In the event of an accident, injury or industrial disease at your jobsite, you must:
Immediate notification can best be made by calling 1 800 222-9775, indicating: the location; name of person injured, if applicable; employer name; contact person; and, brief description of the incident. This notification form will give you an idea of the information you will be asked to provide.
In addition to the above, if the employer is insured under the Workers’ Compensation (WC) Act, a Report of Accident or Occupational Disease (Form 67) must be sent to WorkSafeNB within three days of receiving notification of the accident, when an injury results in:
(Under the WC Act, all employers with three or more usually employed workers (full- or part-time) are required to register with WorkSafeNB. Only these insured employers and those who voluntarily apply for coverage are required to file a Form 67. Under the Occupational Health and Safety Act, however, ALL employers, regardless of size, must report to WorkSafeNB any injuries or illnesses that occur at the workplace.)
You and the injured worker must complete a Form 67 and ensure that the report is forwarded to WorkSafeNB. If there is disagreement between you and your employee, you must still complete a Form 67 and forward it to WorkSafeNB immediately within three working days. Please note: you and your employee cannot agree not to report the accident. All accidents resulting in medical costs, wage loss, or the inability of the worker to perform regular duties must be reported to WorkSafeNB.
A Form 67 does not have to be filed for accidents when no medical costs or loss of wages are incurred, or when the injured worker is able to continue regular job duties. However, you must record the accident, identifying the ill or injured worker and describing the incident and injury or illness, the date of occurrence, and the date the record was made, any treatment or care provided, and the name of the person who provided that care. This record must be kept for five years after the date it was made.
Click to print out a PDF of the Form 67.
Electronic Form 67
For more information, please refer to Policy 21-106: Accident Reporting and Application for Benefits.
|What is an accident?
Under the Workers’ Compensation Act, an accident can be one of the following:
(i) a wilful and intentional act, not being the act of the worker who suffers the accident; or
(ii) a chance event or incident occasioned by a physical or natural cause; or
(iii) a disablement caused by an occupational disease; or
(iv) a disablement or disabling condition; all arising out of and in the course of employment.
It does not include the disablement of mental stress or disablement caused by mental stress, unless it is a result of an acute reaction to a traumatic event.
What is an occupational disease?
Any disease that is peculiar to or characteristic of a particular industrial process, trade or occupation, and which is declared to be an occupational disease by regulation.
WorkSafeNB has the right under the Workers’ Compensation Act to gather evidence and investigate workplace accidents if deemed necessary to help adjudicate and manage a claim, or to detect possible cases of fraud. Health and safety officers may also visit the accident site to determine if the accident occurred as a result of a violation of the Occupational Health and Safety Act.