3. Fill out a Form 6

The Workplace Safety and Insurance Board (WSIB) has a Guide for people with workplace injuries or illness. It describes in detail how to fill out each section of the Worker's Report of Injury/Disease (Form 6).

The guide is also helpful if you're filling out your Form 6 using the WSIB's online services.

Describe your injury

When filling out a Form 6, make sure to give as many details as possible about your injury, including:

  • exactly what happened and how, for example, you were bending down to put boxes on a shelf
  • who was there when it happened
  • anything unusual about the work area or conditions, for example, the floor was wet and slippery
  • what time or how long into your shift it happened
  • what parts of your body were injured
  • what you felt when you were injured, for example, a sharp pain or a burning feeling

Give details about your earnings

Form 6 asks about your usual pay and whether you were working for more than one employer.

It's very important to tell the WSIB about all of your earnings, including overtime, shift premiums, and from other jobs.

There's space for this extra information at the end of the form.

Sign the form

The online Form 6 has a box that you check off when you're done. And the written form has a place for your signature.

By checking off the box or signing the form, you're:

  • stating that the information you filled out is true, and
  • agreeing that your doctor can give information to your employer and the WSIB about what parts of your job you can or cannot do. The law says you must agree to this if you want to claim benefits.
Hide this website