Disclosure of Claim File Information to Worker or Employer 2026

1. Begin by clicking ‘Get Form’ to open the Disclosure of Claim File Information in our editor.
2. In Section A, provide your Worker Information. Fill in your WSIB Claim Number, First Name, Last Name, Employee Number, and contact details including Home Telephone Number and Home Address.
3. Next, indicate the Injury/Onset of Illness Date and specify the Area of Injury if applicable. Include your Job at the time of Injury/Illness along with Division and Work Address.
4. Complete Supervisor Name and Work Telephone Number fields. If you have an Alternate Telephone Number, include that as well.
5. Move to Section B for Health Professional input. Select whether this is an Initial or Follow-Up Form and describe the Nature of Injury/Illness.
6. Provide Estimated Recovery Time and indicate if Complete Recovery is Expected. Specify any further treatment required.
7. Check the appropriate Ability to Work options based on your condition. If there are functional limitations, check necessary precautions under Strength Demands.
8. In Section C, complete the Worker Consent by signing and dating the form to authorize information sharing with relevant parties.

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