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WorkSafeBC Form 6: Application for Compensation and Report of Injury or Occupational Disease

This official WorkSafeBC form is for the worker to report an injury or occupational disease and start a claim.

WorkSafeBC Form 55B23: First Aid Record

This official WorkSafeBC form is for documenting an injury that required first aid.

WorkSafeBC Form 52E40: Employer Incident Investigation Report

This official WorkSafeBC form is for documenting the details of incident investigations.

Form K: Employee Orientation Checklist for Return-to-Work Programs

This checklist describes what a supervisor needs to tell employees about the RTW program.

Form J: Modified Work List

This form describes how a modified work list should be developed and includes a sample list for food and beverage operations.

Form I: Return to Work Plan

This form is for documenting an RTW plan to get an injured employee back to regular duties.

Form H: Manager/Supervisor Communication Log

This form is for documenting communications with injured employees regarding return to work planning.

Form G: Time Loss and Medical Aid Checklist (Reportable Incidents)

This checklist describes steps to follow for incidents that require care from a health-care provider or time away from work.

Form F: No Time Loss and No Medical Aid Checklist (Non-Reportable Incidents)

This checklist describes steps to follow for incidents that don’t require care from a health-care provider or time away from work.

Form C: Physician Assessment – Return-to-Work Planning

Physicians can use this form to describe an injured employee’s physical capacity and work restrictions.