Wsib form 41 2026

1. Click ‘Get Form’ to open the WSIB Form 41 in the editor.
2. Begin by filling in your Claim Number and Worker’s Name at the top of the form. Ensure all information is printed clearly in black ink.
3. Provide the Original Date of Accident/Injury and the name of your Accident Employer. If any details are incorrect, use the designated area to note changes.
4. Indicate your current condition status by checking one of the options: Recovered, Getting Better, No Change, or Getting Worse. Describe any changes to your condition in the provided space.
5. List your primary health professional's name who is directing your treatment and specify any referrals not yet reported to WSIB.
6. Answer questions regarding medications or assistive devices you are using for this injury, and provide details if you have worked for any employer since your first day off.
7. Select your current work situation and complete relevant questions based on whether you have lost time or pay from work.
8. Finally, declare that all information is true by signing and dating the form before submission.

Start filling out your WSIB Form 41 online for free today!