Doctor claim forms
Accidents:
- Doctor’s request for re-opening a claim
- WAc33 – Banking Details Confirmation for Payment.pdf
- WCl4 – First Medical Report in Respect of an Accident.pdf
- WCl5 – Final or Progress Medical Report in Respect of an Accident.pdf
- WCl20 – Enquiry Regarding Unpaid Medical or Chemist Account.pdf
- WCl31 – Supplementary Report on Injury to Hand.pdf
- WCl52 – Final Report on Eye Injuries.pdf
- WCl221 – Supplementary Report on Injury to Foot.pdf
- WG29 – Objection Against a Decision of the Commissioner.pdf
Diseases:
- Doctor’s request for re-opening a claim
- WAc33 – Banking Details Confirmation for Payment.pdf
- WAl20 – Enquiry Regarding Unpaid Medical or Chemist Account.pdf
- WCl22 – First Medical Report in Respect of an Occupational Disease.pdf
- WCl26 – Final or Progress Medical Report in Respect of an Occupational Disease.pdf
- WCl53 – Dermatological Report.pdf
- WCl301 – WRULD Final Progress Medical Report.pdf
- WCl302 – WRULD First Medical Report.pdf
- WCl303 – First Medical Report in Respect of Post Traumatic Stress Disorder.pdf
- WCl304 – Final or Progress Medical Report in Respect of Post Traumatic Stress Disorder.pdf
- WG29 – Objection Against a Decision of the Commissioner.pdf
Employee claim forms
Accidents:
- WAc33 – Banking Details Confirmation for Payment.pdf
- WCl3 – Notice of Accident and Claim for Compensation.pdf
- WCl15 – Sprain Strain Questionnaire.pdf
- WCl32 – Declaration by Guardian or Widow or Widower.pdf
- WCl46 – Burial Expense Account.pdf
- WCl132 – Affidavit by Employee.pdf
- WCl215 – Special Report of Hernia Case.pdf
- WCl236 – Sworn Statement by Employee Late Report of Accident.pdf
- WCl258 – Payment of Lumpsum in Lieu of Pension.pdf
- WCl287 – Application for Supplementary Grant.pdf
- WG29 – Objection Against a Decision of the Commissioner.pdf
- WG30 – Application for Additional Compensation.pdf
- WG33 – Request for Payment of Pension via Electronic Transfer.pdf
Diseases:
- WAc33 – Banking Details Confirmation for Payment.pdf
- WCl14 – Notice of an Occupational Disease and Claim for Compensation.pdf
- WCl32 – Declaration by Guardian or Widow or Widower.pdf
- WCl46 – Burial Expense Account.pdf
- WCl132 – Affidavit by Employee.pdf
- WCl236 – Sworn Statement by Employee Late Report of Accident.pdf
- WCl258 – Payment of Lumpsum in Lieu of Pension.pdf
- WCl287 – Application for Supplementary Grant.pdf
- WCl305 – Employee Affidavit for an Occupational Disease.pdf
- WG29 – Objection Against a Decision of the Commissioner.pdf
- WG30 – Application for Additional Compensation.pdf
- WG33 – Request for Payment of Pension via Electronic Transfer.pdf
Employer claim forms
Accidents:
- Letter to CC regarding assault.pdf
- Letter to CC regarding MVA.pdf
- WAc33 – Banking Details Confirmation for Payment.pdf
- WCl2 – Employers Report of an Accident.pdf
- WCl6 – Resumption Report.pdf
- WCl21 – Goggle Questionnaire.pdf
- WCl32 – Declaration by Guardian or Widow or Widower.pdf
- WCl46 – Burial Expense Account.pdf
- WG29 – Objection Against a Decision of the Commissioner.pdf
- WAc33 – Banking Details Confirmation for Payment.pdf
- WCl1 – Employers Report of an Occupational Disease.pdf
- WCl6 – Resumption Report.pdf
- WCl32 – Declaration by Guardian or Widow or Widower.pdf
- WCl46 – Burial Expense Account.pdf
- WCl110 – Exposure History.pdfWCl110 – Exposure History.pdf
- WG29 – Objection Against a Decision of the Commissioner.pdf