How do I file my claim with the Board?

Worker’s Report of Injury/Disease (Form 6)

To file a claim, you must fill out a Worker’s Report of Injury/Disease form (Form 6) and send it to the Board. Contact the Board right away to get the Form 6 sent to you, or download one from Fill out the form and return it to the Board. You must also give your employer a copy.

Part of the Form 6 has a section that asks for your signature. When you sign this section, you are agreeing to allow your doctor to give information to your employer and the Board about what parts of your job you can or cannot do. The law says you must agree to this if you want to claim workers’ compensation benefits.

You can let the Board know about your injury before you get your Form 6. This might make the process faster. Write to the Board and give them your employer’s company name and your name, address, social insurance number, and date of birth. Write down the details about the job you were doing at the time you were hurt. Say how you were hurt. Give the names of anyone who saw you get hurt. List all the parts of your body that were hurt. Ask the Board to send you a Form 6.

What should I say in the Form 6?

Give as many details as possible. For example, if you fell, say how you fell and explain how you were hurt:

“I was walking in the factory in the assembly department. I slipped on some oil that was on the floor. My right leg went forward and I lost my balance. I fell backward. I hit my shoulder on the machine, then I landed on the floor. I hurt my right shoulder on the machine. When I landed on the floor, I also hurt my neck, my back, and my right hip.”

The Form 6 asks about your usual pay and whether you were working for more than one employer. It is very important to tell the Board about all your earnings, such as overtime, shift premiums, and wages from other jobs. You can put this extra information in section K on the last page of the Form 6.

How can I get help with the Form 6?

The Board has a “Reference Guide for Workers” on their website that can help you to fill out the Form 6. Go to and click on “Workers“, then click on “Forms“. Or you can call the Board for help at the following toll?free numbers:

English or French: 1-800-387-0750

TTY: 1-800-387-0050

Filling out a Form 6 can be difficult. See “Where can I get help and information?” for more information about where to get more help.

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