3. Fill out a Form 6

The Workplace Safety and Insurance Board (WSIB) has a Reference Guide for Workers. It describes in detail how to fill out each section of the Worker’s Report of Injury/Disease (Form 6).

Describe your accident or illness

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 wages from other jobs. You can put this extra information in the section called “Additional Information” at the end of the form.

Sign the form

The e-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 to let your doctor 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 workers’ compensation benefits.