FEIN PHONE CARRIER/CLAIMS ADMINISTRATOR CARRIER NAME ADDRESS PHONE POLICY PERIOD CLAIMS ADMINISTRATOR NAME ADDRESS PHONE NO TO CHECK IF APPROPRIATE SELF INSURANCE CARRIER FEIN POLICY/SELF-INSURED NUMBER ADMINISTRATOR FEIN AGENT NAME ...

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Is WSIB and WCB the same thing?

The Workplace Safety and Insurance Board (WSIB) pays the cost of services billed using the WCB payment program with money paid into our Insurance Fund by Ontario employers. We need to ensure that these employers aren't paying for services that should be covered by the Ministry of Health and Long Term Care (MOHLTC).

What is WCB in Canada?

Canadian Workers' Compensa- tion Boards (WCB) are provincially and territorially regulated throughout the Country and provide insurance for workplace injuries and illnesses. As with the US, certain industries are exempt from this required coverage such as dentistry, banking, insurance and trust companies to name a few.

What WCB means?

When an employee cannot work because of an employment-related injury, a workers' compensation board may award benefits as compensation for lost wages.

How much is WCB in Alberta?

Choosing a coverage amount The minimum annual premium on a WCB account is $200. It's important to base the coverage on your actual employment earnings (earnings before tax, CPP and EI deductions).